Colostomy surgery is a major operation, and will require a hospital day of at least several days and six weeks or more of recovery at home.
The Days Before SurgeryYou will receive instructions from your surgeon on how to prepare in the days leading up to your surgery. If you are taking other medications, your surgeon may ask you to contact the prescribing physician for instructions on either continuing, discontinuing or adjusting the dose of drugs during your surgery and convalescence. It is important to make the surgeon aware of all medications as some may inhibit the healing process (such as prednisone) or interact with other drugs.
You also may need to have certain routine examinations prior to your surgery such as a physical and a chest x-ray. You should also meet with an enterostomal therapy (ET) nurse. An ET nurse will teach you how to take care of your ostomy. In the initial meeting, you may discuss where your stoma will be placed on your abdomen, what kind of supplies you will need immediately after surgery, and how to best fit your ostomy into your lifestyle.
Colostomy surgery will often require a bowel prep to clean out the colon. In the day or two prior to surgery, you will follow your surgeon's instructions to remove all stool from your bowel, much as if you were preparing for a colonoscopy. This may be accomplished through fasting, enemas, laxatives, any of the standard bowel preps such as GoLytely or Phospho Soda, or a combination of these. You may also be asked to take antibiotics or other medications to prevent infections prior to, during, and after the surgery.
The SurgeryDirectly before surgery you will receive an IV to receive fluids and anesthetic. The surgery itself will last several hours. When you awaken, a colostomy bag will be attached to your abdomen over your new stoma, and you may also have one or more drainage tubes. After some time in recovery, you will be moved to your hospital room when the doctor determines that your vital signs (pulse, blood pressure, respiration, etc.) are stable.
Hospital StayFor the first few days after surgery you will continue to receive pain medication through your IV. You will not receive any food until the doctors hear the bowel sounds from your abdomen that indicates your intestines are "waking up." Your nurses may get you out of bed and standing or sitting in a chair a few days after surgery, depending on your condition. Standing and walking as soon as possible is very important to the recovery process, even though it will be uncomfortable at first.
After the doctor hears bowel sounds and the stoma begins to function, you may be given some clear liquids to eat such as broth, gelatin, and juice. If the clear fluids are tolerated well, your doctor will let the staff know that your diet can progress to full liquids or solid food.
Your ET nurse may visit you before you leave the hospital to help you learn more about taking care of your stoma and changing your ostomy bag. You will also want to know where you can obtain your colostomy supplies and any special instructions about your ostomy.
Recovery at HomeRecovery at home is generally about six weeks, although it may be longer for patients who are very ill before surgery or who have complications. Activity will be restricted at first, and lifting, housework, and driving are not recommended. The hospital staff will advise you about your diet when you first get home, which may be restricted to low fiber. Regular appointments with your surgeon will help ensure that your abdomen and the area around the stoma are healing well.
You will be learning to take care of your stoma during the first few weeks of recovery. Your ET nurse will answer any questions, and may help you with your first few bag changes.
Your doctor will let you know when you are ready to resume your regular activities at work, school or home. If your colostomy is going to be reversed, your surgeon will help you decide when that is possible based on your recovery as well as your own schedule.
National Institute of Diabetes and Digestive and Kidney Diseases. "Ileostomy, Colostomy, and Ileoanal Reservoir Surgery." National Digestive Diseases Information Clearinghouse Apr 2003. 28 Jul 2007.
McKesson Provider Technologies. "Colostomy and Ileostomy." University of Michigan Health System. 11 Nov 2006. 28 Jul 2007.
United Ostomy Association of America, Inc. "Frequently Asked Questions Following Ostomy Surgery." UOAA 2007. 28 Jul 2007.