What is a Colostomy?
A colostomy procedure is usually performed the patient has been diagnosed with severe infection or disease in their large intestine, such as colorectal cancer or perforated diverticulitis detected during colonoscopy. The colostomy procedure involves actually opening up the large intestine via intensive surgery and relocating it outside of the body, where a bag is attached for stool to drain into.
The procedure is necessary in some patients who suffer from extreme diverticulitis (infected colon pouches), perforation (tearing of the colorectal wall), colorectal blockage, severe wound or injury to the colorectal area and some particularly bad cases of colon cancer in which part, or all, of the colon has had to be re-sectioned or removed. Depending on how much the infected or diseased area is able to heal over time, the installation of the colostomy bag can be permanent or short-term. Colostomies are reversible in many cases, but you should discuss this option prior to proceding with the procedure.
How is a Colonoscopy Performed?
A patient undergoing colostomy surgery is always put under general anesthesia, which means that he or she will be asleep and feel no pain throughout the entire procedure. This type of medical sedation is very different from the “conscious” sedation given to patients undergoing colonoscopy.
A surgical incision (cut) will need to be made in the patient’s abdominal area; the cut’s size depends on how much of the colon needs to be re-sectioned and where those areas are located. After the appropriate areas of the colon are repaired or removed, the part remaining is brought outside the abdomen and attached with stitching to the patient’s skin. A detachable, disposable bag made of artificial material is then attached to the opening, or stoma, now present in the abdominal wall. The purpose of the colostomy bag is to allow for sanitary stool collection and disposal while the patient’s colon recovers. Colostomies can be reversed after some time in many cases; however, this possibility should be discussed with your surgeon – as not all cases are able to be reversed for various reasons, and alternative surgical approaches may be considered.
The patient will need to stay in the hospital for nearly a week after the surgery—longer if the procedure was ordered under emergency circumstances and needs more close monitoring. A day after the procedure you may be allowed to drink clear liquids and soft foods, but for the first day it’s routinely prohibited. Normal eating usually cannot resume for at least couple of days.
What are the Advantages and Disadvantages of a Colostomy?
Colostomies are very invasive, intensive surgical procedures that are only resorted to in very dire scenarios. Most patients experience a lot of stress when they find out that a colostomy might be necessary, as the exterior colostomy bag and overall implications of the surgery can be embarrassing and may seem painful. Nevertheless, it is sometimes a necessary step in the recovery process, as it lets the diseased colon heal and prevent extreme complications, including death.
Risks associated with the colostomy procedure include trouble breathing while under sedation and bad reactions to any medications given to the patient before surgery. As with any surgery, bleeding may occur during a colostomy. Other complications that may come up after the procedure is over include internal bleeding, organ damage, scarring, a collapse of the stoma (prolapse), infection, stoma blockage, intestinal blockage, open breaks in the skin and general irritation.
Reviewed 12/29/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014