What’s a Colostomy?

Colostomy is an unavoidable medical procedure in some patients. In some cases, the only alternative is to continue with life. In this article, we’ll tell you all about this surgical technique.

Reviewed and approved by the doctor Leonardo Biolatto.

Written by Leonardo Biolatto

Last update: 27 May, 2022

A colostomy is one of the ostomy techniques. In medical terms, “ostomy” defines communication between an internal hollow organ and the exterior. Ostomies can be of the digestive system or the urinary system.

In the specific case of colostomy, it consists of an opening in the abdomen, allowing part of the large intestine to communicate with the exterior. That point of contact is known as a “stoma”.

Colostomy artificially divides the intestines into two parts. The section located before the stoma is functional and performs its relatively normal activities. The remaining part after the stoma no longer works, since the stool will come out through the opening.

In the same way, in addition to the last portion of the large intestine, the rectum and anus stop being functional. However, it’s possible that the mucosa continues producing liquids that are ejected to the exterior.

As medical professionals place the colostomy in the large intestine, the absorption of nutrients remains intact. Remember that this process belongs to the small intestine, located above and unaffected by the technique. What is affected is the production of fecal matter and its disposal.

Colostomy types

There are three types of colostomies:

1. Temporary

A temporary colostomy, as the name suggests, responds to pathologies or interventions that evolve better if a part of the large intestine is resting.

For example, when a patient has an intestinal surgery that should be given time to heal. Then, to prevent the passage of stools, the medical professional creates a temporary stoma that they’ll subsequently close. When they perform the closure, the entire digestive system functions normally again.

2. Permanent

In this case, the medical professional performs the technique with the aim of permanently leaving the colostomy. It could be due to colon cancer, for example, that was diagnosed at an advanced stage and doesn’t allow any other solution than the removal of a large section of the large intestine. When the medical professional envisions that the transit will be irreparable, they place a permanent colostomy.

3. Transverse

These colostomies get their name due to their location. The large intestine has three parts, and one of them is the transverse colon, located in the upper part of the abdomen.

It isn’t common to perform a colostomy there, but it may be necessary due to particular conditions. In this location, it’s also possible to plan a temporary or permanent technique.

Colostomy bags

Thus, colostomy releases stools through the stoma to the exterior. Stools no longer pass through the rectum and anus.

Colostomy bags receive the stools that pass involuntarily. These bags are attached to the stoma and act as a deposit for the functioning large intestine, which ejects stools regularly.

While there are multiple bag models and designs, they all have two main parts: the system that attaches the device to the skin and stoma and the collection system, which may be a simple bag or a mechanism with emptying.

Many manufacturers produce these bags, which is why there are many different prices. There are cheap and expensive bags, varying resistance of materials, small, medium, or large bags, transparent or colored bags, and bags with or without a lid.

Another point of differentiation of the bags is their emptying system. This decision will depend on the patient’s comfort, the availability of models, and the purchasing power of whoever buys the bags. Basically, the different types are:

• Replaceable. The bag is used only once. When it fills, the patient removes it and places another.
• Drainable. The bag has an opening that allows it to remove the contents and continue using it.
• Washable. Some bags have a special attachment system to allow removal. They’re made of washable material and, once clean, they can be completely re-adhered.

Possible complications

Disrupting the normal function of the intestine and having a stool bag attached to the body logically leads to certain complications. Some are more difficult to solve than others. The most common ones are:

• Dermatitis. The skin can redden around the stoma due to the colostomy and flow of stools. In general, with proper hygienic care and the use of certain creams formulated for such purpose, the adverse effect is manageable.
• Stoma shrinkage. After surgery, the stoma decreases in diameter. Although this is normal, if it shrinks too much, a medical professional may need to recanalize it with a new intervention. This is because it can block stool output.
• Movement of the stoma. In the area of the colostomy, the intestines change their disposition. Therefore, they can exert more pressure, causing a hernia of the stoma. On the contrary, it can happen the other way around, which means the stoma can retract inwards. Both situations require medical consultation to take measures to keep the colostomy working.