Can You Still Pass Gas After Colostomy Surgery?

After having a colostomy, can the anus still pass gas?

The mother underwent surgery to remove fecal matter after being diagnosed with colon cancer, and now has a colostomy with a stoma bag to collect waste.
During her recovery at home, she noticed that she still passes gas through her anus.
The question is why, after having a colostomy, gas and stool are not both contained in the stoma bag for elimination, and whether it is normal to still pass gas through the anus.
Additionally, there is concern about whether stool could also bypass the colostomy and enter the rectum.

Sheng, 60~69 year old female. Ask Date: 2023/01/04

Dr. Zhang Shuhao reply Surgery

Colostomy for colorectal cancer is typically performed to divert feces, alleviating obstructive symptoms and preventing feces from passing through the tumor or the anastomosis site.
As long as the majority of feces is drained through the stoma, the desired effect is achieved.
It is normal to pass gas through the anus, as gas may not be completely diverted, and intestinal flora can produce a small amount of gas.
If the stool is formed, it is unlikely to bypass the stoma and enter the distal bowel; even if a small amount does bypass, it generally will not have significant effects.

Reply Date: 2023/01/04

More Info

After colostomy surgery, it is indeed possible to still pass gas through the anus, even when a stoma (artificial anus) is present. This phenomenon can be confusing for patients and their families, especially after undergoing such a significant surgical procedure for conditions like colorectal cancer.
To understand why this happens, it’s important to know how a colostomy works. During the surgery, a portion of the colon is brought to the surface of the abdomen to create a stoma, which allows waste to exit the body into a colostomy bag. The stoma is essentially a new exit point for fecal matter, but it does not completely eliminate the function of the rectum and anus.
Gas is produced in the intestines as a byproduct of digestion, primarily due to the fermentation of undigested food by bacteria in the colon. Even after a colostomy, the rectum may still retain some function. If there is any remaining segment of the colon or rectum that is intact, it can still produce gas. This gas can accumulate and eventually be expelled through the anus, leading to the sensation of passing gas.
In many cases, patients with a colostomy may experience a reduction in the ability to control gas and stool passage through the rectum, but it is not uncommon for some gas to escape. This is especially true if the rectum has not been removed during the surgery. The presence of gas can also be influenced by dietary choices, as certain foods can lead to increased gas production.

As for your concern about fecal matter bypassing the stoma and entering the rectum, this typically should not happen if the colostomy was performed correctly and the rectum is not functioning. However, if there is any remaining bowel that is still connected to the rectum, there is a possibility that some stool could pass through. This is more likely if the colostomy is a loop colostomy or if there are any complications with the surgical site.

If your mother is experiencing significant gas or any unusual symptoms, it is essential to discuss these with her healthcare provider. They can provide guidance on what is normal post-surgery and help manage any discomfort. Additionally, they can assess whether there are any concerns regarding the function of the colostomy or the remaining bowel.

In summary, passing gas after colostomy surgery can be normal, especially if there is any remaining rectal function. It is crucial to maintain open communication with healthcare providers to ensure that any concerns are addressed promptly and that your mother receives the appropriate care during her recovery.

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