What is a Colostomy?

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The origin of the word Colostomy is Greek. It is derived from two words, “Colon” and “Stoma”. The Colon is the large intestine and the Stoma is the name given to the artificial outlet that is formed to replace the anus. By giving you a Colostomy the Surgeon is diverting any waste matter you produce away from the problem area of the bowel. The healthy end of the Colon is brought out to the surface of the abdomen and stitched in place, usually on the left hand side of the abdomen just below the belt line. This way the whole digestive system works as normal whilst bypassing any inflamed or damaged problem areas in the bowel.

Before the operation you’ll have had complete control over the passing of any waste matter. You’ll have felt full when you needed to go and will have been able to hold it until you got to a toilet.

Colostomy bowel graphic


With a Colostomy things are different. You have no muscle control over a Stoma whatsoever and this is why it is necessary to wear an “appliance” over the stoma to collect all waste. There are literally hundreds of different bags and systems on the market these days all tailored to suit different people’s needs and life styles. Your Stoma nurse will make the initial choice for you and then after that you are free to experiment.

Just because you are having a Colostomy it doesn’t necessarily mean you will be wearing a bag for life. These days it is getting more and more common for Surgeons to perform temporary Colostomys.

So what is the difference between “temporary” and “permanent”? The difference is the removal of the bowel itself. If it is removed it is permanent, there is no way to reverse the operation (although in the future who knows, we are already seeing surgeons experimenting with pig transplants into Humans so maybe one day people can have bowel transplants from pigs!)
With a temporary Colostomy the bowel isn’t removed, the stump end is simply sown up to prevent any leakage into the body’s system and left inside. As said previously this is becoming more and more common and these days a Surgeon is reluctant to remove a person’s bowel if they are under the age of 45, unless it is cancer.

If the bowel is still in the body you will notice that at times it is still working. It may have been disconnected from the rest of the digestive system but this does not stop it from producing a mucus which will need to be passed into the toilet about once a fortnight.

There are some disagreements about how long a bowel can be left unused before reversal is no longer a possibility. The longer it is left the harder it is to reverse successfully. Over time the bowel begins to go on strike and the longer it is left the harder it is to kick start back into action. If this was the case you’d be left incontinent and the Stoma would have to be returned.

However, my own Stoma Nurse has told me a story of how a three day old baby had a Colostomy and eighteen years later the operation was reversed and she hasn’t looked back since. With that knowledge one can’t help but feel that one day we can all have our stomas reversed.

I suppose that another reason for the hospitals being keen on temporary Colostomys rather than permanent ones is because with a temporary Colostomy there is a quicker turn around in the patient, especially if this is performed by the key-hole technique (the Hartmann’s Procedure).

I was lucky as my operation was performed in a teaching hospital with all the latest equipment and methods. This meant I was one of the first to have my temporary Colostomy performed by key-hole surgery.

Key-hole surgery is undoubtedly the future of this operation. To have a Colostomy – temporary or otherwise – performed by open surgery means you are looking at a two weeks stay in hospital and six month recovery period. All because of the large incision they need to make.

Key-hole surgery takes less time, and because the Surgeon need only make two tiny incisions (one for the instruments and one for the air hose) you need only spend on average four days in hospital, if that. You’d be out next day if it wasn’t for the fact that you need guidance with the appliances for the first few days.

Because of the lack of cuts you heal much quicker and can be back to normal in a matter of weeks, although your Stoma Nurse or Surgeon would probably recommend a space of three months before exerting yourself. During this time care needs to be taken so the stoma can heal quickly to it’s full strength.

The stoma itself is fairly unobtrusive. It is oval in shape and looks similar to the inside if your bottom lip, a nice pinkish colour. As I mentioned earlier there is no muscular control over the stoma, and there is also no nerve supply so you can gently touch it if you want and you will not hurt yourself.

Immediately after the operation the Stoma will be extremely swollen and bloody. This is perfectly normal. The swelling is the bowel’s natural defence mechanism coming into effect. You have to remember that the bowel has been man-handled and moved from it’s comfy resting position! Over the course of the first few weeks the Stoma will shrink and the stitches that are visible will dissolve away to leave a clean, healthy (and much smaller) stoma.

Also see:
Loop Colostomy
End Colostomy
Double Barrel Colostomy
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