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Patient Instructions

Colostomy is a surgical procedure that brings the end of the large intestine through the abdominal wall. Stools moving through the intestine drain into a bag attached to the abdomen.

The procedure is usually done after bowel resections or injuries and it may be temporary or permanent.

Colostomy is done while you are under general anesthesia (unconscious and pain-free). It may be done with invasive, open surgery or several small surgical cuts (laparoscopically).

The type of approach used depends on what othe operation needs to be performed. In general, the incision (cut) is made in the abdomen. The bowel resection or repair is performed as needed. See also: Large bowel resection and Intestinal obstruction repair.

For the colostomy, the end of the healthy colon is brought through the abdominal wall. The edges are stitched to the skin of the abdominal wall. A bag called a stoma appliance is secured around the opening to allow stool to drain.

Your colostomy may be short-term. If you have surgery on part of your large intestine, a colostomy will allow the remainder of your intestine to rest for a while while you recover. Once your body has fully recovered from the initial surgery, you will have another surgery to reattach the ends of the large intestine.

There are a number of reasons to perform a colostomy:

• Infection of the abdomen, such as perforated diverticulitis or an abscess
• Injury to the colon or rectum (for example, a gunshot wound)
• Partial or complete blockage of the large bowel (intestinal obstruction)
• Rectal or colon cancer
• Wounds or fistulas in the perineum -- the area between the anus and vulva (women) or the anus and scrotum (men)

Whether a colostomy is temporary or permanent depends on the specific disease or injury. In most instances, colostomies can be reversed.

Risks for any anesthesia are:

• Problems breathing
• Reactions to medications

Risks for any surgery are:

• Bleeding

Additional risks are:

• Bleeding inside your belly
• Damage to nearby organs
• Development of a hernia at the incision site
• Infection, particularly in the lungs, urinary tract, or belly
• Narrowing or obstruction of the colostomy opening (stoma)
• Scar tissue forming in your belly and causing intestinal blockage
• Skin irritation
• Wound breaking open

You will be in the hospital from 3 to 7 days. You may have to stay longer if your colostomy was an emergency operation.

You may be able to suck on ice chips on the same day as your surgery to ease your thirst. By the next day, you will probably be allowed to drink clear liquids. Your health care providers will slowly add thicker fluids and then soft foods as your bowels begin to work again. You may be eating normally within 2 days after your surgery.

The colostomy drains stool (feces) from the colon into the colostomy bag. Most colostomy stool is softer and more liquid than stool that is passed normally. How liquid the stool is depends on the location of the segment of intestine used to form the colostomy.

You'll need to learn how to care for the colostomy and ostomy appliance.

Intestinal opening

Fry RD, Mahmoud N, Maron DJ, et al. Colon and Rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008: chap 50.

Cima RR, Pemberton JH. Ileostomy, Colostomy, and Pouches. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006: chap 110.

Updated by: Robert A. Cowles, MD, Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.