When is a colostomy necessary?
A colostomy is created when the lower colon or rectum is damaged, diseased, or needs time to heal. This can happen for various reasons:
- Bowel cancer or anal cancer
- Chronic inflammatory bowel diseases like Crohn's disease or ulcerative colitis
- Diverticulitis
- Traumatic injuries
- Faecal incontinence
- Congenital abnormalities
Types of colostomies
End colostomy
End colostomy is the most common form. It's created when the rectum, anal sphincter, or lower colon needs to be removed, often due to certain cancers or severe inflammation. The stoma is usually located in your lower left abdomen and is permanent.
Since most of your colon remains, your stool consistency usually doesn't change much. What does change: you lose voluntary control over when waste is eliminated. Your body now manages this in its own way.
Temporary colostomy (Loop colostomy)
A loop colostomy is temporary. Part of your colon is brought to the surface to protect and give a damaged section time to heal. This creates two stoma openings: one for active emptying and one for relief.
What's unique about this type is that it can be reversed. Once your bowel has healed sufficiently, the ends are sewn back together and relocated inside your abdomen, and your bowel functions normally again.
Challenges after surgery
A colostomy changes your life, there's no getting around that. For most people, this change brings strong emotions: both positive and negative. Some experience pain relief and a new quality of life. Others initially struggle to accept their changed body. Both responses are completely normal.
Remember that you'll still live a full and active life with a stoma. Your body isn't less valuable or less beautiful. It's a normal process to adjust to the change, and counselling or support groups can help you process your feelings and rebuild your confidence.
Nutrition and colostomy
Food is more than just nutrition, it affects our mood and wellbeing. Your stoma shouldn't prevent you from enjoying your favourite meals.
Most people return to eating normally relatively quickly. What your body tolerated before surgery, it will usually tolerate afterwards. That said, everyone responds differently to different foods.
The key is avoiding constipation and watching out for foods that cause bloating or unpleasant odours. This sounds restrictive, but it's not. Anything that tastes good and your body tolerates is allowed. Simply listen to your body.
Practical nutrition tips:
- Eat a balanced diet and favour easily digestible foods
- Drink about 2 to 2.5 litres of fluid daily
- Prepare food in low-fat, gentle ways
- Take your time with meals and drinks: chew thoroughly and sip drinks slowly
- Eat several small meals throughout the day at regular intervals
- Stay physically active
- Maintain a stable weight, as significant changes can shift your stoma's position
Physical activity and sport with colostomy
Exercise is important, even with a stoma. After an appropriate recovery period (rest immediately after surgery), you can do almost any sport that feels comfortable for you.
Tips for staying active with a colostomy:
- Wear an ostomy belt or supportive clothing: this gives you security and reduces stoma hernia risk
- Start slowly and build up gradually
- Stay well-hydrated
- Discuss extreme sports like contact sports or heavy lifting with your doctor
Stoma care and hygiene with a colostomy
A decent stoma skin care is absolutely essential, which is why it's also crucial that you understand what causes skin problems, which products work best for you, and how to care for your skin properly.
How to care for your stoma properly:
- Clean your stoma and surrounding skin gently with warm water
- Avoid perfumed soaps, lotions, and creams as these irritate your skin
- Pat your skin gently dry after washing
- If your skin is already irritated, special skin barrier lotions can help
- Unscented wipes are useful when you're out and about, but only in emergencies
If you have ongoing skin problems, talk to your stoma care nurse. For more detailed information on stoma skin care, read our comprehensive guide.
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Key takeaways on colostomy
Managing a colostomy can be emotionally and psychologically challenging. You're not alone. Talking with your stoma care nurse, family, or supportive people can make a real difference in how you adapt. There are many support groups and resources available to help.
Learn more about recovery after ostomy surgery in our detailed guide.
FAQ: Colostomy
What is a colostomy?
A colostomy is a surgical procedure that creates an opening (stoma) in your abdominal wall to bring your colon to the surface. This becomes necessary when your lower colon or rectum needs to be removed or is damaged. After surgery, waste passes directly through your stoma into a special pouch.
When do you need a colostomy?
A colostomy is created when your lower colon or rectum is diseased or damaged and can no longer function properly. This might be necessary for:
- Bowel cancer or anal cancer requiring removal of the affected area
- Chronic inflammatory bowel diseases like Crohn's disease or ulcerative colitis that can't be treated otherwise
- Diverticulitis or other infections
- Traumatic bowel injuries
- Faecal incontinence when conservative treatments don't help
- Congenital abnormalities
Your doctor will discuss with you whether and when a colostomy makes sense for your situation.
What happens to your rectum when you have a colostomy?
When you have a colostomy, natural bowel movements are replaced by drainage through your stoma, your rectum no longer has a function. Depending on how much of your colon was removed, there may occasionally be minor discharge, but this is usually minimal and harmless.
With a temporary colostomy, your rectum can regain its normal function when the stoma is reversed. With an end colostomy, your rectum won't have a bowel function long-term.
How often do you have bowel movements with a colostomy?
This is very individual and depends on several factors:
- How much colon remains: The more colon that stays intact, the firmer and less frequent your bowel movements are usually
- Your diet: Fibre, fluid intake, and certain foods influence frequency
- Your metabolism: Everyone's body is different
People with a colostomy usually have one to three bowel movements daily, some only every other day. This is completely normal. Over time, you'll learn your body's patterns and adapt naturally.
Many people also discover they have some control over timing, for example, by allowing time after meals. What applies to you is individual. Your stoma care nurse can help you better understand your personal patterns.