Understanding a Colostomy

April 08,2022 |
Two people sitting on a mountain.

Your digestive system runs from your head all the way down to the bottom of your pelvis. As food enters your mouth it begins the digestive process and is broken down by mastication. Next, saliva initiates nutrient breakdown as food is carried down the pharynx and esophagus into the stomach. Once it reaches the stomach, acid begins to break things down even further and push the remaining substance into the intestines to start the process of nutrient absorption. The small intestine absorbs nutrients like vitamins, minerals, carbohydrates, proteins, fats, and water so they can be used for cellular energy. Once all usable materials are extracted, food waste enters the large intestine (colon) where it’s turned into stool and passed through the rectum. In most individuals, this process occurs involuntarily and rarely causes concern. However, sometimes damage, disease, or injury can limit the function of certain parts of the digestive system. If damage occurs to the large intestine, a colostomy may be required to support your body’s natural digestive process. For more information, here’s everything you need to know about colostomies.


What is a Colostomy?

A colostomy is a type of ostomy surgery that’s performed when one or more parts of the large intestine aren’t working as they should. During the operation, a small hole is made in the abdominal wall and the large intestine is redirected and attached to this opening. In some instances, this is done temporarily as an individual recovers from surgery, injury, or an illness. This is called a loop colostomy and can be reversed later on.

End colostomies, on the other hand, are permanent and require the large intestine to be brought out through the abdominal wall. The edges of the large intestine are then reattached to the skin surrounding the hole in the abdominal wall. This creates an opening called a stoma. After surgery, food will pass through your body’s digestive system in the same manner as before, but instead of exiting through the rectum, it will exit directly out of the stoma. This will happen involuntarily, so you need to use a pouching system to catch waste and properly dispose of it.

Undergoing a permanent colostomy can create a lot of distress and bring about major life changes, but try to remember that it’s a lifesaving procedure. If you need a colostomy surgery, talk to your doctor about options for emotional support and don’t be afraid to ask questions.


Reasons to Undergo a Colostomy

There are several different reasons that an individual may need to undergo colostomy surgery. Oftentimes, permanent colostomies are recommended whenever the large intestine is damaged or diseased beyond repair. Some of the most common reasons to undergo a colostomy include inflammatory bowel disease, colon or rectal injury, colon or rectal cancer, bowel blockages, serious infections, diverticulitis, birth defects like imperforate anus, fistulas within the perineum, or more.

The primary purpose of a loop colostomy is to allow the body’s digestive system to heal following trauma or surgery. It’s also used as a way to temporarily treat conditions such as Crohn’s disease, bowel cancer, or diverticulitis that are still mild. Depending on the damage or spread of the disease, permanent surgery may be required. Typically, temporary colostomy procedures are needed for about three to six months.


Risks of Colostomy Surgery

A colostomy is a major surgery and the main risks involved are related to the operation. This includes the risk of internal bleeding, damage to surrounding organs, and infection. Generally speaking, the surgery itself is fairly straightforward. It’s performed under general anesthesia and can either be done laparoscopically or as an open surgery. Some colostomy-specific risks include a narrowing of the stomal opening, scar tissue that affects intestinal flow, irritation, or hernias that develop near the stoma. Always discuss the risks with your doctor and make sure to ask questions well ahead of time.


What to Expect During Surgery?

As mentioned, colostomy surgeries are lifesaving procedures and are generally carried out without complications. Try to relax and ease your anxiety. To help you with this transition, have a loved one accompany you to the hospital. Your doctor will provide you with a detailed list of pre-op instructions, which are important to follow in precise detail. During the procedure, your surgeon will provide you with general anesthesia so that you don’t feel a thing. You’ll need to stay in the hospital for about three days, where your doctor will help you ease into recovery. This reduces the risk of post-op problems and allows for careful monitoring of the stoma while you adapt to these changes. Once released, you can return home to continue recovery. Eventually, you’ll be able to do everything you did before the surgery as there are no physical limitations to having an ostomy. Always await your doctor’s approval to resume any strenuous activity.


Using a Pouching System After a Colostomy

During your time in the hospital, your doctor or an ostomy nurse will teach you how to use a pouching system to catch your stool. Before you leave, try to get comfortable doing this on your own. Aside from a few moments each day—showering and skin care—you’ll need to wear a pouching system to catch waste. While this is a major life change, the routine does get easier. You’ll learn to pouch in difficult situations and eventually, it becomes second nature. Work with your doctor to find a pouch that you’re comfortable with and if you have any questions during the process, don’t hesitate to ask. 


Self-Care Tips for New Ostomates

To keep yourself healthy, both mentally and physically, there are a few things to consider. As mentioned, no type of ostomy creates physical limitations. You can do everything that you were doing before the surgery, as long as you’ve been cleared by your doctor. Consider some of these tips to help you through the transition.

Maintaining Skin Health 

Since your pouching system will be attached to your skin, it may lead to irritation from time to time. By taking a proactive approach to ostomy skin care and health, you can reduce this risk and stay comfortable and protected. Avoid using harsh soaps on your stoma, perform regular visual checks of your stoma, shower regularly, and choose a pouch that fits comfortably, but securely.

Sex and Stomas 

Ostomates have no sexual limitations. With a colostomy, you can have the exact same sex life as you once had, you just have to be mindful of your pouch during the process. If you’re not comfortable engaging in sexual intercourse with your partner, there are plenty of other ways to be intimate. Try to have an open conversation to communicate your feelings and be patient. Eventually you’ll regain your confidence.

Managing Odor

Many new ostomates are nervous about their pouching systems emitting an odor. While it’s an understandable fear, a properly secured pouch will not smell. However, if you want to take extra precautions, there are plenty of ways for you to manage ostomy odor.

Eating a Balanced Diet

A lot of people assume that after a colostomy, they need to change their diet. This isn’t necessarily true. While your doctor may have you on a modified diet during recovery, once you’ve healed you should be able to go back to a diet free of restrictions—unless you’re managing an underlying condition. Just keep in mind that what you eat has an impact on your stools, so be mindful if you know certain things upset your stomach or aren’t digested well.


Traveling with an ostomy pouch can present unique challenges, but it’s still possible. All you need to do is take the time to ensure you’re adequately prepared and bring supplies with you to change your pouch on the go. Your colostomy won’t restrict you from exploring and seeing the world.

How to Deal with Negative Emotions

Attending an ostomy support group has a lot of benefits. It allows you to connect with other individuals who are in a similar situation. While some people don’t understand how this can help with their own negative feelings, you’d be surprised at how much better it can make you feel. If anything, it’s worth a shot. Check the list of support groups affiliated with The United Ostomy Associations of America (UOAA) for locations around you. UOAA is a national, 501(c)(3) nonprofit organization that supports, empowers, and advocates for people who have had or will have ostomy or continent diversion surgery.

To help you navigate life with a colostomy, Byram Healthcare has an array of ostomy supplies and support systems. We’re committed to helping improve the lives of those living with ostomies through convenient product delivery and a diverse product catalog.