What to Know Before a Colostomy

What do you tell a patient facing a colostomy?

Well first of all, there's low colostomies, and these low colostomies can be, the patient can almost train them, they can irrigate every day, and nothing comes out then during the day, so it's not like it's smelly or a problem. And I've had patients where they just put a little band-aid over it and live very normal lives.

So I think the concept of colostomy is not as bad as it usually is. In some patients, where there is an emergency operation and then they put a colostomy right in the middle of the abdomen and there is stool coming out, it is a miserable thing. But, that's not the usual situation for a colostomy, or shouldn't be the usual situation.

In places where the surgery is done correctly, that type of colostomy should not be done unless it's being done to protect the anastomosis, which means where they are putting back the two pieces of bowel, so they are protecting that with a colostomy up higher with the hope that in the future, they will close that colostomy. So that's the only reason to use one of those high colostomies really.

So this sounds like something that patients need to be aware of, so that they can discuss that with their doctor?

Yes. Because remember it's very low, and to do it correctly and to preserve the nerves, because there are nerves there to the sexual organs and other nerves that they want to preserve is done better in certain big institutions and by certain very well known surgeons. So rectal surgery is an art, and should be done by physicians that are very familiar with it. And there are studies, more in Europe, than in the states that show the results really depend on who is doing the surgery, so on surgeons who just do one rectal cancer a year or something, verses a surgeon who does 50 a year, the results are much better in the one who does 50 a year. I mean the outcome is much better.