A colostomy is an opening made in the abdominal wall during surgery. The end of the colon is brought through this opening to form a stoma where the stoma will be on the abdomen depends on which part of the colon is used to make it.
Various colostomies are large, various small various are on the left side of the abdomen, various are on the right and others may be in the middle.
The way the stoma looks depends on the type of colostomy the surgeon makes and on individual body differences. Colostomy may look quite large at first but will shrink to its final size about 6 to 8 weeks after surgery.
Unlike the anus, the stoma has no valve or shut-off muscle. This means that the patient won’t be able to control the passage of stool from the stoma, but sometimes bowel movements can be managed in other ways. There are no nerve endings in the stoma, so the stoma itself is not a source of pain.
A colostomy is not a disease, but a change in the way patient’s body works. It surgically changes normal body function to allow stool to pass after a disease or injury.
What does a colostomy do?
If a colostomy has been created, the intestines will work just like they did before except:
- The colon and rectum beyond the colostomy are disconnected or removed.
- The anus is no longer the exit for stool, but it will still pass mucus from time to time. This is normal.
As nutrients are absorbed in the small intestine, a colostomy does not change how the body uses food. The main functions of the colon is to absorb water, move the stool toward the anus, and then store stool in the rectum until it’s passed out of the body. When a colostomy changes the stool’s path, the storage area is no longer available.
The higher up in the colon the colostomy is made, the shorter the colon is. The less time the colon has to absorb water, the softer or more liquid the stool is likely to be. A colostomy further down in the colon will put out stool that has been present in the intestine for a longer time.
Depending on the effects of illness, medicines, or other forms of treatment, the longer colon can put out a more solid or formed stool. Some people having colostomies find that they are able to pass this stool at certain times of the day with or without the help of irrigation.
After surgery, some people still may feel urges and even have some discharge from the anus. This discharge is mucus, blood, and at times stool, left from the operation. If the rectum remains after surgery, it will keep putting out mucus that can be passed harmlessly whenever the patient has the urge.
Types of Colostomies
A colostomy can be short-term (temporary) or life-long (permanent) and can be made in any part of the colon. The different types of colostomies are based on where they are located on the colon.
Certain lower bowel problems are treated by giving part of the bowel a rest. It’s kept empty by keeping stool away from getting to that part of the bowel. To do this, a short-term colostomy is created so that the bowel can heal. The healing process may take a few weeks, months, or even years. In time, the colostomy will be reversed, and the bowel will work like it did before – the stool will exit from the anus again.
When any part of the colon or the rectum becomes diseased, a long-term (permanent) colostomy must be made. The diseased part of the bowel is removed or permanently rested. In this case, the colostomy is not expected to be closed in the future.
The transverse colostomy is mostly present in the upper abdomen, either in the middle or toward the right side of the body. This type of colostomy allows the stool to leave the body before it reaches the descending colon.
If there are problems present in the lower bowel, the affected part of the bowel might need time to rest and heal. A transverse colostomy may be used to keep stool out of the area of the colon that’s inflamed, diseased, or newly operated on – this allows healing to take place. A transverse colostomy is usually temporary.
The ascending colostomy is placed on the right side of the belly. Only a short portion of colon remains active. It means that the output is liquid and contains many other digestive enzymes. A drainable pouch must be worn by the patient at all times, and the skin must be protected from the output. Ascending colostomy is rare because an ileostomy is often a better choice if the discharge is liquid.
Closing or reversing a colostomy
If the patient is going to have his colostomy closed, the surgeon might mention plans to “take it down” or “reverse it” in a few weeks or months, but sometimes the doctor doesn’t say anything about it.
It’s best to talk to the surgeon about these things before leaving the hospital so the patient knows what the plans are and when to see the surgeon again. If the patient is at home now and didn’t get instructions, call the doctor’s office and find out what the doctor wants him to do.
Various things must be taken into account when thinking about closing a colostomy, such as:
- The reason you needed the colostomy
- Whether you can handle more surgery
- Your health since the operation
- Other problems that may have come up during or after surgery
Which are the different tests which have to be performed before colostomy?
Some of the tests which have to be performed before colostomy are: