Doctors' Answers to "Frequently Asked Questions" - Colostomy

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Internal colostomy
Question: Last year, after a lifetime of struggling with my colon, it was discovered that I had a megacolon. In November I had an internal colostomy leaving about a foot of colon. I had about 8 feet of "extraordinarily tortuous" colon. Now, I'm wishing they could have left a little more. I am extremely sensitive to what I eat, getting diarrhea easily. I have at least 7-8 bowel movements a day and more when I've eaten the wrong thing. I'm having trouble figuring out what to eat. I'm taking lots of vitamin supplements as it would seem I would be losing nutrients since food goes through me so fast. I'd like to find out more about managing this situation (having gone from 45 years with one extreme to another). Are there any solutions to slow this down? I take an Immodium with almost every meal. It helps a little. How can I find a good doctor to help me with this?

Answer: The colon's main function is to absorb water from your food. Failure to absorb the water leads to large volumes of loose stool and occasional dehydration. Agents to slow your colon may help. Fiber is the place to start. I'd discuss your problem with an Ostomy Nurse or a Colorectal Surgeon. They deal with these problems all the time. You shouldn't need additional Vitamins or calories if only your colon was removed. If any of your small intestine was removed, this alters things considerably.

Question: I have had a colostomy for 6 years and they say it is permanent. Is there any hope in the future that doctors could figure out a way to reverse it? Since doctors can do heart transplants and so forth, why is it so complicated to reverse colostomy?

Answer: It can be reversed if you still have an anus with enough colon to reanastamose the surgical stump. However, if your anus has been removed, or if there is insufficient stump to connect there is no way to reconnect the colon.

Question:My grandmother's doctor has described her problem as "adnoma of the colon" and has provided three options: 1. Daily milk of magnesia dosage and monthly follow-ups to check growth of mass 2. Colostomy 3. Surgical resectioning of colon which could end up being a colostomy. He feels that option 3 could be dangerous since he has described the process has being "grueling" - my grandmother is 93. Would you please define current processes for colostomy? To my concern, my grandmother is in New York and I'm in Oklahoma, and I'd like to know more about what she's up against.

Answer:An adenoma of the colon is a relatively common finding. These are the usual cell type found in polpys of the colon. If left unchecked, these will eventually grow into cancers. Once an adenoma has progressed to the point that it is blocking the colon it will usually turn out to be a cancer of the colon as well. Surgery in an elderly patient should not he undertaken lightly. However, her other health problems are probably more important than the abdominal surgery. That is, if she is active and relatively healthy, I'd proceed with surgery. The reason for this is that obstruction of the colon or intestines is a painful and grueling way to die. A rapid surgery should not be exceptionally risky. Also, there have been pioneering work in colon resection using laparascopic techniques. There are several research oriented surgical centers who could probably perform this type of surgery. Whether your grandma will need a colostomy depends on the size and position of the tumor/growth. More importantly, I'd leave this decision to your grandma-once she is in possession of the facts.
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