What is a colostomy?

A colostomy is a surgical procedure in which the doctor brings the large intestine out through an opening in your abdomen. Your bowel movements then pass through this opening instead of your rectum and are collected in a bag outside the body. It may be either temporary or permanent, depending on the type of problem you have.

When is it used?

A colostomy may be part of the surgical treatment for the following common conditions affecting the large intestine:

• Inflammatory disease
• Cancer
• A blockage in the intestine
• An internal injury.

Other less common causes are:

• A pocket of pus (abscess) in the intestine
• An incomplete connection between the large intestine and other organs
• A torn intestine
• A birth defect.

How do I prepare for a colostomy?

You will need to be emotionally prepared to accept the surgery and willing to learn how to care for yourself afterward. The doctor will explain the surgery and how it will affect bowel movements and your physical appearance. Most hospitals also have specially trained staff members to teach you what you need to know for self-care. You may want to have family members learn about your care so they can help you initially with support and encouragement.

Your doctor will give you instructions on how to make your intestines clean for surgery. This "bowel prep" usually consists of taking medicines the day before surgery that will make your bowels loose. You may be told not to eat anything and to drink only clear liquids the day before surgery. You may be given antibiotics to prevent infection.

What happens during the procedure?

You are given a sedative and a general anesthesia. During the procedure, the doctor will make an opening through your abdomen into your intestine. The doctor cuts (resects) your intestine and attaches the loose end to the new opening in your abdomen. A bag is attached to collect bowel movements.

What happens after the procedure?

After surgery you will be given intravenous fluids and electrolytes. You may feel some discomfort from the incision and the drainage tubes. This will go away in 3 or 4 days.

The doctor will first put you on a clear liquid diet. You will progress gradually to regular food.

Self-care is important in regaining your independence and self-esteem. Try to adjust positively to the change in your appearance. You can continue your normal lifestyle (including sexual activity) with some adjustments for changes in your physical appearance and bowel movement function. You can:

• Prevent odor by keeping the seal leak proof, cleaning the appliance well, and using a pouch deodorant.
• Use a room deodorizer if necessary.
• Empty the bag every night to prevent leaking.

What are the benefits of this procedure?

This procedure permits normal nutrition and allows the doctor to remove and/or revise structures to produce the healthiest outcome. It can reduce pain and symptoms as well as diminish long-term problems.

What are the risks associated with this procedure?

As with any surgery there is a risk that the general anesthetic will put stress on your heart. Also, there is always a risk of an infection at the site of the surgery.

Other risks include:

• The colostomy may become narrowed or blocked.
• The colostomy can extend too far out from the abdomen.
• Internal bleeding could occur.

When should I call the doctor?

Call the doctor immediately if:

• You develop a fever.
• You have any change or worsening of pain or symptoms.
• You have unusual drainage from the surgery area (including bloody drainage).
• You have a change in odor or type of feces.

Call the doctor during office hours if:

• You have questions about the procedure or its results.
• You want to make another appointment.