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The Different Types of Colostomy Procedures

Updated on September 20, 2017
AloBeDa profile image

Adjusting to a colostomy is tough—for me it was like a horrible dream. But with a positive mindset, I adjusted wonderfully.

Colostomy surgery is usually carried out as a life-saving procedure whereby a section of the colon is diverted and attached to an opening that leads out through the abdominal wall. This opening is called a stoma. With this procedure done, a patient can only expel human waste (faeces) from the digestive tract through this stoma. At this time, the colon and the rectum have been disabled and no longer functions.

A colostomy may be temporary and therefore reversible, or permanent, in which case making it an irreversible procedure and while some stomas are large, others are small. And depending on the type of procedure, you will find some a stoma located on either the left side of the abdomen, on the right side or, in the middle of the abdomen.

Types of Surgical Procedures

Your doctor is the one who will know the type of colostomy that is required. His decision will be based on a number of reasons – Is it an emergency situation, trauma to the abdomen, the progression of an existing disease, or a birth defect (in babies or the very young). These are just a number of reasons why anyone will require colostomy surgery.

There are three different types of colostomy procedures and they are all named after where they are sited (on the anatomy) and the area of the stoma opening.

  1. Ascending
  2. Transverse
  3. Descending

Ascending Colostomy - The ascending colostomy is located on the right side of the abdomen and is the least common procedure of the three. Your waste that’s excreted through the stoma is more fluid meaning it is not well-formed. Water has not been fully absorbed in the digestive tract so waste is more fluid.

Transverse Colostomy – Here, the stoma is found in the upper-middle part of the abdominal wall. The excreta expelled ranges from liquid to semi-solid. It is the second most common type of colostomy surgery.

Descending Colostomy - Stomas sited in the lower left side of the abdomen are referred to as descending colostomies. Faeces expelled from the stoma is semi-formed to solid form, a texture that comes about because it has gone past the digestive tract to the lower parts of the colon. This procedure is the most common one carried out among the three.

Preparing for Colostomy Surgery

Before the procedure is carried out (except in emergency situations), your doctor will inform and educate you about the whole process, how it is done, what it entails, and about life after surgery. It is understandable if you are anxious, not knowing what to expect and how to cope with life after surgery. This is normal and that’s why your doctor will discuss extensively with you pre-surgery.

In many instances, you can choose how high or low you want your stoma sited but it is always left to the discretion of your doctor who will always base his decision on what is required and your general condition is.

Necessary preparations before surgery include a form of colon cleansing. Some doctors want their colostomy patients to undergo colon cleansing before the surgical procedure. Preparations may also include a build-up of a patient's stamina some days before surgery. Like a pre-surgery diet.

Pre-Surgery Diet

Basically, a pre-surgery diet is simple and easy to keep to, at least for some days pre-surgery. The diet recommended is to maintain and provide adequate nutrition to the body and to minimize the chances of cramping. They must contain ample quantities of the following:

  • Calories
  • Protein
  • Carbohydrates

Good sources of calories are butter, oils like olive, coconut, vegetable, or sesame seed oils. Meats will supply ample protein, and pasta and rice are great for a pre-surgery diet.

Bowel Preparation

It is important to prepare the bowel before a colostomy procedure. A couple of days before, your doctor will request a bowel preparation which is essential to cleanse the colon before surgery. You may have an enema and need to fast for about eight hours prior to the operation. There must be no snacks, small bites, water, or sips of drinks. If the fast is broken, surgery will have to be postponed.

Your nurse will walk-you-through these preparations which you must follow diligently. Any omission of instructions may cause a postponement of the surgical procedure.

Talk about Life after Your Colostomy

One of the best ways to prepare your mind for the operation is to talk to someone who has just had colostomy surgery. Because my case was an emergency, I didn’t have the privilege of talking to a colostomy patient who recently had surgery. But I did get to talk to one some days after my procedure. They needed to boost my confidence.

This can be arranged in the hospital. Talking makes a whole lot of difference and will help you understand more and accepting of the condition. You’ll get great tips on how to live a good life with a stoma.

What to Expect after Surgery

After surgery, if you were like me, you’ll feel very heavy and tight around your abdomen and you’ll also feel a lot of pain, and feel extremely weak. You will be on intravenous pain relievers that will help the pain reduce to the barest minimum.

You will soon be aware of a colostomy bag stuck to your abdomen. Depending on your physical and mental condition; your doctor will carefully explain your current condition and tell you what to expect.

For the first few days, you won’t be able to stand on your own two feet and it’s virtually impossible to take a shower. You will be towel-washed by the nurses and you will have to contend with some discomfort.

At first, your stoma will not function and because you haven’t started to eat solid foods, you won’t pass out waste through the newly installed stoma. As a post-surgery patient, you will not be allowed to eat or drink anything until the stoma starts to function.

When your stoma starts to function varies from one patient to another but in my case, it took about a week. Peristalsis (involuntary constriction and relaxation of the muscles of the intestine) must be confirmed through auscultation (listening to sounds with a stethoscope) of the patient's stomach for intestinal movements.

As soon as intestinal movement is ascertained, you can start to ‘eat’ your first meal which will be clear liquids. It soon progresses to eating softer foods like broths.

A couple of days after colostomy surgery, once conditions are favorable, you will be encouraged to sit up in bed though you will have to be lifted up (you can't do this simple task on your own) to achieve this. Depending on your strength and willpower, you will be encouraged to try standing up unaided. Soon enough, you should be able to take a few steps, aided by a nurse.

It is very important to start this early process as it encourages early healing and a faster recovery.

Post-Surgery Monitoring

After surgery, you will be checked and observed constantly for any signs or symptoms of complications. You will be closely monitored for signs of infection which may indicate an internal leak of waste into your stomach. Tests will also be carried out to ensure that your recovery is normal and acceptable. There will be very frequent checks for vital signs too.

You will be encouraged to cough lightly without putting any stress on your waist/abdomen, move around often (very important), and take deep breaths frequently. These activities help a long way in preventing complications from setting in.

There may be some bleeding from your stoma which will be evident when you start to change your colostomy bag but this will be closely monitored so, any sign of increased bleeding will be investigated and promptly treated.

Most colostomy patients are always concerned about if and when their stoma will start to work and will be just as anxious as the doctor and nurses. Once your stoma starts to work, it is a great step towards a full recovery.

How Long Does it Take to Fully Recover?

It usually takes between two to six weeks to fully recover after surgery but the exact time depends on the type of operation they performed on you, whether ascending transverse or descending colostomy surgery. However, it also depends on whether you have other medical conditions, your determination, and your attitude, and whether or not you have post-surgery complications.

For the first couple of weeks, after you get home, your Stoma Nurse will pay you visits. He/she will dress your wounds if you have any and continue to tutor you on how to use your colostomy bags and the other stoma supplies.

Accepting your condition is the first bold step towards your full recovery and it will help you better if you accept your condition as a challenge. Millions of colostomy patients manage their stomas well and so can you. Think about it this way, with your procedure, you’ve been offered a new lease on life.

There is no reason why you can't live a wonderful fun filled life with a colostomy and once you have passed the acceptance stage and have become adept at stoma management, it will be a new beginning.

© 2010 Alobeda

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