Colostomy is a surgical procedure in which one end of the colon is diverted through an incision in the abdominal wall to create a stoma. A stoma is the opening in the skin where a small bag is attached for collecting faeces. People with temporary or long-term colostomies can explore colostomy bag use. There are several types of colostomy bags for different kinds of medical requirements where faeces can collect and be easily disposed of. A colostomy is also referred to as bowel diversion therapy. This surgical procedure is often done along with other procedures to correct problems in the lower digestive tract.
Why colostomy is performed?
Colostomy is performed for treating diseases in the lower bowel. Some of the diseases can be corrected by temporarily diverting stool away from the bowel. Conditions in which a patient may need a permanent colostomy include:
1. Inflammatory Bowel Disease
Inflammatory Bowel Disease (IBD) refers to the condition when inflammation in the digestive tract is detected. IBD includes Crohn’s disease and ulcerative colitis. Symptoms of these diseases include abdominal pain, diarrhoea, rectal bleeding, and fatigue.
Doctors first treat IBD with diet and medications. A colostomy surgery may be required in case of serious problems, such as severe bleeding or colon blockage. Doctors also perform this surgery when other treatments do not improve severe symptoms.
Diverticulitis is the condition when there is inflammation or infection of the small pouches formed in the colon. It causes stomach pain, fever, and vomiting. At first, doctors attempt to treat diverticulitis with modified diet and antibiotics. In case this does not work or there is serious infection or repeated bouts of the disease, surgery becomes necessary. In very serious cases, surgery includes taking out the affected part of the colon and creating a colostomy until the remaining colon is healed.
A bowel obstruction or blockage prevents the passage of digested food through the colon. It may be due to severe constipation, adhesions, tumours, hernias, complications from earlier abdominal surgery, and paralysis of the colon. Symptoms of bowel obstruction include fever and abdominal pain and swelling.
A bowel obstruction can become life threatening and requires prompt surgery to remove the blockage or obstruction. Doctors may remove part of the colon and perform a colostomy in severe cases.
4. Colorectal Cancer
Symptoms of colorectal cancer include rectal bleeding, change in bowel movements, and abdominal pain. Doctors may recommend colostomy to help cure the disease or treat symptoms. Patients with colorectal cancer need ongoing screening even after colostomy to check for recurrence of the cancer.
Injury or trauma can cause severe damage to the colon, rectum or anus. Sometimes, it is not possible to repair and restore the normal health and function of colon, rectum or anus. In that case, the doctor may decide to remove all or part of these organs and create a colostomy. For less severe trauma, only a temporary colostomy may be required.
6. Birth Defects and Genetic Disorders
A baby born with imperforate anus (blocked or missing anal opening) may require a colostomy. This kind of surgical intervention is also required in case a child suffers from Hirschsprung’s disease which is a genetic disorder. In this condition, some of the nerves that control the colon muscles are missing. It can lead to a serious blockage. That's why, to prevent the blockages, doctors may remove the defective part of the colon and create a colostomy.
Risks of a Colostomy
As with any surgery, there are risks of allergic reactions to anaesthesia and excessive bleeding. The same holds true for colostomy. It may also cause an infection or internal bleeding.
Colostomy also carries the following other risks:
- blockage of the colostomy
- damage to other organs
- a wound breaking open
- problems from scar tissue
- prolapse of the colostomy
The doctor will best explain all the risks involved in the surgery, the potential for complications, and the advantages to the patient before proceeding with the surgery. Furthermore, all possible precautions are undertaken to minimize risks and complications and let the patient benefit fully from the surgery.
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