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Colostomy
Colostomy is performed much less commonly than in the past, largely because of improved surgical techniques. But some patients, particularly those whose tumor is very low in the rectum, may require a permanent colostomy. This operation typically is performed when the rectal cancer invades too close to the anal sphincter muscles, requiring removal of the anus. To allow wastes to leave the body, the surgeon creates an opening in the abdomen, called a stoma. The wastes are collected in a special bag that adheres to the skin and covers the stoma. Because there is no sphincter muscle, the timing of bowel movements isn't controllable the way it was before surgery. Patients can achieve some measure of control over the timing of a bowel movement, however, by regularly irrigating, or flushing fluid into, the stoma once every day or two.
After a brief period, most patients can adjust well to a colostomy. Nurses and experts known as enterostomal therapists can help with the transition by teaching patients how to care for their colostomy as well as guiding them in their return to normal activities.
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