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Colostomy: Before Your Surgery

What is a colostomy?

Colostomy pouch

A colostomy is surgery to make an opening in the skin on the belly and connect your bowel (colon) to that opening. The opening is called a stoma.

After surgery, stool will no longer leave your body through your anus. It will go through the stoma and into a plastic bag. The bag is attached to the stoma.

The surgery can be done in two ways. In open surgery, the doctor makes one large cut (incision) in the belly. In laparoscopic surgery, the doctor makes several small incisions in the belly. Then he or she puts a thin, lighted tube and special surgical tools through the incisions. The tube is called a scope. It lets the doctor see your organs and do the surgery. In either surgery, the incisions leave scars. These will fade with time.

You may worry about life after this surgery. Many people with colostomies lead active, normal lives. It may help to know that the bags don't smell bad. They also don't show under clothes. Other people won't know that you have a colostomy unless you choose to tell them.

In the hospital, an ostomy nurse will help you learn to care for your colostomy. You will probably go home in 4 to 7 days. But it could take 6 weeks to fully recover.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines, vitamins, supplements, and herbal remedies you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
  • If you have an advance directive, let your doctor know. It may include a living will and a durable power of attorney for health care. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
  • The surgery will take about 2 to 4 hours.
  • You will have a colostomy bag attached to your stoma on your belly. Stool will leave your body through the stoma and go into the bag. Colostomy stool is softer and more liquid than normal stool.
  • After surgery, the bowel usually "rests" for a few days before it starts to work again.
  • You may have a thin plastic tube in your nose that goes into your stomach. It drains stomach juices and prevents nausea. The drainage usually looks green, brown, or even black with a bit of blood. This tube is usually removed after a few days. Then you can start to drink and eat again.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Current as of: May 22, 2013

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Care instructions adapted under license by Kaiser Permanente. This care instruction is for use with your licensed healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.


The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.

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