This is a part of the Hot Topic podcast series from the Model Systems Knowledge Translation Center on Managing Bowel Function After Spinal Cord Injury. Gianna Rodriguez, MD, researcher, discusses Colostomy as a Last Resort.

Gianna Rodriguez, M.D.

Asst. Professor, Dept. of Physical Medicine and Rehabilitation

University of Michigan

For a person with spinal cord injury where conservative measures fail such as use of, you know, bowel techniques and medications and they end up with frequent bowel obstructions, there are surgical options such as a colostomy. There are many risks involved in a surgical procedure for a colostomy and so therefore this is really reserved for people who are having major problems and issues with their bowels.

A colostomy is a diversion of a part of your colon which is typically the last part of your colon which is your sigmoid to the abdominal wall so that stools are passed through a bag. The terminal colon which is your sigmoid is typically what is chosen so that the stools that are passed through the bag are solid or formed. A person with a colostomy will still need medications to help move stools along their colon sufficiently and adequately and they still might need to do an enema now and again to clean out their rectal area.

The advantage of having a colostomy is that, you know, the stools are passed into a bag and, you know, persons with spinal cord injury are not rendered with fecal incontinence or bowel accidents. The intake of medications will still have to be timed so that, you know, the person has a regular schedule as well based on output of stools and they can still choose to have it, you know, be done in the morning or in the evening. But again, the importance is consistency and regularity of intake of the medications.

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