A colostomy is a surgically created opening in the abdomen in which a piece of the colon (large intestine) is brought outside the abdominal wall to create a stoma through which digested food passes into an external pouching system. The opening is usually made just below the navel to the left side and is called a stoma. It can be as small as 2.5-4cm or as large as 4mm, round or oval in shape, shiny, wet and dark pink in colour, similar to the inside lining of your mouth and occasionally bleeds a little; it will gradually shrink after surgery until it assumes a permanent size some weeks later. Although stomas are rich in blood vessels, they do not transmit pain or other sensations and require little care.
A colostomy is created when a portion of the colon or rectum is removed due to a disease process or damaged area of the colon.
Temporary colostomy: May be required to give a portion of the bowel a chance to rest and heal. When healing has occurred, the colostomy can be reversed, and normal bowel function restored.
Permanent colostomy: May be required when a disease affects the end part of the colon or rectum.
Reasons for surgery: Cancer, diverticulitis, imperforate anus, Hirschsprung’s disease, trauma, other.
Care of a Colostomy
A Pouching system is usually worn. Pouches are odour free and different manufacturers have a variety to fit one’s lifestyle and needs. Ostomy supplies will come through your Stoma Nurse.
Irrigation – certain people are candidates for learning irrigation techniques that will allow for increased control over the timing of bowel movements. The purpose of irrigation is to stimulate peristalsis (the wave-like movement of the bowel). People who irrigate must have a descending or sigmoid colostomy (most of the large bowel remains). Talk to your Stoma Nurse or Surgeon to see if you may be a candidate for this practice.
Living with a Colostomy
Work: With the possible exception of jobs requiring very heavy lifting, a colostomy should not interfere with work. People with colostomies are successful businesspeople, teachers, carpenters, welders, etc.
Sex and social life: Physically, the creation of a colostomy usually does not affect sexual function. If there is a problem, it is almost always related to the removal of the rectum. The colostomy itself should not interfere with normal sexual activity or pregnancy. It should not prevent one from dating and continuing relationships and friendships.
Clothing: Depending on stoma location usually one is able to wear similar clothing as before surgery including swimwear.
Sports and activities: With a securely attached pouch one can swim and participate in practically all types of sports. Caution is advised in heavy body contact sports and a guard or belt can be worn for protection. Travel is not restricted in any way. Bathing and showering may be done with or without the pouch in place.
Diet: For guidance, follow your nurse or doctor’s orders at each stage of your post-op adjustment. Individual sensitivity to certain foods varies greatly but many can eat as they did before surgery. You must determine, by trial, what is best for you. Alcohol can be drunk in moderation, but carbonated drinks can cause gas problems. After surgery you may find your stoma noisy, but this will settle down and rarely causes embarrassment in public. Eat in moderation 3 times a day at regular times in the early stages, introducing new foods one at a time. If you find one particular food upsets you, discontinue it, but try it again, at a later date. The next time there may be no reaction. A good practice for all is to chew thoroughly and hydrate properly.