Colostomy

Formation

A colostomy (or a stoma) is also commonly known as a “bag”. A colostomy is an opening on the abdomen where the intestine is joined onto the skin of the abdomen. An adhesive bag is then applied onto the stoma which collects waste such as faeces. In a normal person, the contents of the large intestine usually empty via the rectum and the anus. In a patient with a colostomy, faecal material passes from the intestine via the colostomy into the adhesive bag instead of the rectum and anus. The bag can then be emptied or changed as required.

Patients may require a colostomy bag because of a bowel cancer or because of an emergency operation for diverticulitis or because of inflammatory bowel disease where a segment of the intestine has been removed and the two ends of bowel were not joined together either because it is not possible or not safe to do so.

Most patients who have colostomies have a normal life. They are able to resume their usual activities of daily living including sports, driving and an intimate relationship.

Although some colostomies can be reversed, it is not always possible to do so. Your specialist will discuss if your colostomy can be reversed.

Closure

Closing a colostomy is to restore intestinal continuity such that faecal material now passes through the intestine via the anus to the outside world.

To close a colostomy, the downstream part of the intestine must be available and identified. The opening in the intestine where the stoma was previously joined onto the skin then needs to be joined to the downstream part of the intestine. The join between the two parts of the intestine can be either sutured by hand or be stapled using a purpose designed stapler.

Bowel function after initial closure of colostomy can be erratic. This generally settles down after a period a months. In patients who continue to have difficulties with their bowel motion after closure of colostomy, your specialist is the best person to provide advice on appropriate treatment.