A colostomy is a type of ostomy bowel diversion. It is a surgical procedure that involves partially resecting and disconnecting the colon (the large intestine). The colon is about four to six feet long. The first portion is the “secum” (where the small intestine ends). It is followed by the “ascending colon” (right part of the abdomen), then the “transverse colon” (horizontal above the abdomen), then the “descending colon” (left part of the abdomen), and finally the “sigmoid colon” where it connects to the rectum. The colon aids in the job of digesting, solidifying unused food, and turning it into stool. It receives everything the small intestine cannot absorb. The colon is then responsible for further absorbing water, nutrients, electrolytes, and certain vitamins. It processes, stores, and evacuates indigestible matter in the form of feces through the anus. A colostomy creates a hole (an ostomy) so that stool can leave the body without reaching the rectum and the anus.
Colon removal occurs when a section of the intestine is diseased. Colon disconnection ensues and may lead to either a Temporary or a Permanent Colostomy. In both cases, the end part of the colon that remains connected to the digestive system is brought out through an incision on the abdominal cavity (an ostomy). The portion of colon that protrudes through the ostomy is called the stoma. With a colostomy all body excretions are expelled through the stoma. If there is a Permanent Colostomy, the stoma will always be the channel for disposal and the patient will always need colostomy bags for collection. If there is a Temporary Colostomy, once the bowel heals from the surgery (at least 4 months), a new surgery is performed to eliminate that colostomy. At that point, the colon is reconnected. The stoma is joined with the part of the colon that connects with the rectum, and the colostomy patient can again secrete stool through the rectum and the anus. The patient will no longer need colostomy bags.
The main causes leading to a colostomy are rectal cancer, diverticulitis, necrotizing enterocolitis (acute inflammatory bowel disease), Crohn’s disease, puncture accidents, and congenital defects such as Hirschsprung’s disease (abnormal bowel nerve control) and imperforate anus (lacking anus). A colostomy is the most common stoma accounting for about 53% of the total. There are different types of colostomy and they all involve a section of the colon. The most common one occurs on the descending colon and displays on the left side of the abdomen