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Will You Need a Colostomy Bag After Colorectal Cancer Surgery?

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Will You Need a Colostomy Bag After Colorectal Cancer Surgery?

Jan 26, 2016

It’s a common question many people have when they find out they need surgery because of colorectal cancer: Will I need a colostomy bag? Dr. Tom Miller asks specialist Dr. Molly Gross how she answers this question and, if they have to, how she helps patients come to terms with it.

Episode Transcript

Dr. Miller: You have rectal cancer and you're concerned that you might need a colostomy bag. We're going to talk about that next on Scope Radio.

Announcer: Access to our experts with in-depth information about the biggest health issues facing you today. The Specialists with Dr. Tom Miller is on The Scope.

Dr. Miller: Hi, I'm Dr. Tom Miller here for Scope Radio, and I'm here with Dr. Molly Gross. She's a colorectal surgeon and an Assistant Professor in the Department of Surgery here at the University of Utah.

Molly, you get referrals, I'm sure frequently, with patients who have colorectal cancer, and one of the concerns and most frightening things that a patient would probably wonder about when they're visiting you is when you do the surgery, if you need to do surgery, will they need to wear a colostomy bag. How do you address that problem and what do you say to the patients in terms of what the likelihood of that need might be?

Dr. Gross: Everyone wants to poop the normal way. No one wants to poop in a bag. Our goal is always to help people poop the normal way even if they have rectal cancer. Sometimes that means they need a temporary bag while a new connection heals, an ileostomy that's called, but we always try to reconnect people, reconnect their colon back to their rectum, as long as the muscles of control, the sphincter muscles, aren't involved with tumor.

Dr. Miller: Now, would it be fair to say that the majority of surgeries that you do result in the patient pooping the normal way?

Dr. Gross: Unfortunately, once people's rectums are removed they never really poop completely normally. I like to say the rectum is the smartest organ in the body. It knows the difference between solid, liquid and gas, so without the rectum, if we have to remove it for cancer, it's difficult sometimes to hold onto poop. People have urgency, meaning they have to get to the bathroom quickly, but they usually have control. They just might need to know where the bathrooms are.

Dr. Miller: And certainly that would seem to be a better option than having a bag.

Dr. Gross: For some people it is. Everybody's different. Some people would rather poop in a bag because they want to fish, and it's really hard from your boat to go have a bowel movement.

Dr. Miller: Do some people find that if they have a colostomy that it's psychologically damaging?

Dr. Gross: It can be for a lot of people initially, but with time they learn to live with it. We also have other resources in the form of patients that have bags who are willing to talk to other patients who are just about to get a new bag. It takes some adjustments and it can be hard, but sometimes people live even fuller lives with a bag than they did when they were having 20 bowel movements a day.

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