Colostomy and Ileostomy in Ovarian Cancer

What are Stomas?

Doctor discussing with patient
Ovarian Cancer Patient. Portra Images / Getty Images

Ovarian cancer does not start in the intestines, but it can grow on their surface and twist or kink them. This is part of the reason bloating can occur in advanced ovarian cancer. If they are small, these cancerous growths on the surface can often be removed without taking intestinal parts out. However, in about 25% of surgeries, it is necessary to either relieve a kink or to remove as much visible cancer as possible.

Most of the time, the surgeon can take the two ends of the intestine and put them together so that the flow of intestinal contents and stool remains normal. Sometimes, for technical reasons, this is not possible.

When parts of the small or large bowel are taken out and can't be put back together, your body needs a new way for stool to exit your body. In order to do this, your surgeon has to make an opening through your abdominal wall onto the skin and bring the end of the intestine through it. This is called the creation of an ostomy. It is commonly called a colostomy if it involved large intestine (colon) or an ileostomy if it involves small intestine. The end of the bowel is open, is sewn directly to the skin and is called a stoma.

The stoma will provide a way for stool to exit your body, so it needs to be contained some way. This is done by attaching special appliances, using glue, to your skin.

The appliance then holds a bag which needs to be changed periodically. There are special nurses, called entero-stomal therapists, who work with you to find the right combination of appliances and bags that work and don't leak.

In the case of ovarian cancer, the colostomy or ileostomy is often temporary.

There are numerous types of stomas beyond this simple description, but suffice it to say that with a temporary ostomy the surgeon can take you back to surgery and "reverse" the ostomy or put things back together. When this happens, the skin opening is closed and you no longer have to wear an appliance.

In some cases, the colostomy is permanent and reversal is not possible. For this reason, it is very important to talk with your gynecologic oncologist before surgery about the chances of a colostomy and whether or not you would accept a permanent one. The following is a good demonstration of a colostomy procedure, shown in pictures. An ileostomy would be very similar, but a segment of small intestine would be brought to the skin.