What Is a Colostomy?

During a colostomy part of the colon (large intestine) is removed or disconnected. If the large intestine was diseased, it may be removed. If it was injured, it may be disconnected for a short time while it heals, then reconnected. During a colostomy, the colon is brought through the abdominal wall. This makes an opening, called a stoma, for stool and mucus to pass out of the body.

Types of Colostomies

The type of colostomy you have depends on what part of the colon is removed or disconnected. The most common types of colostomies are:

Sigmoid Colostomy

  • The last section of the colon is removed or disconnected. The rectum and anus may be removed, or they may be disconnected and left in the body.
  • The stoma is usually on the lower left side of the abdomen.
  • Stool is most often firm

Descending Colostomy

  • The sigmoid colon and part of the descending colon are removed or disconnected. The rectum and anus may be removed or just disconnected.
  • The stoma is usually on the left side of the abdomen.
  • Stool may be almost firm.

Transverse Colostomy

Types of Stomas

The stoma is created by bringing the colon through the abdominal wall and turning it back on itself, like a cuff. The stoma is pink and moist, like the inside of the mouth. It shrinks to its final size 6–8 weeks after surgery. The kind of stoma you have depends on your surgery. The most common types are:

An end stoma, most often done for a permanent colostomy. Stool and mucus pass from the same opening. If the anus is not removed, mucus passes from it as well.

A loop stoma, most often done for a temporary colostomy. Stool passes from one side of the stoma. Mucus passes from the other. The anus is most often not removed, so mucus passes from it, too.

Two stomas may be done for a temporary or permanent colostomy. Stool passes from one stoma. Mucus passes from the other. If the anus is not removed, mucus passes from it as well.

Colostomy: Caring for Your Stoma

You need to take care of your stoma and the skin around it (peristomal skin). That means keeping the stoma and the skin clean. It also means protecting the skin from moisture and contact with stool. This helps prevent skin problems and odor.

Check the Stoma

Check the stoma and the skin around it each time you change your pouch. Stand in front of a mirror, or use a hand mirror so that you can see all the way around the stoma. It should look shiny, moist, and dark pink or red. The skin around it should be smooth, with no red or broken spots.

Clean Around the Stoma

Clean around the stoma with warm water and a soft washcloth each time you change the pouch. Water does not harm the stoma. You can even take a bath or shower without your pouch if you choose.

Protect the Skin Around the Stoma

For the pouch to stick well, the skin around the stoma needs to be dry and smooth. If the skin is moist or uneven, the pouch is more likely to leak. A leaky pouch will irritate the skin. It can also cause odor.

Common Causes of Skin Problems

Call Your ET Nurse or Other Healthcare Provider If:

  • The skin around the stoma is red, weepy, bleeding, or broken.
  • The skin around the stoma itches, burns, stings, or has white spots.
  • The stoma swells, changes color, or bleeds without stopping.
  • The stoma becomes even with or sinks below the skin, or it sticks up more than normal.

Colostomy: Selecting Your Pouch

After a colostomy, stool is most often collected in a pouch that attaches to your body around the stoma. An adhesive skin barrier holds the pouch in place and keeps stool from leaking onto the skin. Most pouches are made of lightweight, odor-proof plastic. They lie flat against the body so they don’t show or make noise.

Types of Pouches

There are many styles of pouches. Your healthcare provider will help you select the one that’s best for you. The skin barrier has to fit around the stoma without touching it. And it must stick well so there is no leaking or odor from the pouch.

Two-Piece Drainable

One-Piece Drainable

One-Piece Closed-End

Sizing the Stoma Opening

For the pouch to fit around the stoma, the skin barrier must have an opening. Some skin barriers have precut openings, and some you size and cut yourself. To find the correct size opening for your stoma, use a measuring guide. Most pouches come with a guide in the box. Your healthcare provider may also give you one.

Pouch Accessories

You can buy other stoma care products through special catalogs, at medical supply stores, and at some drugstores.

Colostomy: Irrigating Your Colostomy

Irrigating a colostomy allows you to time your bowel movements. Once a day, or once every
other day, you irrigate by flushing the colostomy with warm water. To irrigate, you need an
irrigation kit, hook, and water-soluble lubricant.

1. Fill the Bag

2. Put On the Sleeve

3. Insert the Cone

4. Remove the Cone and Clamp the Sleeve

5. Clean the Cone and the Sleeve

Colostomy: Dealing with a Food Blockage

After an ostomy, high fiber foods eaten in large amounts can get stuck in the small intestine, causing a blockage. You need to know the signs of a blockage and what to do if you have one.

Signs of a Blockage

A blockage can be an emergency. That’s because you can become dehydrated quickly. The
intestine can also rupture. You may have these signs of a blockage:

What to Do at the First Sign of a Blockage

You can also try one or more of the following:

If a blockage lasts more than 2 hours, or if you start to vomit, call your doctor or ET nurse right away. Or go to the nearest hospital emergency room.

To Help Prevent a Blockage

Sometimes a blockage occurs no matter what you do. But you can help prevent one.

Colostomy: Nutritional Management

Avoiding Digestive Problems

You don’t have to eat a special diet just because you’ve had a colostomy. Most foods, chewed well and eaten slowly, won’t give you problems—unless they did before. But you may need to be more aware of foods that cause gas or odor and foods that make your stool too runny or too hard.

Choosing Foods

Learning which foods cause gas or odor, or make your stool runny or hard, takes a little time. You may want to add foods back to your diet one at a time.

Causes of Gas and Odor

Some gas is normal, but constant gas is not. Neither is constant odor from stool. What causes gas or odor can differ from person to person.

Causes of Diarrhea

Stool that’s more runny than normal (diarrhea) can be a sign of an illness, such as the flu. Some foods and medications can also cause runny stool.

Preventing Constipation

Your stool can sometimes be too hard (constipation). Hard stool is often caused by not eating
enough roughage (fiber) or not drinking enough fluids. Stress and some medications can also
cause hard stool.

Call Your ET Nurse or Other Healthcare Provider If:

  • You have nausea, vomiting, pain, cramping, or bloating.
  • You have a change in your normal bowel habits, such as little or no stool.
  • Your stool is loose or more runny than normal for more than 5–6 hours.
  • The stoma changes size, or the stool is black (blood in the stool).