7399-7333 Colostomy

Definition

Colostomy is the opening of a portion of the colon through the abdominal wall to its outside surface for the purpose of rerouting the fecal stream. The name assigned indicates the location in the large intestine: ascending colostomy, transverse colostomy, or sigmoid colostomy. The procedure can be temporary, allowing the gastrointestinal (GI) tract time to heal, or to provide an outlet when an obstruction is present. It may also be permanent, when the intestine cannot or will not be reconnected.

Etiology

Common reasons for colostomy include: trauma (gunshot wound, stab wound); complications of diverticulitis, volvulus, bowel ischemia, perforation, or colon or rectum cancer.

Signs & Symptoms

Opening in abdominal wall (stoma) with requirement to wear a pouch to retain fecal material.

Tests

Not applicable.

Treatment

Surgery to place the colostomy is the treatment for the etiologies aforementioned.

Residuals

Postoperative care includes: monitoring the stoma for swelling, color, function and intactness of mucocutaneous suture line and drainage; protecting the skin surrounding the stoma; changing the pouch; promoting regular elimination (colostomy irrigation) for a sigmoid colostomy; promoting proper nutrition; promoting return to normal activity (including sexuality); and detailing community resources.

Special Considerations

  1. May be entitled to special monthly compensation where the veteran has a single service-connected disability rated as 100% with additional service connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service connected disability and involves different anatomical segments or bodily systems. See 38 CFR §3.350(i)(1)– Total plus 60% and M21-1, Part IV, Subpart ii, 2.H – Special Monthly Compensation (SMC).

  2. Depending upon etiology may be considered a chronic disease; subject to presumptive service connection under 38 CFR §3.309 [38 CFR §3.309 [Disease subject to presumptive service connection], §3.309(a) [chronic disease]. For example, a colostomy resulting from trauma or diverticulitis would not be considered chronic and therefore not subject to presumptive service connection, but colostomy due to cancer would be.