Colostomy Basics

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Updated June 08, 2015.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Whether it is permanent or temporary, a colostomy is going to change the way you do things. An ostomy is an artificial opening that is surgically made in your body. People have ostomies surgically created in a couple different area,s including:
  • Colostomy –- located in any part of the colon
  • Jejunostomy or ileostomy -- located in the small intestine
  • Urostomy -- located by the bladder in the ureters


  • Esophageal -- located on the neck

The surgical opening is called a stoma. If you have (or will need) a colostomy, the stoma will be located somewhere on your lower abdomen. Other colostomy terms you may frequently hear include:
  • Ostomy bag or pouch – the external bag that collects waste (stool)
  • Skin barrier – a cream, powder or ointment that protects your skin from the caustic effects of irritation from the pouch and stool
  • Wafer – a disc-like insert that adheres around your ostomy (for connecting the bag)
  • Ostomy belt – sometimes used to secure the ostomy bag
  • Irrigation – like an enema, this is how the colostomy and bag are cleaned
  • ET Nurse – an enterostomal therapy nurse who specializes in ostomies and skin care
  • Adhesive remover – used to safely remove the adhesives left on your skin from your colostomy bag

Temporary or Permanent?


The colostomy has two main purposes: to create an exit for waste removal or allow the remaining colon to rest and heal after surgery. A temporary colostomy may be created following bowel surgery, when the remaining section of the colon or rectum needs time to heal prior to being used again.

A permanent colostomy usually follows a colectomy or proctectomy -– when most of the colon or the entire rectum and anus are permanently removed. Only temporary colostomies can be reversed, usually a few months after the original surgery.

Types of Colostomies


The location of your stoma (on your abdomen) will correlate with the portion of your colon affected. Typically, there are four types of colostomies:
  • Sigmoid or descending colon – on the left side of your abdomen
  • Transverse – higher on your abdomen, anywhere from the middle to the right or left side
  • Loop – two stomas; one for mucous drainage and one for stool
  • Ascending – stoma on the right side of your abdomen

Caring for Your Colostomy


Before you leave the hospital, you will be introduced to your enterostomal therapy (ET) nurse. He or she will help you adapt -- physically and mentally -- to your new stoma. The ET nurse will teach you:
  • About your post-surgery diet and transitioning back to a regular diet
  • How to clean and protect the ostomy and surrounding skin
  • What symptoms to watch for and report to your doctor
  • How to choose and apply the colostomy bag
  • How to remove, empty and irrigate the bag
  • How and when to irrigate the stoma
  • How to mitigate concerns about relationships, self-esteem and body image
  • How to start "timing" and retraining your bowels

When you look at your stoma, it should be shiny, moist and pink -- a sign that it is healthy and has a good blood supply. Also, you can develop complications with the skin surrounding the stoma, such as a rash or skin breakdown (characterized by bleeding, tearing or weeping skin). If you notice any unusual changes to your stoma or the surrounding skin, contact your ET nurse and your surgeon.

The Ostomy Diet


If you've heard horror stories about dietary restrictions with an ostomy, rest assured that most of these tales do not refer to people with colostomies. For the first few days following surgery, you may start on a clear liquid diet. This means you can eat or drink anything that you can see through, including broth, gelatin, water and clear sodas.

Unless you have other medical conditions precluding a normal diet, you shouldn't have to change the way you eat with a colostomy. However, foods that "bothered" you before surgery will probably still "bother" you, unfortunately.

Because the majority of nutrient absorption occurs in the small intestine, the stool passed through your stoma may be very similar to what you're used to, including the odor. If the smell bothers you, you can change the bag more frequently, try more expensive bags (with charcoal filters) or make a few dietary changes (animal proteins, such as meat or eggs, tend to cause more odiferous stools).

If passing gas becomes an embarrassing problem, consider the source. Flatulence will now pass without your permission (you cannot "hold in" gas from a stoma). Certain foods, such as the cruciferous vegetables, cause excessive gas, as does drinking carbonated beverages and using straws.

Boosting Your Self-Esteem


Don't dismiss your emotional concerns about having a colostomy. The stoma and bag will change your appearance, but bystanders do not need to know you have a colostomy unless you want to share that information. The bags are streamlined and hardly visible underneath clothing. Talk to your doctor if you have concerns about your appearance or sexuality. These feelings are normal, but many people with ostomies find relief in talking to other men or women with colostomies.

Sources:

American Cancer Society. (2006). American Cancer Society's Complete Guide to Colorectal Cancer. Clifton Fields, NE: American Cancer Society.

Lange, V. (2009). Be a Survivor. Colorectal Cancer Treatment Guide. Los Angeles: Lange Productions.

National Digestive Diseases Information Clearinghouse. (n.d.). Bowel Diversion Surgeries: Ileostomy, Colostomy, Ileoanal Reservoir, and Contin. Accessed April 14, 2012.

United Ostomy Associations of America. (n.d.). What is an Ostomy? Accessed April 14, 2012.
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