Colostomy Closure vs. Permanent Colostomy in Patients with Anorectal Malformation
are defects of the anus and the rectum. All kinds of anorectal malformations can and should be repaired. Some types are more likely to cause poor bowel control. The success of bowel control is based on how the sphincter (the ring-like band of muscles that open and close the anus) and the sacrum (the lower part of the spine that forms part of the pelvis) develop.
Most patients born with anorectal malformations need a colostomy at birth. An opening (stoma) is made to let stool to pass out of their body. The stool goes into a stoma bag. After the malformation is repaired, the colostomy can be closed. With a good bowel management program, the child can have a very good quality of life.
Bowel Management Program
A bowel management program helps patients with anorectal malformation that are not able to control their bowels.
Patients will get an enema each day in this program. This keeps their colon clean. The enema takes about one hour to do. For the next 23 hours after the enema, the patient does not pass any stool.
Most patients and caregivers favor doing an enema each day over living with a stoma.
When Are Permanent Colostomies Needed?
A permanent colostomy is very rare. We believe this is only a good fit for patients who have very bad diarrhea and cannot form solid stool. A permanent colostomy is very rare. We believe this is only a good fit for patients who have very bad diarrhea and are not able to form solid stool. If their colostomy was closed, they would keep passing stool in their underwear, even after getting an enema.
These patients may do better with bowel management through a stoma. This means they would get an enema through their colostomy one time each day. This keeps the bag mostly empty for the rest of the day. Some patients favor the convenience of having an empty bag.