Colostomy means creation an opening of the large intestine on the surface of the abdomen. The procedure is relatively unpopular among the people due to its cosmetic consequences, but it may become a necessary temporary or long-term solution of many diseases of the digestive tract.


Colostomy is created in various diseases of the intestines, where it is necessary to establish passage of the stools. Typical indications are severe inflammations such as diverticulitis and complications of Crohn's disease and ulcerative colitis. Even extensive surgery of a colorectal cancer may force the doctors to create at least a temporary colostomy. In all these cases, a temporary stoma is used to divert the stool and allow calm and healing of the rest intestine. Permanent colostomy is usually performed in surgical removal of a part of the large intestine with rectum. The reason of such operation may be severe complications of Crohn's disease and ulcerative colitis, rectal form of colorectal cancer, familial adenomatous polyposis and functional damage of anal sphincter that leads to uncontrolled fecal incontinence.


There are more types of surgery depending on the reason of colostomy formation and whether it is planned to be temporary or permanent. Classically, the upper part of the colon is opened on the surface and sewn to the adjacent skin. The lower part of the intestine is either sewn blindly (with preserved anus), or completely removed. The patients with colostomy are cared about by specially trained stoma nurses that help them to get used to the stoma and to treat it properly.



Scheme - One of the the possible forms of the colostomy. In this case, upper part of the colon is opened on the surface of the body, while the lower part  is blinded.



The main disadvantage is the cosmetic defect and the loss of rectum and its function. The colostomy misses the anal sphincter and the stool leaves continuously in small quantities. This problem is solved by special stomic bags that are stuck to the skin around the circumference of the stoma. These bags are designed to collect the stool and must be regularly exchanged. Thanks to high-quality seals and by careful manipulation, there is no leakage of the stool and not any unpleasant odor.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources