Anal leakage with sigmoid colostomy

I have an elective sigmoid colostomy scheduled in 2 weeks. I plan to keep the last foot of colon. Will there be anal leakage (due to mucous build-up)? How often? It is a concern to me because I am quadriplegic and won't be able to feel it, and need help dealing with it (want to avoid accidents).

Would leakage be prevented if we removed the last foot of colon? Would the procedure then still be reversible?

How different is the anal leakage issue with a sigmoid colostomy, versus an ileostomy? It seems like most folks here have an ileostomy, and I'm surprised they have the same problem.

Hello Davey,

For the past 3 years, I have an ileostomy, along with my rectal stump to be connected again sometime in the future.

Not certain from your post if your keeping your rectum. I think that that's what you are referring to by stating the last foot.

The rectum is what produces mucous. Just this past July, I was scoped there. There is inflammation which looks like puss-like striations throughout. It's called disuse proctitis. On some days, I have urges to use the bathroom, just like a bowel movement, to expel the mucous. It doesn't leak out, you do have to lightly strain to expel. You will have control over it. But being quadriplegic, this might be a concern to have bowel function. If you have control now, you will afterwards. Mucous does have an odor, and sometimes there is blood which is normal. If not expelled, an episode like this will produce pain, and take about 15-20 minutes to get over it. It is intermittent....ranging to a couple times a month, couple times a week, and sometimes everytime I urinate. Also the discharge range varies.

Is the colostomy permanent? If so, I'd discuss why the rectum is staying. You asked about if the procedure would afterwards be reversible if once removed and the answer is no.

Just a personal note about a permanent ostomy, I have an uncle that is in a wheelchair due to a stroke, and my surgeon has done several bowel surgeries for quadriplegic's. They actually prefer the 'bag' because it's made daily life easier.

Discuss your concerns with your surgeon and his wound nurse. Wishing you my best!

I think this is different for everyone. I had a total proctocolectomy with permanent ileostomy about 10 months ago. Typically during this procedure everything is removed and one is sewn up "back there". My surgeon opted to not do that with me, fearing I was much too sick to recover from all of that surgery at once. So, I was left with an anal stump. All the rectum was taken out, and the anus was stapled off at the top. I have had mucous every day since surgery, almost every time I urinate. Lately I'll even get uncomfortable feelings of fullness and urgency, like I really have to go, but clearly I don't...just mucous! And yes, once in a blue moon, it does just leak out...especially when I'm sleeping. Good luck with everything!

ActiveUCer said...
Are you having anything removed or are things just being disconnected for awhile (hence the need for the colostomy)?

If things are just being disconnected for awhile, then it's best that you keep things as intact as possible. The further down they remove the colon, the harder the surgery is.

Nothing is being removed. Things are being disconnected, probably permanently, as a way to manage my bowels better as a quadriplegic. The parts work now, but it is too time consuming, and has to be done twice a day, with nursing help.

The surgeon normally does a transverse colostomy on quadriplegics/paraplegics to get a pastier output and reduce likelihood of blockage. He removes 2.5 feet of colon in that case, to reduce mucous. But I told the surgeon I want to disconnect as low as possible on the sigmoid colon to get more fluid absorption and firmer output for easier cleanup and fewer skin problems. I also hope to irrigate regularly (with a nurse's help), and rarely have to change bags. He said he could go as low as 1 foot from the end.

My plan has been to keep things as intact as possible, but wanted to know if that means more mucous. The answer seems to be "Not necessarily" -- that I will probably be dealing with mucous in any case.

My next question will be about the likelihood of blockage.

Thank you all for such helpful replies!

Post Edited (daveyBoBaby) : 1/15/2014 11:44:25 PM (GMT-7)