What is a colostomy?

A colostomy is created from a part of the large bowel (Colon in Latin) and is usually placed on the left hand side of the navel. The output is faeces that are usually firm and formed.

After surgery, your stoma may be quite swollen to begin with, but will reduce in size over time – usually after six to eight weeks.

No sensation, no pain

A stoma is red in colour. This is because it is a mucous membrane, just like the mucous membrane inside your mouth. There is no sensation in the stoma, so it is not at all painful to touch. The stoma can bleed a little when being cleaned, especially in the beginning, but this is quite normal, and should stop shortly afterwards.

Stomas come in all different shapes and sizes - some are quite short and sit flat against the belly, while some protrude a little. Some people will have more than one stoma, depending on their condition.

In a colostomy operation, part of your colon is brought to the surface of your abdomen to form the stoma.

A colostomy is usually created on the left-hand side of your abdomen. Stools in this part of the intestine are solid and, because a stoma has no muscle to control defecation, will need to be collected using a stoma pouch.

There are two different types of colostomy surgery: End colostomy and loop colostomy.

End colostomy

If parts of your large bowel (colon) or rectum have been removed, the remaining large bowel is brought to the surface of the abdomen to form a stoma. An end colostomy can be temporary or permanent. The temporary solution is relevant in situations where the diseased part of the bowel has been removed and the remaining part of the bowel needs to rest before the ends are joined together. The permanent solution is chosen in situations where it is too risky or not possible to re-join the two parts of the intestine.

Loop colostomy

In a loop colostomy, your bowel is lifted above skin level and held in place with a stoma rod. A cut is made on the exposed bowel loop, and the ends are then rolled down and sewn onto the skin. In this way, a loop stoma actually consists of two stomas (double-barrelled stoma) that are joined together. The loop colostomy is typically a temporary measure performed in acute situations. It can also be carried out to protect a surgical join in the bowel.

Generally, with a colostomy you will need to use a closed bag.

Generally, with a colostomy you will need to use a closed bag. But if the output from your stoma is particularly fluid, a drainable bag may be more appropriate. You may want to move away from the clear bag fitted immediately after your operation to an opaque version that could also be smaller. Also if you have had an end colostomy, you may be able to manage your stoma with a colostomy plug or irrigation.

There are two main types of systems:

  • One-piece system

    This consists of a collection bag with an integrated adhesive baseplate, which firmly fits around your stoma.

  • Two-piece system

    In the two-piece system, the collection bag is separate from the adhesive baseplate, and the two halves are securely clipped or sealed together. This means that you don’t have to remove the adhesive plate from around the stoma every time you change the bag.

After stoma surgery

What to expect after stoma surgery

Read more about what to expect after ostomy surgery and adjusting to life with your new stoma.

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