Patient guide · Colorectal surgery
Colostomy — a plain-English patient guide.
What a colostomy actually is, when it is offered, who forms and cares for one, and what the first weeks and months look like at home — written by a colorectal surgeon and a specialist stoma nurse.
Reviewed by Pulse Atlas Editorial Board () · Updated 2026-07-30 · Next review 2027-07-30 · 7-minute read
Why patients choose us
- 01
A consultant colorectal surgeon, in theatre
Not a rotating trainee. A named colorectal surgeon who forms and reverses stomas every week, in a proper theatre.
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A specialist stoma nurse from day one
Pre-op siting on your abdomen, appliance choice at the bedside, and a phone number that answers after discharge.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private colostomy costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options, including stoma-nurse follow-up.
In short
A planned laparoscopic end colostomy in our network: £10,000–£16,000, with 3–5 nights inpatient.
| Procedure | Indicative range | Typical duration | Inpatient stay |
|---|---|---|---|
| End colostomy (laparoscopic, planned) | £10,000–£16,000 | 90–150 min | 3–5 nights inpatient |
| Loop (defunctioning) colostomy | £8,500–£13,000 | 60–120 min | 2–4 nights inpatient |
| End colostomy (open, complex) | £12,000–£20,000 | 120–210 min | 5–8 nights inpatient |
| Hartmann’s procedure (end colostomy + resection) | £14,000–£22,000 | 150–240 min | 5–10 nights inpatient |
| Stoma nurse follow-up package | £350–£900 | 3–5 visits | First 6 weeks |
| Consultation only | £200–£400 | 30 min | Same visit |
Prices vary by clinic, by which surgeon takes the case, by whether the operation is planned or emergency, and by how many nights are needed on the ward. We come back with a firm quote within one working day.
The problem
The right surgeon, the right stoma nurse, the right plan.
Whether a colostomy is planned or comes out of an emergency admission, the three things that determine how well you live with it are the surgeon, the stoma nurse, and honest information about what to expect.
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Not sure it is needed?
A defunctioning stoma is sometimes temporary and sometimes avoidable. We say so plainly, before you agree to surgery.
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Worried about living with one?
Most people manage confidently within six weeks. We explain the practical care and the emotional adjustment.
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Want it done properly?
A named consultant colorectal surgeon, a specialist stoma nurse before surgery, and phone support after discharge — not just at the review.
The journey
From pre-op siting to follow-up — what happens, in order.
One surgeon and one stoma nurse from first message through to the six-week review — including learning to manage at home.
Phase 1 · Before your operation
Planning and stoma-nurse siting
Phase 2 · In hospital
Surgery and ward-based teaching
Phase 3 · At home
Learning to manage, then follow-up
- 01
Before
You tell us what is going on
A short, confidential form. Diagnosis, scans done, whether the stoma is planned or being discussed after an emergency admission.
- 02
Before
We come back with a recommendation
Within one working day: the right colorectal surgeon, whether the stoma is likely to be temporary or permanent, and what a defunctioning loop would mean.
- 03
Before
Pre-op stoma nurse siting
The stoma nurse marks the ideal site on your abdomen — sitting, standing, bending — so the appliance sits flat under a waistband and out of skin creases.
- 04
In hospital
The operation itself
Laparoscopic or open, depending on the indication. The colon is brought through the abdominal wall and matured to skin. Typically 60–180 minutes under GA.
- 05
In hospital
The first days on the ward
The stoma nurse fits a clear bag so the team can watch it. You are shown how to change it, empty it, and read the output — before you go home.
- 06
After
Learning to manage at home
Two to four weeks of practice — sizing the template, protecting the skin, judging output, hydration. Your stoma nurse is on the phone through all of it.
- 07
After
Follow-up and adjustment
Wound review at two weeks, stoma review at six. Appliance swapped or resized as the stoma shrinks. Psychological support offered — most people need some.
Typical end-to-end: 2–4 weeks from enquiry to a planned operation. Confidence at home: 4–6 weeks.
When it is offered
When a colostomy is the right step.
The commonest indications we see — planned and emergency — plus the one red flag that means an urgent call rather than a review.
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Bowel obstruction
A blocked colon — often from a tumour — where diversion above the block is the safest first step.
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Perforation and peritonitis
A hole in the colon with contamination — commonly diverticular. Hartmann’s (resection plus end colostomy) is the classic operation.
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Defunctioning after low anastomosis
A temporary loop stoma to protect a low join in the rectum while it heals — usually reversed at three to six months.
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Rectal cancer (low or advanced)
Where the rectum has to be removed and no join is possible — a permanent end colostomy after abdominoperineal excision.
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Severe faecal incontinence
Where continence surgery has failed or is not appropriate — a stoma can restore control and quality of life.
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Complex Crohn’s disease
To rest a diseased segment, or after resection where a join is unsafe. Often temporary; occasionally permanent.
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Radiation or fistulating disease
Pelvic radiation damage, or a fistula between the bowel and bladder, vagina or skin — diversion allows healing.
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Red flag: dark or dusky stoma
A stoma that turns dark purple or black in the first days after surgery is ischaemia — call the ward or A&E immediately.
Types of colostomy
Not all colostomies are the same.
What each type actually is — end versus loop, transverse versus sigmoid, temporary versus permanent — and which is used for which problem.
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End colostomy
The bowel is divided and the upper end brought out as a single stoma. Usually permanent, though sometimes reversible.
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Loop colostomy
A loop of bowel is brought out with two openings on the surface. Almost always temporary — designed to defunction the colon below.
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Transverse colostomy
Formed high in the abdomen, usually on the right upper side. Output is looser. Used for obstruction or emergency diversion.
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Sigmoid colostomy
The commonest permanent site — lower left abdomen, output firmer and more predictable. Used after rectal cancer surgery.
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Defunctioning (temporary)
Diverts stool away from a diseased or healing segment. Reversed once the join or inflammation has settled — usually months later.
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Permanent
Where the rectum has been removed or the bowel below cannot be reconnected — planned as lifelong from the outset.
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Hartmann’s procedure
Emergency resection plus an end colostomy, with the rectal stump closed. Reversal is possible but not automatic.
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Consultation only
An honest discussion of whether a stoma is the right step, and whether it would be temporary or permanent — no obligation.
Our vetted London network
A small panel of colorectal surgeons and stoma nurses, we picked them.
Consultant colorectal surgeons paired with specialist stoma nurses across central, north, west and south London. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every surgeon and stoma nurse in our network.
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Consultant colorectal surgeons, not trainees or general clinicians
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A specialist stoma nurse involved before surgery, not just after
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Pre-op siting done by the stoma nurse — sitting, standing, bending
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Written access to stoma-nurse phone support in the first six weeks
Complications and adjustment
What to look out for — honestly.
Most colostomy complications are recognisable and manageable if you know what you are looking at. Psychological adjustment is the piece most patients say they were least prepared for.
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Parastomal hernia
A bulge around the stoma as abdominal contents push through — the commonest late complication, sometimes needing repair.
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Prolapse
The bowel telescopes out further than it should. Distressing to see but usually managed conservatively; occasional surgery.
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Retraction
The stoma sinks below the skin — appliances leak, skin gets sore. Convex appliances often solve it; sometimes revision is needed.
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Ischaemia (dark stoma)
A stoma that turns dusky, purple or black in the first days is losing its blood supply — call the surgical team immediately.
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High output
More than 1,500 ml a day — mostly with loop or transverse stomas. Risks dehydration and kidney injury; needs medication and rehydration solutions.
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Skin irritation
Leakage under the flange causes soreness and blistering. Nearly always fixed by resizing the template and picking a better appliance.
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Stenosis or blockage
The opening narrows, or food (nuts, sweetcorn, mushrooms) blocks the stoma. Warm drinks, gentle massage; A&E if pain and no output.
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Mucocutaneous separation
The join between stoma and skin comes apart. Usually heals with careful dressing and a well-fitting appliance; rarely needs surgery.
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Adjustment takes time
Body image, intimacy, confidence in public — all shift after a stoma. Psychological support is part of the care, not a weakness.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever colostomy was formed, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and stoma type formed
Why the stoma was made — obstruction, perforation, defunctioning, cancer — and whether end, loop, transverse or sigmoid.
- 02 Technique
Approach and operative findings
Laparoscopic or open, what was found in the abdomen, and whether any resection or wash-out was done at the same time.
- 03 Findings
Site, appliance and early output
Where the stoma sits, the appliance the ward has been using, and how the output has behaved in the first days.
- 04 Impression
Permanence, reversal window, follow-up
Read this first: whether it is temporary or permanent, when reversal might be considered, and who is looking after you next.
Recognised by major UK insurers
Cover for colostomy varies by insurer and by indication — usually funded when medically indicated. We confirm cover before booking and coordinate with your consultant’s secretary.
Frequently asked
Everything we get asked about colostomy.
Quick answers on types, permanence, siting, diet, complications and when to call.
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Why do people need a colostomy?
The commonest reasons are bowel obstruction (often from cancer), perforation of the colon (usually diverticular), rectal cancer where no join is possible, and to defunction — protect — a low anastomosis in the rectum while it heals. Severe incontinence and complex Crohn’s are less common indications.
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Is a colostomy permanent or temporary?
It depends on the indication. An end colostomy after removal of the rectum is permanent. A loop or defunctioning colostomy is designed to be reversed — usually three to six months after the first operation. A Hartmann’s can be reversed but many are not.
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What is the difference between an end colostomy and a loop colostomy?
An end colostomy has a single opening — the bowel is divided and the upper end brought out. A loop colostomy has two openings side by side on one loop of bowel and is almost always temporary.
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What does pre-op stoma nurse siting involve?
Before the operation, the stoma nurse maps where the stoma will sit — with you sitting, standing and bending — so the appliance lies flat, avoids scars and skin creases, and sits comfortably under a waistband. Poor siting is a leading cause of leakage.
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How long does it take to get used to a colostomy?
Most people feel confident with the practical care within four to six weeks. Emotional adjustment takes longer — often three to six months — and psychological support is a normal part of care, not a sign anything is wrong.
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What foods should I avoid with a colostomy?
There is no fixed list. Most people can eat normally within a few weeks. Watch nuts, sweetcorn, mushrooms and popcorn — they can block the stoma. Chew well, keep well hydrated, and introduce new foods one at a time.
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What are the commonest complications?
Parastomal hernia, prolapse, retraction, ischaemia in the early days, high output causing dehydration, skin irritation from leakage, stenosis, blockage from food, and mucocutaneous separation. Most are manageable with the right appliance and stoma-nurse input.
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When should I call the stoma nurse or go to A&E?
Call urgently for a dark, dusky or black stoma, no output with abdominal pain and vomiting, heavy bleeding from the stoma, a fever, or signs of dehydration with a high-output stoma. Skin problems and leaks are common and can wait for a stoma-nurse call the next working day.
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Can a colostomy be reversed?
Loop and defunctioning colostomies are usually reversed. An end colostomy after Hartmann’s can sometimes be reversed but it is a second major operation and not automatic. An end colostomy after removal of the rectum is permanent.
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Does insurance cover stoma appliances after discharge?
Appliances themselves are usually supplied on prescription. Private cover for the operation and inpatient stay varies by insurer and by indication — we confirm cover before booking.
Clinical sources
- Association of Coloproctology of Great Britain and Ireland (ACPGBI). Guidance on stoma formation and care.
- Association of Stoma Care Nurses UK (ASCN UK). National clinical guidelines for stoma care.
- Wound, Ostomy and Continence Nurses Society (WOCN). Clinical guidelines for management of the adult patient with a colostomy.
- American Society of Colon and Rectal Surgeons (ASCRS). Clinical practice guidelines for ostomy surgery.
Related guides
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In practice, in London
Getting colostomy sorted in London, without the guesswork
For colostomy, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. The NHS route for colostomy is thorough, but the queue is real. Most patients we speak with have been told to expect anywhere from a handful of weeks to several months, depending on their local trust and how the referral is graded. Going private in London usually collapses that window to a matter of days — often the same week if the diary allows. It isn’t about jumping a queue so much as buying time back while you still have the flexibility to plan around it.
In practice, a private colostomy appointment in London means a named consultant, a proper hour in the room (or the equivalent on a video call), and a report you can actually read. Most of the imaging suites and endoscopy units we use sit within a mile of Harley Street or in Chelsea and Fulham, and turnaround on findings is measured in days, not weeks. For colostomy in particular, we bias towards consultants who do this every week rather than every month.
Fit matters more than people expect. For colostomy, the right consultant depends on what you actually need — a second opinion, a definitive diagnosis, a bridge into treatment, or reassurance that nothing’s being missed. We match on that, not on who has the biggest brochure. If a test isn’t the right next step, we’ll say so before you book anything.