What Is a Colostomy?

If a surgeon has mentioned a colostomy to you, the word probably arrived with a picture in your head that is vaguer — and scarier — than the reality. So let's walk through what you would actually experience, step by step. A colostomy is an operation that creates an opening for the colon, the large intestine, through the wall of the abdomen. Instead of leaving the body the usual way, stool passes through that opening into a pouch worn on the skin. The short video above, "Colostomy Surgery," covers the essentials in a little over three minutes: what the operation creates, and why it may be temporary or permanent.

The opening itself has a name: the stoma

The visible part of a colostomy is the stoma — the end of the colon brought through the abdominal wall and turned back slightly on itself, a bit like the cuff of a sleeve. It sits on the surface of the tummy, usually low on one side, and the pouch fits over it. Because the bowel works on its own schedule rather than on request, output collects in the pouch through the day, and the pouch is emptied or changed as part of a routine you learn before you leave hospital. Where exactly the colon is divided shapes what the output is like: a stoma made from the last stretch of colon behaves differently from one made higher up, which is one reason the site's "Sigmoid Colostomy" video is worth watching alongside the main film — it follows that final segment specifically, in about three minutes.

Why a surgeon creates one

A colostomy is rarely the goal in itself; it is a way of giving the bowel a safer route while something else is dealt with. It is usually done after bowel surgery or injury — for example when a diseased or damaged section of colon has been removed, when the bowel below needs time and quiet to heal without stool passing through it, or when a blockage has to be relieved. Conditions further up this pathway, such as diverticulitis, are among the situations in which the conversation can arise. Your surgical team will explain which of these applies to you, because the reason matters for everything that follows.

Temporary detour, or a permanent change?

This is usually the first question people ask, and the honest answer is: it depends on why it was made. Some colostomies are planned as a detour — the bowel rests, heals, and is later reconnected in a second operation, after which the stoma is closed. Others are permanent, typically when the lower bowel or rectum has had to be removed or cannot safely be used again. If yours might be reversed, expect the team to talk in terms of healing first and timing second; reversal is an operation in its own right and is only considered once recovery is well established.

The first weeks at home

Expect a learning curve, and expect it to flatten. Stoma care nurses usually practise pouch changes with you before discharge, and those early sessions — measuring, fitting, emptying — are where confidence is built. Most people return to ordinary clothes, ordinary food (reintroduced gradually, as their team advises), work, and exercise once they have healed, with the pouch sitting discreetly under clothing. What deserves a prompt call to your team rather than patience: the stoma changing colour, output stopping altogether, persistent leaking that defeats a good fit, or increasing pain around the opening. Those are practical problems with practical fixes, and the team would rather hear early.

Frequently Asked Questions

Is a colostomy the same as an ileostomy?
No. Both create a stoma, but a colostomy is made from the colon (large intestine), while an ileostomy is made from the ileum, the last part of the small intestine. The position on the abdomen and the consistency of the output tend to differ between the two.

Does a colostomy hurt?
The stoma itself has no nerve supply of the kind that registers pain from touch, so the opening is not sore in itself. Soreness after the operation comes from the surgery and healing, and is managed as part of normal post-operative care — tell your team if pain is not settling.

Can a colostomy be reversed?
Some can, when the colostomy was created as a temporary detour and the bowel below has healed. Reversal is a further operation and is not suitable or necessary for everyone; whether it is an option, and when, is a decision your surgical team makes with you.

Will people be able to tell I have one?
Generally no. The pouch sits flat under ordinary clothing, and emptying or changing it is done privately in a bathroom, much like any other personal routine. Most people find it becomes unremarkable background within a few weeks.

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Educational only — this article is general information about colostomy, not medical advice and not a diagnosis. If you are facing bowel surgery or living with a stoma and have concerns, talk to your surgical team or stoma care nurse, who know your situation.