Colostomy, a life-saving yet lifestyle-changing surgery is performed on 7,00,000 individuals each year, according to the American Cancer Society. This figure includes individuals undergoing colostomy as part of their treatment for conditions such as colorectal cancer, inflammatory bowel disease, diverticulitis, trauma, or congenital anomalies affecting the colon or rectum.

However, one biggest concern of every individual remains the same that is what happened to my anus after the colostomy? Do they sew up the anus after colostomy?

Well, the answer is pretty much nuance as it depends upon various factors such as the specific type of colostomy and the individual’s underlying medical condition.

Here you will find answers to all your questions regarding your anus after colostomy surgery including what will happen to it and how it will be managed.

COLOSTOMY

A colostomy is a surgical procedure that changes the natural path of your stool elimination. Rather than exiting through your anus, it is redirected through a newly created opening in your abdomen known as a stoma. Individuals who undergo this surgery may require the use of a specialized pouch, known as a colostomy bag, to collect the stool. Depending on the individual’s medical needs colostomy can be either temporary( 3 to 6 months) or permanent.

THE STOMA

In the Greek language, Stoma means mouth or oral cavity. It is a hole created surgically in your abdomen by bringing out a small piece of bowel outside the abdomen by creating a small incision in the abdominal wall. The size and location of the stoma varies depending upon the individual. In ileostomy, part of the small intestine called the ileum is brought outside the abdominal wall whereas, in colostomy, a part of the large intestine is brought outside the abdominal wall. However, in both procedures, bodily waste has to pass through the stoma.

REASONS FOR COLOSTOMY:

Colorectal cancer: When cancer cells have grown in your colon and surgical; intervention is required to remove the cancerous part of the colon. In such conditions, a colostomy is performed. The purpose of a colostomy in this case is to effectively manage the disease by redirecting waste through the stoma.
Inflammatory bowel disease (IBD): Conditions like Crohn’s disease or ulcerative colitis might necessitate a colostomy. The objective here is to divert stool away from inflamed or diseased areas of the colon.
Trauma or injury: Severe colon injuries, such as perforations or trauma-induced damage, may call for a colostomy. The goal of colostomy in such cases is to aid the healing process of the affected area by allowing waste to bypass it during recovery.

WHAT HAPPENS TO YOUR ANUS AFTER COLOSTOMY SURGERY?

Nearly all of the ostomates experience mucus discharge after colostomy surgery. This mucus is already present in the wall of the bowel and its purpose is to lubricate the lining of the bowel so that stool can move easily across the bowel. However, after colostomy, the rectum no longer holds the stoll, but it still makes mucus which discharges from the anus after colostomy surgery. It is because of this mucus that ostomates feel the urge to go to the washroom.

There is a possibility that mucus sometimes dries up and forms a ball inside the rectum which leads to discomfort and pain. In order to avoid such complications, it is often advisable to sew up the anus, especially in case of a permanent colostomy.

DO THEY REALLY SEW UP YOUR ANUS AFTER COLOSTOMY?

Well, the answer to your question is YES, they really do sew your anus. The medical terminology is Abdominoperineal Resection. This is the type of surgery which is often performed to remove cancer that is situated lower in the rectum or anus. In this surgery, the rectum is removed and the anus is closed permanently. The end of the intestine is attached to an opening in the surface of the abdomen and body waste is collected in a disposable bag outside the body called a colostomy bag.

This surgery is performed in two ways. The first one is the traditional method of opening up the abdomen above your navel down in a straight line. This is called open surgery in which anus is also removed and permanently stitched up. the wounds will take 2 weeks to heal up.

Another way to perform this surgery is via laparoscopy which is minimally invasive surgery.

Abdominoperineal resection is the last treatment option for colorectal cancer.

However, in other disease states like inflammatory bowel disease, diverticulitis, or a condition when temporary colostomy is required, sewing up of anus is not at all recommended.

BENEFITS OF NOT CLOSING THE ANUS:

Closing the anus or sewing the anus is rarely necessary or advisable only in serious complications. Usually in temporary colostomy anus is not at all closed. Even though you will have discomfort due to continuous mucus discharge but your physician will never recommend permanent anas closure as there are many benefits of not closing anus.

Preservation of Anorectal Function: When the anus is intact there are high chances of restoring normal bowel continuity in the future. This can be achieved through surgical procedures like colostomy reversal.

Prevention of Complications: Closing the anus unnecessarily can sometimes lead to serious complications such as infection, abscess formation, or impaired healing. Chances of risk are almost zero when the anus is kept open.

Psychological Comfort: Many patients find psychological comfort in knowing that their natural anatomy remains, even after colostomy surgery. Indeed that is a big relief.

Conclusion:

In conclusion, the notion that the anus is sewn up after colostomy surgery is not a myth, it happens but only in case of serious colorectal cancer. In the case of temporary colostomy, Surgeons prioritize preserving anorectal function whenever possible, and complete closure of the anus is not a routine aspect of colostomy procedures. Ostomates should manage rectal discharge by using protective pads and by engaging in pelvic strengthening exercises that will strengthen the muscles responsible for controlling the leakage of mucus. Patients undergoing colostomy surgery should discuss their concerns and expectations regarding anus closure with their healthcare providers to ensure informed decision-making and optimal post-operative care.