Colostomy

A colostomy is a surgical procedure that brings a portion of the colon to the abdominal surface to form a stoma. Fecal waste exits through the stoma into an external ostomy pouch. Colostomies involve the large intestine and usually produce formed stool, unlike ileostomies.

Indications include colorectal cancer, diverticular disease, inflammatory bowel disease, bowel injury, and obstruction. A colostomy may be temporary or permanent; some patients later have the bowel continuity restored (stoma takedown).

Types: End colostomy creates a single stoma from the proximal colon with the distal bowel closed or diverted. Loop colostomy is usually temporary and creates a single stoma with two openings. Double-barrel colostomy forms two stomas from a divided loop of bowel.

Stoma and appliances: The stoma is pink and moist and lacks sensation. Stool consistency depends on the colon segment used. An external bag attaches to the skin with a barrier. Skin care aims to prevent irritation.

Care and complications: Regular cleaning and bag changes, monitoring skin, and ensuring a good seal. Complications include stoma blockage, retraction, prolapse, parastomal hernia, skin irritation, and infection. Dehydration risk is higher with ileostomies than colostomies.

Living with a colostomy: Many people adjust with healthcare support, ostomy nurses, and education. Reversal surgery may be possible for some patients depending on healing and disease.