Why Is a Colostomy Needed?
A colostomy is a surgical procedure in which a part of the large intestine (colon) is brought out through an opening in the abdomen (belly) to create a new pathway, called a stoma, for stool (bowel movement) to leave the body. Instead of passing out through the anus, waste exits through the stoma into a special colostomy bag attached to the skin. A colostomy may be temporary (used to help the intestine heal after surgery) or permanent (when normal bowel function cannot be restored).
Doctors recommend a colostomy when the lower bowel cannot safely carry stool out of the body due to disease, injury, or obstruction. This procedure allows the bowels to work again and prevents serious complications such as infection or blockage. While the idea of a colostomy can be overwhelming for many, it often improves quality of life by relieving pain, infection, or bowel dysfunction. Learning what to expect from the surgery and life afterward can help reduce anxiety and support a confident recovery.
Who May Need a Colostomy?
A colostomy may be recommended for people who:
● Have colorectal cancer affecting the bowel
● Suffer severe diverticulitis with complications
● Have traumatic injury to the colon or rectum
● Develop bowel obstruction not corrected by other treatments
● Have inflammatory bowel diseases like Crohn’s disease or ulcerative colitis
● Experienced bowel perforation or infection
● Are recovering from complicated colon surgery
● Have birth defects of the bowel (in children)
The surgeon evaluates symptoms, imaging tests, and overall health before deciding if a colostomy is the safest option.
Types of Colostomy
There are different types of colostomies based on where the stoma is made:
1. Ascending Colostomy
Located on the right side of the abdomen. Stool here is usually more liquid.
2. Transverse Colostomy
Made across the upper abdomen. Stool is somewhat formed nd may require more frequent bag changes.
3. Descending Colostomy
Made on the left side of the abdomen. Stool is usually firmer and more formed.
4. Sigmoid Colostomy
Located low on the left side near the sigmoid colon. Stool here is usually firmer and formed.
The type depends on the disease location and the condition of the bowel.
Colostomy Procedure
A colostomy is performed in a hospital operating theatre under general an aesthesia, so you are asleep and pain-free during the procedure.
1. Preparation
○ The surgeon discusses the plan with you, including stoma location and expectations.
○ Bowel preparation may be needed to clear stool before surgery.
○ Fasting (no food or water) is required as advised.
2. Anesthesia
○ General anesthesia is given so you remain completely asleep and comfortable.
3. Incision and Access
○ A surgical cut (incision) is made in the abdomen to access the colon.
4. Creating the Colostomy
○ A section of the colon is brought to the surface of the abdomen through a small opening.
○ The edge of the intestine is folded slightly and stitched to the skin, forming the stoma.
5. Closure
○ The abdomen is closed with sutures or staples.
○ A colostomy pouching system is fitted over the stoma to collect stool.
The surgery usually takes 1–3 hours depending on complexity and whether other procedures are done at the same time.
Recovery & Aftercare
After a colostomy, proper care helps healing and return to normal activities:
● Hospital Stay: Most people stay in the hospital for 3–7 days to monitor recovery and learn stoma care.
● Pain Control: Pain medicines help manage discomfort around the surgical site.
● Stoma Care Education: A stoma nurse teaches how to clean the stoma, change the colostomy bag, and watch for skin irritation.
● Diet & Hydration: A gradual return to eating is advised. Drinking enough fluids and a balanced diet support healing.
● Activity: Light activity, such as short walks, is encouraged. Strenuous lifting and heavy exercise are usually limited for 4–6 weeks.
● Follow-Up: Regular follow-up visits help check healing, stoma health, and overall progress.
Living with a colostomy becomes easier with time and practice. Most people adapt well and return to normal social and work activities with proper planning and support.
Risks & Possible Complications
A colostomy is generally safe but can have risks and complications, such as:
● Infection at the surgical site
● Bleeding or bruising
● Skin irritation around the stoma
● Stoma blockage or narrowing (stricture)
● Stoma prolapse (stoma protrudes more than expected)
● Hernia near the stoma
● Psychological or emotional adjustment difficulties
Your surgeon and stoma care nurse discuss these risks and help you prevent or manage complications.