Learning Objectives

Upon completion of this Journal Club the participant will be able to:
1. Identify the most common type of colostomy
2. Describe potential complications of colostomies
3. Describe the basic steps of colostomy care

Background Information

An ostomy may be required if there is trauma, disease, or other blocks to normal flow and elimination of waste products through the urinary or gastrointestinal tract. Examples of conditions that lead to colostomies are bowel cancer, Crohn’s disease, or congenital anomalies. Preoperative care and education are important features to support ostomy placement and care.

Ostomies or stomas are surgically created openings that divert the urinary or gastrointestinal tract through the skin for the purposes of eliminating waste products. Ostomies can be categorized as continent or incontinent. A continent ostomy is connected to a sphincter that regulates waste elimination. An incontinent ostomy has no sphincter and requires a pouch to collect and eliminate waste products.

Generally, colostomies are the most commonly performed ostomy procedure. Examples of colostomies include the double-barrel colostomy, loop colostomy, and sigmoid colostomy. The double-barrel colostomy is temporary and allows both the passage of waste and drainage of mucus. The loop colostomy diverts the pathway around an injured, diseased or blocked part of the colon to the skin surface. It is also considered temporary.

Colostomies may be located in the ascending, transverse, descending, or sigmoid colon. It is usually necessitated by cancer or other bowel disease. A colostomy in the ascending colon is rare and an ileostomy may be favored when this section of the colon is affected. If the ostomy is placed in the ascending colon, it will be located on the right side of the abdomen and will result in mostly liquid waste removal.

A transverse colon-placed colostomy may be temporary as a loop or double-barrel colostomy. It is located on the right or left side of the abdomen in the middle or upper quadrant. This type of colostomy may be required in the case of cancer, diverticulitis, or trauma in the transverse colon. Waste products range from thick liquid to semi-formed feces.