Colostomy: A Guide

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What is a colostomy?

A colostomy is an opening in the belly (abdominal wall) that is made during surgery. The end of the colon (large intestine) is brought through this opening to form a stoma. Where the stoma will be on the abdomen depends on which part of the colon is used to make it. Some colostomies are large, some small; some are on the left side of the abdomen, Some are on the right side, others may be in the middle. An enterostomal therapy (ET) nurse or the surgeon will figure out the best location for your stoma. (An ET nurse is a specially trained registered nurse who takes care of and teaches ostomy patients. This nurse may also be called a Wound, Ostomy and Continence nurse (WOC) or an ostomy nurse.)

When you look at a stoma, you are actually looking at the lining (the mucosa) of the intestine, which looks a lot like the lining of your cheek. The stoma will look pink to red. It is warm and moist and secretes small amounts of mucus.

The way the stoma looks depends on the type of colostomy the surgeon makes and on individual body differences. It may look quite large at first, but it will shrink to its final size about 6 to 8 weeks after surgery. The shape will be round to oval. Some stomas may stick out a little, while others are flush with the skin.

Unlike the anus, the stoma has no valve or shut-off muscle. This means you will not be able to control of the passage of stool from the stoma, but sometimes bowel movements can be managed in other ways. There are no nerve endings in the stoma, so the stoma itself is not a source of pain or discomfort.

A colostomy is not a disease, but a change in the way your body works. It surgically changes normal body function to allow stool to pass after a disease or injury. Although a colostomy is a big change for the patient, the operation itself is rather simple. Digestion and body chemistry are not changed by a colostomy.

What does a colostomy do?

After a colostomy has been created, the intestines will work just like they did before except:

  • The colon and rectum beyond the colostomy is disconnected or removed.
  • The anus is no longer the exit for stool.

Since nutrients are absorbed in the small intestine, a colostomy does not change how the body uses food. The main functions of the colon are to absorb water, move the stool toward the anus, and then store stool in the rectum until it is passed out of the body. When a colostomy changes the stool's route, the storage area is no longer available.

The higher up in the colon the colostomy is made, the shorter the colon is. The less time the colon has to absorb water, the softer or more liquid the stool is likely to be. A colostomy further down in the colon, near the rectum, will put out stool that has been in the intestine a longer time. Depending on the effects of illness, medicines, or other forms of treatment, the longer colon can put out a more solid or formed stool. Some people with colostomies find that they are able to pass this stool at certain times of the day with or without the help of irrigation. (Irrigation is discussed later.)

After surgery, some people still may feel urges and even have some discharge from the anus. This discharge is mucus, blood, and at times stool, left from the operation. If the rectum remains after surgery, it will keep putting out mucus that can be harmlessly passed whenever you have the urge.

Why have a colostomy?

Colostomy surgery is done for many different diseases and conditions.

Certain lower bowel problems are treated by giving part of the bowel a rest. It is kept empty by keeping stool from getting to that part of the bowel. To do this, a short-term (temporary) colostomy is created so that the bowel can heal. This may take a few weeks, months, or even years. In time, the colostomy will be reversed (removed) and the bowel will work like it did before.

When part of the colon or the rectum becomes diseased, a long-term (permanent) colostomy must be made. The diseased part of the bowel is removed or permanently rested. In this case, the colostomy is not expected to be closed in the future.


Last Medical Review: 03/17/2011
Last Revised: 03/17/2011