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7 Reasons for Colostomy Surgery

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First I heard of the word 'colostomy' was after I had one as a result of an emergency surgical procedure. I soon found my case wasn't unique


What Is a Colostomy?

There are a number of reasons why you may need a colostomy surgical procedure. In this procedure, a section of the colon is diverted and then attached to a stoma, which is a hole made in the abdominal wall. This opening, the colostomy stoma, enables a patient to expel faeces from the digestive tract because the bowels and rectum have been surgically disabled.

The colostomy procedure is performed as a life-saving measure that may be linked to various illnesses or conditions.

Why Do You Need a Colostomy Procedure?

There are a number of reasons why a patient may need to undergo colostomy surgery, but the seven most common reasons why anyone may require this surgical procedure is if they have:

  1. Diverticulitis
  2. Crohn’s disease
  3. Cancer of the bowels
  4. Obstruction of the bowels
  5. Trauma and/or injury
  6. An emergency situation
  7. Bowel incontinence

1. Diverticulitis

In diverticulitis, the diverticula, small pouches in the walls of the colon, get inflamed and then infected. The onset of this will give symptoms such as:

  • Severe pain in the stomach
  • Very high temperature
  • Vomiting

With severe or repeated diverticulitis, a patient's doctor may feel there is a need to remove the affected section of the colon and reattach the remaining part of it. And because the colon will heal naturally but needs some time, a patient may require a colostomy stoma as a temporary measure.

2. Crohn’s Disease

Crohn’s disease is a condition that causes inflammation of the digestive tract. Symptoms include:

  • Abdominal pain
  • Diarrhoea

Patients with cases of Crohn’s disease can be treated without surgery, but if there is no response to treatment, colon surgery will have to be performed by surgically removing a section of the bowel and performing a temporary colostomy procedure.

3. Cancer of the Bowels

Cancer of the bowels is one of the most common cancers in the developed world, with thousands of new cases occurring each year. They mostly develop within the rectum or the colon, and this condition is referred to as colorectal cancer.

Temporary Colostomy

Colostomy surgery is the most common form of treatment, where the affected portion of the bowel is surgically removed. With the removal of the diseased part, the remaining colon is then reattached, and a temporary colostomy stoma 'installed' to perform waste (faeces) elimination duties.

The temporary ostomy will be in use for times ranging from four months to a couple of years, depending on the physician's recommendations and the patient's condition. With reversible colostomy surgery, the colostomy and stoma will be removed, and the healed colon is reactivated.

Permanent Colostomy

However, with colorectal cancer, if the problem is within the rectum and it has to be removed, the patient will likely require a permanent colostomy. This form of colostomy procedure is irreversible.

4. Obstruction of the Bowels

An obstruction in the bowel is a serious condition and must be treated as a medical emergency.

This is because there is the risk of bowel rupture, which in turn will cause a serious infection and, many times, internal bleeding.

The ways that the passageway of the bowel can become blocked include:

  • Acute constipation
  • Bowel cancer
  • Scarring of the bowel or the lining (due to infection or inflammation)
  • Hernia

With severe bowel obstruction or rupture, it may become necessary to remove either a portion of the colon, in which case, a temporary colostomy will be performed.

However, if all of the colon is removed, the patient will require a permanent colostomy surgery.

5. Trauma and Injury

An experience of severe damage by a penetrating injury to the colon—for example, a gunshot wound, a knife stab, or a gruesome accident to the abdominal area—may require the colon to be removed.

Depending on the degree of injury, a temporary or permanent colostomy surgical procedure may be performed.

6. An Emergency Situation

Some patients in the hospital for surgery related to other conditions may wake up to discover they have a colostomy stoma. This most likely occurred during that involves dissection close to the colon.

For example, a female patient with massive fibroids may be in hospital to have them removed. Their size in itself may have encouraged 'gumming' to nearby organs.

And in trying to remove these fibroids, the colon may have been cut (accidentally) or nicked. If, after surgery, there is an indication of severe infection, there is the likelihood of seepage of faeces into the body system.

With this, a temporary colostomy may have to be done to save the patient's life. The colostomy reversal may then be carried out after a number of months.

