Intestinal opening

Alternative names
Colostomy

Definition
Colostomy is a surgical procedure that creates an opening (stoma) on the abdomen for the drainage of stool from the large intestine (colon). The procedure is usually done after bowel resections or injuries and it may be temporary or permanent.

Description

The procedure is done while the patient is under general anesthesia (unconscious and pain-free). An incision is made in the abdomen and the bowel resection or repair is performed as needed.

For the colostomy, the proximal (nearer to the small intestine) end of the healthy bowel tissue is then passed through the abdominal wall, and the edges are stitched to the skin of the abdominal wall. An adhesive drainage bag (stoma appliance) is placed around the opening. The abdominal incision is closed.

Indications

There are a number of reasons to perform a colostomy:

     
  • When the lower large intestine, rectum, or anus is unable to function normally  
  • When the lower large intestine, rectum, or anus needs rest from normal functions  
  • When infection or contamination from stool within the resected colon would prevent healing

Whether a colostomy is temporary or permanent depends on the disease process or injury being treated. In most cases, colostomies are temporary and can be closed with another operation at a later date. If a large portion of the bowel is removed, or if the distal (far) end of the colon is too diseased to be reconnected to the proximal intestine, the colostomy may be permanent.

Risks

Risks for any anesthesia are:

     
  • Reactions to medications  
  • Problems breathing

Risks for any surgery are:

     
  • Bleeding  
  • Infection

Additional risks are:

     
  • Narrowing or obstruction of the colostomy opening (stoma)  
  • Development of a hernia at the incision site  
  • Skin irritation

Expectations after surgery
The colostomy functions to drain stool (feces) from the colon into the colostomy bag. Most colostomy stool is softer and more liquid that normally passed stool. The degree of liquidity of the stool depends on the location of the intestinal segment used to form the colostomy.

Convalescence
Hospital stay is usually 7 to 10 days. After 2 to 4 days, the patient will be able to resume eating. Complete healing may take one to two months. Learning to clean the abdomen and change the colostomy bag will be necessary. Most people can eventually change the bag at regular and convenient times.

Johns Hopkins patient information

Last revised: December 7, 2012
by Sharon M. Smith, M.D.

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