What is a colostomy?

A colostomy is a surgical procedure that creates a stoma in the colon through the abdomen.
A colostomy is a surgical procedure that creates a stoma, or opening, in the colon that connects to the outside by going through the abdomen. With a loop colostomy stoma, the entire loop of the colon is turned outward.

A colostomy is a surgical procedure to create a stoma in the large bowel (colon) through the abdomen. 

Surgical stomas are openings made in a hollow organ (e.g. bowel) to connect it to the outside and are named according to their anatomic location, for example, colostomy, ileostomy, or urostomy. It is usually done after an injury or surgery to create a passage for the waste produced in the bowel to be removed from the stoma (opening) on the abdomen.

A colostomy may be temporary or permanent depending upon the reason for which it is performed; for example, some infections or injuries may require giving the bowel a temporary rest, then reattaching it. A permanent colostomy may be required for a long-term or irreversible problem, such as cancer that requires the removal of the rectum or failure of the muscles that control bowel emptying or stool elimination.

A colostomy can be constructed as a loop colostomy or as an end colostomy.

  • A loop colostomy is a stoma in which the entire loop of the colon is turned outward such that both the limbs of the loop have a common opening and are not completely separated from each other.
  • An end colostomy, however, is created by bringing one end of the colon out through the abdominal wall, where it may be turned under, such as a cuff. The edges of the colon are then stitched to the skin on the abdomen to form an opening (stoma).

Is a loop colostomy permanent?

Loop colostomies are usually temporary and generally preferred over end colostomies if the intention is to reverse it at a later date. The closure of a loop colostomy is associated with a shorter average hospital stay, less intraoperative blood loss, and a lower complication rate. 

What are the reasons for a colostomy?

The indications for a colostomy are:

  • Inflammatory bowel disease 
  • Imperforate anus (a blocked or missing anal opening)
  • Serious bowel infections
  • Injury to the colon or rectum
  • Bowel obstruction
  • Rectal or colon cancer
  • Wounds or fistulas in the perineum (a woman’s perineum is the area between her anus and vulva; a man’s perineum lies between his anus and scrotum). Fistulas are abnormal connections between internal parts of the body, or between an internal organ and the skin. 

What is the difference between an end colostomy and a loop colostomy?

The differences between an end colostomy and a loop colostomy are as follows:

  • A loop colostomy is done by taking out a loop of the colon through the abdominal wall such that both the limbs of the loop have a common stoma opening, whereas an end colostomy is done by taking out the proximal end (upper part, closer to the small bowel) of the colon on the abdomen and closing the other end or taking it out through a separate opening.
  • Two openings can be observed in case of a loop colostomy, whereas only one opening is observed in case of an end colostomy.
  • A loop colostomy rests on the abdomen with the help of a support rod, whereas an end colostomy is held on the abdomen by stitching it to the abdominal wall.
  • A loop colostomy is easier and safer to reverse compared with an end colostomy.
  • A loop colostomy is generally a temporary colostomy for reasons such as infections or injuries, which may require giving the bowel a temporary rest. End colostomies are generally permanent colostomies required for long-term or irreversible problems, such as cancer that requires the removal of the rectum or failure of the muscles that control bowel emptying or stool elimination.

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Medically Reviewed on 7/20/2020
References
Medscape Medical Reference
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