What is Colostomy Surgery?
Colostomy surgery is a procedure where a section of the bowel is diverted to an opening in the abdomen, called a stoma. This allows waste (poo) to leave the body into a colostomy bag, bypassing damaged or blocked parts of the digestive system downstream. In children, colostomy surgery is often performed to treat serious conditions affecting the bowel or rectum, such as anorectal malformation or Hirschsprung disease.
Depending on the underlying condition, a colostomy may be temporary or rarely permanent. Most children require a temporary colostomy to allow healing or prepare for additional surgery to restore normal bowel function.
Why Might a Child Need Colostomy Surgery?
Colostomy surgery is typically recommended when a child’s lower digestive system is not functioning properly due to structural issues, injury, or disease. Common reasons for colostomy surgery in children include:
- Anorectal Malformation: A birth defect affecting the anus or rectum, requiring a temporary colostomy to manage waste while preparing for corrective surgery.
- Hirschsprung Disease: A condition where part of the bowel lacks the nerve cells needed to move stool effectively, leading to a blockage.
- Bowel Obstruction: A severe blockage that prevents waste from passing through the digestive tract.
- Trauma or Infection: Significant damage or infection to the bowel may require a colostomy to protect the affected area.
Your paediatric surgeon will explain why colostomy surgery is the best option for your child and discuss what to expect during the procedure.
Types of Colostomy Surgery
There are two main types of colostomies performed in children, depending on their condition:
- Temporary Colostomy: This is the most common type of colostomy for children. It allows the digestive system to heal or provides time for corrective surgery to be performed.
- Permanent Colostomy: Rare in children, this may be necessary if the bowel cannot be repaired or restored to normal function.
What Happens During Colostomy Surgery?
Colostomy surgery is performed under general anaesthesia, meaning your child will be asleep and won’t feel anything during the procedure. The steps of the surgery include:
- Making an incision in the abdomen.
- Creating a stoma by bringing a portion of the bowel to the surface.
- Securing the stoma to the skin.
- Applying a dressing or a bag over the stoma.
Depending on your child’s condition, the surgery may take 1-2 hours. Your paediatric surgeon will provide detailed information about the procedure beforehand.
What to Expect After Colostomy Surgery
After surgery, your child will need time to recover in the hospital. Here’s what to expect:
Hospital Recovery
- Your child will receive pain relief and antibiotics through an intravenous (IV) drip to prevent infection.
- Fluids and nutrients may be provided via IV until your child can eat and drink normally again.
- Most children stay in the hospital for a few days, but the exact length will depend on their condition and overall health.
Adjusting to the Colostomy
- A colostomy bag will be placed over the stoma to collect waste. Your healthcare team will teach you how to care for the stoma and change the bag.
- Initially, the stoma may appear swollen, but this will reduce over time.
Caring for Your Child at Home
Once your child is discharged, you’ll receive guidance on caring for their colostomy at home. We often work with the team at Children’s Nursing Queensland for pre and post operative care. There may be a fee for this service.
- Stoma Care: Keep the stoma clean and dry. Use the recommended products to prevent irritation.
- Colostomy Bag Maintenance: Empty and change the bag as instructed by your healthcare team.
- Dietary Adjustments: Your child can usually eat a normal diet, but some foods may need to be avoided initially to prevent irritation or blockages.
Your surgeon will provide specific aftercare instructions tailored to your child’s needs.
Possible Complications After Colostomy Surgery
While colostomy surgery is generally safe, there are potential complications to be aware of:
- Stoma Irritation or Infection: Redness, swelling, or discharge around the stoma may indicate irritation or infection.
- Prolapse: The stoma can protrude outwards. This can be painful and may require you to come to the emergency department if it becomes dark.
- Skin Issues: Prolonged contact with stool can cause skin irritation.
- Blockages: A blockage at the stoma can lead to swelling, discomfort, and reduced output (as in less poo coming into the bag).
- Colostomy Bag Leaks: Improper placement or size can cause leaks.
If you notice any concerning symptoms, contact your surgeon or healthcare provider immediately.
Will My Child’s Colostomy Be Reversed?
In most cases, a colostomy is temporary and can be reversed once the underlying condition is treated. Often this is within a few months. Colostomy reversal surgery reconnects the bowel, allowing normal bowel motions to pass through the anus. Your surgeon will monitor your child’s progress and advise on the best timing for a reversal.
When to Contact Your Surgeon
Seek medical attention if your child experiences any of the following:
- Persistent redness, swelling, or bleeding around the stoma.
- Fever above 38.5°C.
- Signs of a blockage, such as no waste output or abdominal pain.
- The stoma prolapses and becomes dark / dusky / painful.
- Leaking or poorly fitting colostomy bags.
Related Information
For more details on conditions that may require colostomy surgery, visit our Anorectal Malformation in Children page.