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Colostomy Creation

WHAT YOU NEED TO KNOW:

A colostomy creation is surgery that brings part of your colon (bowel) to the surface of your abdomen. This creates a small opening in your abdomen called a stoma. Bowel movements pass through the stoma into a pouch that is attached to your abdomen.


HOW TO PREPARE:

The week before your surgery:

  • Tell your caregiver if you know or think you might be pregnant.
  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  • Ask your healthcare provider if you need to stop using blood thinners, aspirin, or any other prescribed or over-the-counter medicine before surgery.
  • You may need tests before surgery, such as blood and urine tests, a 12-lead ECG, and a chest x-ray. Ask your healthcare provider for more information about these and other tests that you may need. Write down the date, time, and location of each test.
  • Healthcare providers will talk with you about the lifestyle changes that happen with a colostomy. They may help you meet with other people who have colostomies. They may tell how to adapt your diet, bathing, and other activities to a stoma. Write down any questions you may have so you will remember to ask them at your visits. Bring a family member or friend with you so they can learn how to help you.

One to 2 days before your surgery:

  • Healthcare providers will tell you to stop eating solid foods for 1 to 2 days before surgery. This helps empty your colon before surgery. Ask your healthcare providers when you need to stop eating or drinking before your surgery.
  • A healthcare provider will talk with you about the best place for your stoma. A pen or a small disk is used to mark the stoma site on your abdomen. The healthcare provider will ask you to sit, lie down, stand, and bend. This helps your healthcare provider position the stoma to prevent leaks and skin problems. It will also help your stoma better fit your clothes and ostomy bag.
  • You may be given antibiotics to help prevent infection.

The night before your surgery:

  • Colon cleansing: The colon must be empty before surgery to prevent infection. You may be given an enema or medicine. An enema is a liquid that is put inside your rectum to help empty your colon. The medicine is given as a drink or as pills.

The day of your surgery:

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  • Ask your healthcare provider before you take any medicine on the day of your surgery. Bring your pill bottles or a list of your medicines with you to the hospital.
  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  • Antibiotics: You may be given antibiotics before surgery to help prevent infection.
  • Anesthesia: An anesthesiologist may talk to you before surgery. This healthcare provider may give you medicine to make you sleepy before your surgery. You will be given medicine to keep you asleep and free from pain during surgery. Tell your healthcare provider if you or anyone in your family has had a problem with anesthesia in the past.

WHAT WILL HAPPEN:

What will happen:

  • You will lie on your back. Your feet may be in stirrups. If you are having an open surgery, your healthcare provider will make 1 long incision in the middle of your abdomen. During laparoscopic surgery, 3 to 4 small incisions are made on your abdomen. The laparoscopic tools are placed inside the incisions, and your abdomen is filled with carbon dioxide (a gas). The gas lifts the abdominal muscles away from the colon and other organs during surgery. Your healthcare provider will cut through the muscles in your abdomen to the colon. He will carefully check your colon for disease or injury.
  • Your healthcare provider will cut your colon into 2 or more parts. Diseased or injured parts of your colon may be removed. One end of your colon will be pushed through an opening on your abdomen. The end will be stitched to the skin on your abdomen to create a stoma. The other part of your colon may be stitched closed or a second stoma will be made. You may have a rod placed under the stoma to keep it above your skin if the colostomy has 2 openings. The other incisions are closed with stitches or staples. Your healthcare provider will attach a pouch around your stoma to collect fluids and bandage your incisions.

After your surgery:

  • You will be taken to a recovery room where healthcare providers will watch you until you are alert. You will then be taken to your room. You will have bandages over your wounds to help prevent infection. Do not get out of bed until your healthcare provider says it is okay.

CONTACT YOUR HEALTHCARE PROVIDER IF:

  • You have a fever.
  • You have questions or concerns about your surgery, medicine, or care.

Seek Care Immediately if

  • You are urinating very little or not at all.
  • You have nausea or vomiting.
  • Your abdomen feels hard and tender.
  • You vomit blood or see blood in your bowel movements (BMs). The BMs may look like tar.

Risks

  • The condition that led to your colostomy may come back, even with treatment. You may get an infection or bleed more than expected. You may get a blood clot in your arm or leg. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
  • Surgery may damage nerves or other organs. Your stoma may narrow, become blocked, or move too far outside or inside your abdomen. You may develop a hernia (weakness in the muscles in your abdomen). Sometimes your stoma tissue does not get enough blood and the tissue may die. A colon incision may come apart or leak bowel movement fluid into your abdomen. This can cause a life-threatening infection. More surgery and other treatments are needed right away to correct these problems.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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