When your doctor tells you that you need to have a "colostomy," which means a pouch in your stomach, you may feel a great deal of fear and shock. That's very normal. But once you know exactly what this is, your fear will go away to a great extent. Especially the type we're talking about today, called a "loop colostomy," which is often only done temporarily . So let's talk about everything simply and clearly.
Simply put, what is a loop colostomy?
Imagine that a major road repair is being done, so the road is closed and a temporary detour is created for traffic. A loop colostomy is similar.
Simply put, a colostomy is a surgical procedure in which a section of your large intestine (colon) is cut and brought to the surface of the skin on your abdomen, creating an artificial opening. This opening is called a "stoma." From now on, your stool (stool) will come out through this stoma, and into a special bag attached to it, instead of coming out through your anus.
A loop colostomy is one way to do this. In this case, the doctor takes a loop of bowel out of the opening made in the abdomen, makes a small incision, and creates two openings. This is the most common type of colostomy. The biggest advantage of this is that it is usually temporary and it is easy to reconnect the bowel and remove the bag (reverse). So this is the method used when you need to give your bowel a little time to heal.
Why do you need to have this kind of surgery?
There are two main reasons for having a loop colostomy.
1. Diversion: Imagine that you have an injury, infection, or surgery in a part of your intestine. In order for that part to heal, you need to stop the passage of stool through it for a while. If you don't, the wound can become infected and the healing process can be delayed. So this surgery creates a path for stool to pass through from a previous site, giving that part a rest.
2. Decompression: Sometimes, an obstruction can occur somewhere in the intestine. This means that stool cannot pass through due to something like a tumor or blockage. Then, the pressure inside the intestine increases and it starts to swell. In such cases, when a stoma is created over the blocked area to temporarily allow stool to exit, that pressure is reduced and you get relief. Then, the doctor can treat the obstruction.
Some conditions that require this surgery:
- Diverticulitis
- Ulcerative colitis
- Crohn's disease
- Large bowel obstruction
- After surgery to remove part of the intestine (Partial colectomy)
- Severe anal injuries or infections
What is the difference between a loop and an end colostomy?
These are the two main types of colostomy surgery. See the table below to easily understand the difference between the two.
| Feature | Loop Colostomy | End Colostomy |
|---|---|---|
| Main objective | Giving the intestines a temporary break to heal. | Performed when the lower part of the intestine is permanently disabled or removed. |
| The ends of the intestine | Both ends of the intestine (the one that comes in through the stool and the one that comes in through the mucus) are located next to each other inside the stoma. | Only the upper end, where stool comes out, is brought out as a stoma. The lower end is sewn closed inside the body or removed completely. |
| Permanent/temporary? | Often temporary and reversible. | Often permanent . |
What happens before, during and after the surgery?
Being aware of this process will bring you great peace of mind.
Before surgery
Before the surgery, your doctor will talk to you about this in detail. He or she will explain how the surgery will be performed, what risks may occur, and what changes to your lifestyle will be required after the surgery. If you wish, you can also discuss pain medication at this time. You will be advised not to eat or drink anything for about 6 hours on the day of the surgery. You may also be given a bowel prep to clean out your intestines.
How the surgery is performed
This surgery is performed under general anesthesia. There are two ways to do this.
- Laparoscopic surgery: This involves making a few small incisions in the abdomen, rather than a large incision, and the surgery is performed with the help of a camera. This method is more comfortable for you and can help you recover faster.
- Open surgery: In an emergency or complicated situation, this surgery may have to be performed by opening the abdomen.
The doctor removes a loop of intestine from a previously marked area, attaches it to the skin, and creates the stoma.
After the surgery
Once you regain consciousness after surgery, you will need to stay in the hospital for a few days. During this time:
- Eating: First, give liquid food, then gradually introduce regular food.
- Colostomy care: A specially trained nurse (Wound Ostomy Continence Nurse - WOCN) will teach you everything from how to keep your stoma clean to how to change your bag.
- Pain control: When you leave the hospital, you will be given some painkillers to use at home.
- Stool: Stool will begin to come out of the stoma a few days after surgery.
When you first see the stoma, it may look large, red, and swollen. Don't be alarmed by that. As it heals, its appearance will change significantly, becoming pink and round.
What are the risks and complications of this surgery?
Like any surgery, there are some risks, such as allergies to the anesthesia and infection. However, there are also some complications that are specific to colostomy.
| Complication | Description |
|---|---|
| Skin irritation | The skin around the stoma can become red, itchy, and sore from contact with stool. This is a common problem. Using a properly fitting bag can help control this to a great extent. |
| Bowel obstruction | Stool may become blocked from coming out of the stoma due to scar tissue that forms after surgery or for other reasons. |
| Stoma retraction or prolapse | The stoma may sink in at the skin level or protrude unnecessarily. This may make it difficult to tighten the bag properly. |
| Hernia (Parastomal hernia) | The abdominal muscles around the stoma become weak, allowing parts of the intestine to protrude through it under the skin. There may be a lump near the stoma. |
Can I remove this bag and get back to normal?
Yes, you can! That's the biggest advantage of a loop colostomy. After your original condition has completely healed, your doctor will examine you, perform another operation to connect the two ends of your intestine, and close the stoma. This can take several weeks, months, or even years. It depends on your health.
When to see your doctor
You should always be aware of these symptoms. If you have any concerns, let your doctor or colostomy care nurse know right away.
- Persistent constipation or diarrhea.
- Persistent nausea or vomiting.
- Blood in the stool.
- A change in the normal size or color of the stoma.
- An unusual odor coming from the stoma.
- Complete cessation of stool output from the stoma.
A loop colostomy is a big change in your life. But remember, this is a very important, life-saving treatment that gives your bowel a chance to heal. Also, it is often temporary . With proper care and following your doctor's instructions, you can successfully manage this time and return to a normal life.
Take-Home Message
- A loop colostomy is a surgery, often temporary , that is done to help your bowel heal.
- Although this is a big life change, it can be managed well with proper training and awareness.
- Keeping the stoma and the skin around it clean is very important to prevent skin problems.
- Once your original condition has healed, you can have the colostomy removed through a second surgery and return to normal.
- Don't be afraid to talk to your doctor about any problems or discomfort you may have.
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