Colostomy: what it is, types, and when it should be recommended

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A colostomy is a procedure performed to connect part of the large intestine to the abdominal wall. The main goal is to allow the exit of feces directly into a bag in situations where natural evacuation is impeded.

The procedure is generally indicated after intestinal surgeries or when there are more serious health problems, such as cancer or complicated diverticulitis, and the fecal transit needs to be diverted.

In most cases, the colostomy is temporary, and the person remains with the bag long enough for the anal region and/or intestine to recover from some surgery.

On the other hand, some colostomies are permanent, especially when it was necessary to remove a large part of the intestine.

When is a colostomy indicated?

There are various situations in which a colostomy may be necessary. Basically, any condition that prevents the patient from evacuating naturally requires the procedure. Among the main causes, it is possible to mention:

• imperforate anus (nonexistent or blocked anal opening);
• partial or total intestinal blockage;
• colorectal cancer;
• fistulas or wounds in the perineum;
• severe inflammation in the colon;
• traumatic injury to the rectum or colon;

What are the types of colostomy?

The types of colostomy are:

Transverse Colostomy

• Performed on the transverse colon;
• The feces are semi-liquid and can cause skin irritation around the ostomy;
• It is usually temporary.

Ascending Colostomy

• Named so because it is done on the ascending colon;
• It is a less common type of ostomy;
• The patient continues to evacuate liquid or semi-liquid feces, which can lead to skin irritation.

Descending Colostomy

• Named so because it occurs in the descending colon;
• The feces are considered semi-formed and cause less irritation when in contact with the skin;
• It is the most common type of colostomy.

Sigmoid Colostomy

• Performed in the lower abdomen, where the large intestine is already approaching the rectum;
• The evacuated feces are considered formed and do not irritate the skin around the ostomy.

What are the benefits and risks?

Benefits

The main benefits involve enabling the evacuation of feces and allowing the patient to lead a normal life, carrying out all their daily activities.

Risks

There are some complications that can occur after the procedure, most of them at the site where the stoma is opened. In most cases, these complications involve:

• dermatitis;
• stenosis;
• hernia;
• infection around the stoma;
• necrosis;
• prolapse;
• retraction;
• bleeding.

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