A Colostomy is created when the healthy end of the colon (large intestine) is sutured into an abdominal opening. This opening is called a stoma. Intestinal waste leaves the body through the stoma. People with a colostomy wear a pouch or a stoma cap over the stoma. Human waste is collected in the pouch or removed through an intestinal enema (irrigation), in which case it is often sufficient to wear a stoma cap.
Colostomy can be performed as a temporary solution to allow the lower portion of the colon to heal after surgery. A temporary colostomy is reversed by re-attaching the colon and closing the stoma.
A permanent Colostomy, most often an end Colostomy, is created when a portion of the colon or the rectum is removed. The remaining colon is brought to the abdominal wall and permanently connected to the stoma.
Placement of the Stoma
The stoma can be positioned at various locations on the abdominal wall, depending on which part of the colon required surgery.
Note: The above picture is showing Sigmoid colostomy with partially removed descending colon and anus.
- In the case of Sigmoid colostomy (Descending colon), the stoma is usually situated on the lower left side of the abdomen.
- If a Transverse colostomy is performed (Transverse colon), the stoma is located in the upper abdomen - middle or right side.
- In the case of Ascending colostomy (Ascending colon) the stoma is placed on the right side.
A loop colostomy is usually performed in emergencies and is temporary in nature. A portion (loop) of the bowel is brought to the abdominal surface and sutured in place. Two openings - one for stool and the second for mucus are created in the bowel. The discharge from both leaves the body through a single stoma.
Colostomy Pouching System
The output of the stoma is collected inside a pouch attached to the abdomen over the stoma. When the pouch is approximately one third full, it can be emptied, washed and re-used or it can be disposed of and replaced with a new one. There is a variety of pouching systems on the market and patients should find the one that suits them best.
Colostomy and Irrigation
Irrigation is a bowel flushing procedure (intestinal enema), where water is instilled into the colon via catheter inserted through the stoma. As with a regular enema the water allows the feces to flush out. Irrigation is usually performed once a day or less, but it varies from person to person. People who irrigate usually do not wear a pouch, but rather a much smaller stoma cap, since the output between irrigations is minimal. One should consult his/her doctor or ET nurse (stoma nurse) before performing irrigation.