From the Guidelines
A patient with a colostomy can still pass stool through the rectum, depending on the type of colostomy they have, as noted in the 2023 study by 1. This is because the type of colostomy created determines whether the distal portion of the bowel remains connected and functional. With certain types of colostomies, such as loop or double-barrel colostomy, where only part of the colon is diverted, stool can continue to travel through the distal portion of the bowel and exit through the rectum. Similarly, with an end-loop colostomy, some stool may pass into the distal segment. However, with an end colostomy where the distal bowel is completely disconnected or removed, no stool will pass through the rectum. Some key points to consider include:
- The type of colostomy created, as this determines the potential for stool to pass through the rectum, as discussed in the study by 1.
- The potential for rectal discharge, ranging from formed stool to mucus, in patients with partial diversions, which is a normal and expected outcome, as noted in the context of managing ostomies by 1.
- The importance of informing patients about this possibility to prevent unnecessary concern, and the potential need for them to continue using toilet paper or pads for rectal discharge even after colostomy placement. It's also worth noting that enteral ostomies, including colostomies, are common in the management of patients with gastrointestinal conditions, and adequate stomal care improves clinical outcomes and reduces hospitalizations, as highlighted by 1.
From the Research
Colostomy and Stool Passage
- A patient with a colostomy may still experience stool passage per rectum, depending on the type of colostomy and the underlying condition being treated 2.
- In some cases, a diverting loop colostomy may be used to treat conditions such as radiation proctitis, where fecal stream diversion can help decrease bowel irritation and reduce rectal bleeding 2.
- However, the provided studies do not directly address the frequency or likelihood of stool passage per rectum in patients with a colostomy 3, 4.
Types of Colostomy
- There are different types of colostomies, including loop colostomy and end colostomy, each with its own indications and effects on bowel function 2.
- The type of colostomy performed may influence the likelihood of stool passage per rectum, but this is not explicitly stated in the provided studies 3, 4.
Complications and Management
- Patients with a colostomy may experience various complications, including peristomal skin complications, retraction, stomal necrosis, and dehydration from high ostomy output 3.
- Management of these complications is crucial to prevent morbidity and improve patient outcomes, but the relationship between colostomy and stool passage per rectum is not fully explored in the provided studies 3, 4.