What are the cons of a colostomy ???

[NW-Will]

Everyone who gets one seems to sing the praises of it.

Why doens't everyone get one?

What are the cons ?

Anyone get one and wished they hadn't ?

Thanks

[SCI-Nurse]

Years ago we were concerned with the negative impact a colostomy might have on body image and self esteem in people with SCI/D who already faced challenges with this. Then, in the 1990s several research studies were done (primarily at the VA SCI Center at Palo Alto) about patients who had had "temporary" diverting colostomies for management of pressure injures and flaps. Their findings were that the opposite was the case; few if any patients opted to have the colostomy reversed after their wounds healed, and many expressed delight with how little of their day was now dedicated to doing bowel care and managing accidents. After this, we started offering elective colostomy to those who had particularly difficult bowel care issues and were spending prolonged times on doing bowel care, or who were not able to get a bowel program established that prevented most accidents.

That being said, it is a surgery, which comes with the usual possible complications of anesthesia side effects, infection, and blood loss. I had one patient whose surgeon made an error and instead of hooking the proximal bowel up to the stoma, only hooked up the distal bowel and the patient developed peritonitis from the proximal bowel dumping stool into his abdominal cavity, but this was a very rare occurrence.

There is a small percentage risk of developing diversion colitis in the distal colon that is left in place. Reversing the colostomy back to normal is usually required if this is severe.

There is risk of skin breakdown around your stoma if skin care is not done properly or you have an ill-fitting appliance. Working closely with your ostomy nurse can help prevent or manage this. The same applies to a lot of gas formation.

There is always a small risk of having a "blow out" or the appliance dislodging from your body cause stool to soil your clothing or bedding.

Depending on the technique that the surgeon uses, many colostomies can be reversed surgically if you don't like the results.

(KLD)

[SLIQNES]

I'm currently on bed rest recovering from a flap surgery I wish someone would have mentioned this to me I would have loved to try it, how long does the surgery and recovery take?

[SCI-Nurse]

It depends on the type you have. If you are a candidate for laparoscopic it can often be done with a 1-3 night stay in the hospital. If you require an open surgery, it is more like a week. You should always see a good ostomy nurse prior to the procedure as well. (KLD)

[beckman]

Good summary of the risks. Blow outs are ugly at least for me as a quad but I didn’t have any until recurrent c.diff seemed to leave me with long term colon irritation. And I’m also one of the lucky ones with diversion colitis.
But prior to the c.diff I was happy with my decision to have the colostomy (reason aging quad and severe hemerhoids)

[vjls]

no as a quad its has improved my life and diginity . also a lot easier to get a caregiver. i just wish they had told me about when i left rehab to come home i heard about on here, i could not have gone down the colorado slept on the banks of river for a week if i had not had one

[HACKNSACK44]

I'm a c3c4 quad injured 32 years ago got my colostomy 8 years ago. Best decision I have ever made! I control my life now not my bowel routine. I missed out on so much. I with I would have gotten it right away.

[pete4sake]

Years ago we were concerned with the negative impact a colostomy might have on body image and self esteem in people with SCI/D who already faced challenges with this. Then, in the 1990s several research studies were done (primarily at the VA SCI Center at Palo Alto) about patients who had had "temporary" diverting colostomies for management of pressure injures and flaps. Their findings were that the opposite was the case; few if any patients opted to have the colostomy reversed after their wounds healed, and many expressed delight with how little of their day was now dedicated to doing bowel care and managing accidents. After this, we started offering elective colostomy to those who had particularly difficult bowel care issues and were spending prolonged times on doing bowel care, or who were not able to get a bowel program established that prevented most accidents.

That being said, it is a surgery, which comes with the usual possible complications of anesthesia side effects, infection, and blood loss. I had one patient whose surgeon made an error and instead of hooking the proximal bowel up to the stoma, only hooked up the distal bowel and the patient developed peritonitis from the proximal bowel dumping stool into his abdominal cavity, but this was a very rare occurrence.

There is a small percentage risk of developing diversion colitis in the distal colon that is left in place. Reversing the colostomy back to normal is usually required if this is severe.

There is risk of skin breakdown around your stoma if skin care is not done properly or you have an ill-fitting appliance. Working closely with your ostomy nurse can help prevent or manage this. The same applies to a lot of gas formation.

There is always a small risk of having a "blow out" or the appliance dislodging from your body cause stool to soil your clothing or bedding.

Depending on the technique that the surgeon uses, many colostomies can be reversed surgically if you don't like the results.

(KLD)

Thanks for the info. Here is my dilemma
My ischial wound is on left cheek. I will be having flap surgery in ( 1to 2 months) I have basically exhausted possibilities of finding acute care.
Even the most connected people in the industry say these are unprecedented times in terms of finding care especially quality care in any type of facility. Even the odds of being placed in a random nursing home without training in wound care are slim as they simply are not taking any patients so we are making preparations to get an acceptable bed and mostly recover at home.Unless I get lucky to get a acute care spot in another state. Without being able to lay on my left side I just don’t see any realistic options other than getting a colostomy asap.
This would be a lot easier decision if I was having problems with my bowel program but it’s been going well for quite some time other than recent hiccups with the wound vac leaking while doing digital stimulation. Now I can certainly see upsides and downsides of colostomy.

My biggest concerns are I have sensitive skin and it can get raw in a hurry even from tape or something like a pic line bandage.

I am now basically 100% continent so even an occasional blowout will be more than I have to deal with now. I am 36 years in and it hasn’t always been this way so I guess my luck could run out at any time.
Back to the flap home are is scarce and my wife works full time and then some and although she is willing to try I can’t ask that much of her

So I am going to try arrange a meeting with ostomy nurse this week.
As always any input is appreciated

[SLIQNES]

I'm a c3c4 quad injured 32 years ago got my colostomy 8 years ago. Best decision I have ever made! I control my life now not my bowel routine. I missed out on so much. I with I would have gotten it right away.

Is there an odor? How do you deal with gas?

[quadvet]

They have deodorizer drops you put in the pouch when you put on a new one. It works really good to eliminate the smell. Some pouches have a vent with a charcoal filter to release gas. Works good

[HACKNSACK44]

Is there an odor? How do you deal with gas?

The bags I use have a filter on them so odor isn't an issue. As far as gas goes not much you can do about that except watch what you eat.

[SCI-Nurse]

There are deodorant discs and drops and some you can vent when it needs it and if possible a private place. Diet helps to control the gas and the smell. Those who have gotten a colostomy after numerous years of trying other bowel programs always seem to feel happy about the time they save and their quality of life. CWO