7. Bowel Incontinence

Bowel incontinence is a medical condition whereby patients are unable to control their bowel movements, thereby experiencing episodes of embarrassing soiling.

This condition is more common in the elderly. A colostomy surgery may be used as a 'last resort’ medical measure if all other medical or surgical procedures prove unsuccessful.

What to Expect After the Procedure

After surgery, as it was in my case, you’ll feel heaviness and tightness around your abdomen. You’ll also feel a lot of pain and extreme weakness. You will be on intravenous pain relievers that will help the pain reduce to the barest minimum.

After Waking

You will soon be aware of the colostomy bag attached to your abdomen, and depending on your physical and mental condition, your doctor will carefully explain your current condition and tell you what to expect.

For the first few days, you won’t be able to stand on your own two feet, and it’s virtually impossible to take a shower. You will be towel-washed by the nurses, and you will have to contend with some discomfort.

At first, your stoma will not function, and because you haven’t started to eat solid foods, you won’t pass out waste through the newly installed stoma. As a post-surgery patient, you will not be allowed to eat or drink anything until the stoma starts to function.

Stoma Begins Functioning

When your stoma starts to function varies from one patient to another, but in my case, it took about a week. Peristalsis (involuntary constriction and relaxation of the muscles of the intestine) must be confirmed through auscultation (listening to sounds with a stethoscope) of the patient's stomach for intestinal movements.

As soon as intestinal movement is ascertained, you can start to ‘eat’ your first meal, which will be clear liquids. It soon progresses to eating softer foods like broth.

Recovery After Surgery

A couple of days after colostomy surgery, once conditions are favourable, you will be encouraged to sit up in bed though you will have to be lifted up (you can't do this simple task on your own) to achieve this. Depending on your strength and willpower, you will be encouraged to try standing up unaided. Soon enough, you should be able to take a few steps, aided by a nurse.

It is very important to start this early process as it encourages early healing and a faster recovery.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Questions & Answers

Question: Do all operations on your colon require a temporary colostomy?

Answer: No, not all colon surgeries require a temporary colostomy.

In some cases, you may have to get a permanent colostomy, but your doctor is the only one who can let you know which one you need.

© 2010 Alobeda


Alobeda (author) from The Global Village on July 22, 2017:

Hello, Michelle.

I'm so sorry you have to go through so much pain.

I doubt you can ask for a colostomy surgical procedure. It is your doctor(s) who'll be in the best position to decide on that. Having a colostomy is really not by choice and it will only be done if it is ABSOLUTELY necessary.

Don't feel so bad and try to look on the brighter side. Having to manage a colostomy is not the best, especially if it's a permanent one.

I don't know if this helps, but I have been having on and off constipation in the past couple of months so i've had to take care about what i consume, quantities, and I drink lots of water. I find it has helped me.

Michelle barry on July 21, 2017:

Can I ask to have a colostomy bag. I suffer severe constipation and have been hospitalised 3 times in the last few months. I also have been told I have colitis. I'm so so miserable and my quality of life is awful. It has not been offered but can I choose to have a bag as on my last admission a few weeks ago I was told that this would keep happening. I get admitted with tremendous pain and they think I have escemic colitus, if they get the bowel moving there will be no intervention if they can't they will operate. Can I ask for a bag seeing as we know the bowel doesn't work.

Alobeda (author) from The Global Village on August 21, 2016:

Hi Sonya

I'll suggest you see your doctor as soon as you can. Bloody stool is an indication of an underlying problem which may be minor or major.

It doesn't mean you'll need to have colostomy surgery so i wouldn't worry too much yet.

But do see your doctor. He'll know what's best for you.

Best wishes

AloBeDa on August 21, 2016:

Hi Sonya

I'll suggest you see your doctor as soon as you can. Bloody stool is an indication of an underlying problem which may be minor or major.

It doesn't mean you'll need to have colostomy surgery so i wouldn't worry too much yet.

But do see your doctor. He'll know what's best for you.

Best wishes

sonya on August 21, 2016:

i have stent and broken back i have taken two bowel movements and both had blood in them i feel sick to my stomache