Some diseases, such as bowel cancer, may require the surgical removal of diseased portions of bowel. The bowel may have to be rerouted through an artificially created hole in the abdomen so that faeces can still leave the body. This hole is called a stoma. A colostomy is an operation that connects the colon to the abdominal wall, while an ileostomy connects the last part of the small intestine (ileum) to the abdominal wall. The stoma may be permanent in the case of bowel cancer or serious injury, or it can be a temporary measure while the bowel recovers from events such as infection, inflammation or stab wounds.

Conditions that may require colostomy or ileostomy

Some of the conditions that may require colostomy or ileostomy include:

  • Bowel infections
  • Bowel inflammation
  • Diverticulitis
  • Crohn’s disease
  • Ulcerative colitis
  • Blocked bowel
  • Bowel cancer
  • Familial adenomatous polyposis (a precancerous condition)
  • Serious injury to the bowel.
  • Medical issues to consider

Before undergoing the operation, you will need to discuss a range of issues with your doctor, including:

  • Medical history
  • Any medications you are taking, including over-the-counter drugs, minerals, vitamins and herbal supplements
  • Possible risks and complications of the operation
  • Any concerns you have regarding body image, cleanliness and sexuality.
  • Operation procedure

Colostomy and ileostomy share similar surgical characteristics. These include:

  • Except in cases of emergency surgery, the bowel is prepared by undergoing a liquid diet and taking special cleansing and antibiotic medications.
  • The patient is put under general anaesthetic.
  • The surgeon marks the point on the abdomen for the intended stoma. A common location is the lower right hand side of the abdomen.
  • The abdomen is opened up.
  • The diseased portion of bowel is removed. The healthy portion is then pulled out through a small incision in the abdomen (stoma).
  • The healthy bowel portion is sewn to the stoma.
  • A plastic bag is glued over the stoma to collect waste.
  • The large abdominal incision is closed with stitches.

Long term outlook

If the stoma is only temporary, a subsequent operation will be needed to reattach the bowel so faeces can once again be passed through the anus. If permanent, the stoma is checked some three weeks later (or when the swelling has subsided) to make sure it has an appropriate diameter. The bags must be changed frequently. The person has no voluntary control over the movement of their faeces, which is also likely to be thin and watery. Many people appreciate the support and understanding offered by stoma associations. These groups can advise on important issues such as clothing concerns, body image and sexuality.