Loop Colostomy: Procedure, Stoma Care, Recovery and Reversal
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is a loop colostomy?
A loop colostomy is an operation that redirects part of the colon to an opening in the abdomen called a stoma, usually temporarily, to let the bowel rest and heal or to relieve an obstruction. Stool leaves through the stoma into a pouch. Recovery includes learning stoma care, and reversal may be possible later but is not automatic.
What the research says
Loop colostomy and loop ileostomy have different complication profiles. In a meta-analysis of 10 studies (2,036 patients; 2 randomized trials and 8 cohorts) comparing the two after anterior resection for rectal cancer, overall morbidity, mortality and stoma-related problems did not differ significantly. Stoma prolapse (RR 0.39, 95% CI 0.19–0.82) and retraction (RR 0.45, 95% CI 0.29–0.71) were less likely with ileostomy, while dehydration or electrolyte imbalance was more likely (RR 2.98, 95% CI 1.51–5.89) (Yang et al., Int J Colorectal Dis, 2024).
Reversal timing is still debated, and earlier closure trades one risk for another. In a meta-analysis of seven randomized trials (599 patients) of defunctioning loop ileostomy after low anterior resection, closure within 30 days (versus 60 days or more) was linked to more wound complications (RR 2.56, 95% CI 1.33–4.93) but fewer small bowel obstructions (RR 0.46, 95% CI 0.24–0.89) and fewer stoma-related complications (RR 0.26, 95% CI 0.16–0.42); the authors advised cautious interpretation (Podda et al., Int J Colorectal Dis, 2022).
Parastomal hernia and prolapse depend partly on how a colostomy is constructed. In a meta-analysis of 10 studies (1,048 patients) of end-colostomy construction, parastomal hernia occurred in 6.3% with an extraperitoneal route versus 17.8% with a transperitoneal route (RR 0.36, 95% CI 0.21–0.62), and prolapse in 1.1% versus 7.3%, although most studies were nonrandomized (Kroese et al., Dis Colon Rectum, 2016).
What is a loop colostomy?
A colostomy redirects the colon, or large intestine, to an opening in the abdominal wall called a stoma. Stool leaves the body through the stoma and collects in a pouching system.
In a loop colostomy, the surgeon brings a loop of bowel through the abdominal wall and partially opens it so two connected ends sit side by side. The upper end remains connected to the small intestine and is where stool exits. The lower end remains connected to the lower bowel and may release mucus.
A loop colostomy is usually temporary. It may be needed for a few weeks, months or years, depending on how the bowel heals and what caused the operation. Temporary does not mean minor, and it does not guarantee that reversal will be possible.
Why is a loop colostomy performed?
A temporary loop colostomy is mainly used for diversion or decompression.
Diversion keeps stool away from a section of bowel that needs to rest and heal. This may be helpful after an injury, surgery or infection, because reducing stool passage can limit contamination and relieve the affected section while it recovers.
Decompression helps relieve pressure when an obstruction blocks the colon. Stool can continue to leave through the stoma while the lower bowel is temporarily out of service. The blockage and the underlying condition may require additional treatment before the bowel can be reconnected.
What conditions may lead to a loop colostomy?
A loop colostomy may be considered when a section of the colon or nearby tissues cannot safely handle normal stool passage for a period of time. Examples include diverticulitis, ulcerative colitis, Crohn’s disease, large-bowel obstruction, partial colectomy and severe anorectal or perineal injury or infection.
The reason for the colostomy affects the goals of treatment, the expected recovery and the possibility and timing of reversal. Ask the treating team what the stoma is protecting or relieving and what milestones need to be reached before the next decision.
Situation | Why a temporary loop colostomy may help |
Healing after bowel injury or surgery | Diverts stool away from a vulnerable area while tissues recover. |
Infection or inflammation | Reduces stool passage through a section that needs rest. |
Large-bowel obstruction | Provides a route for output while the blockage and bowel are treated. |
Partial colectomy | Protects a healing bowel connection or remaining colon in selected cases. |
Severe anorectal or perineal injury or infection | Diverts stool away from injured or infected tissues. |
Inflammatory bowel disease | May temporarily protect a section affected by Crohn’s disease or ulcerative colitis. |
How is a loop colostomy different from an end colostomy?
Loop and end colostomies are the two broad colostomy designs. The key difference is what happens to the two ends of the colon after it is divided.
Feature | Loop colostomy | End colostomy |
Bowel brought to the skin | A loop is brought out and partially opened. | One end is brought out as the stoma. |
Openings | Two connected openings may be visible together. | Usually one functioning opening is visible. |
Typical purpose | Often temporary diversion or decompression. | Often used when the lower bowel cannot be used or a condition is considered irreversible. |
Lower bowel | Remains connected and may release mucus through the lower opening. | May be closed and left inside, brought to another opening or removed depending on the operation. |
Reversal | May be easier to reconnect after healing, but is not guaranteed. | May be permanent, although some end colostomies can be temporary. |
The terms “temporary” and “permanent” describe the intended plan, not a promise. Healing, the original illness, later findings and overall health influence whether reconnection is safe.
How is a loop colostomy different from a loop ileostomy?
A loop colostomy redirects the colon, or large intestine. A loop ileostomy redirects the ileum, which is the last part of the small intestine before it joins the colon.
The operations share some features, including the creation of a stoma and the use of a pouching system, but they are not the same procedure. The location of the stoma and the character of the output may differ. The surgical team and ostomy nurse should explain what applies to the individual operation.
Are there different loop-colostomy locations?
A loop colostomy can use different sections of the colon. The location affects where the stoma is placed and whether output tends to be more liquid or more solid.
Location | General position of the colon section |
Ascending | Travels up the right side of the abdomen. |
Transverse | Travels horizontally across the upper abdomen. |
Descending | Travels down the left side of the abdomen. |
Sigmoid | Forms the lower, curved part of the colon before the rectum. |
There is no complete physical separation between these named sections. The surgeon discusses the relevant section because it affects the operation and the likely stoma location.
What happens before a loop colostomy?
Before surgery, the colorectal surgeon reviews the procedure, possible risks, expected lifestyle changes and consent. The team may perform basic diagnostic tests to confirm that the person is ready for surgery and discuss pain-management options.
The team provides instructions about eating and drinking. Some people are asked to stop food and drink before surgery and may be given an enema or bowel preparation at home. Follow the exact instructions from the treating team rather than applying a general time to a personal situation.
The stoma site is usually marked before surgery. This planning step helps the team choose a location that supports pouch fit, visibility and daily care, while also considering the person’s body and the operation.
Tell the team about medicines, supplements, allergies, prior operations, bowel symptoms and other health conditions. Do not stop or change a prescribed medicine unless the treating team tells you to.
How is a loop colostomy performed?
A loop colostomy may be performed laparoscopically or through open abdominal surgery. Laparoscopic surgery uses several small incisions and a lighted camera. Open surgery, called a laparotomy, uses one larger incision and may be needed for emergencies or more complicated conditions.
The operation is performed under general anesthesia. The surgeon makes the planned stoma opening, identifies the section of colon to use, brings the loop through the abdominal wall and partially divides it so the two connected openings sit side by side. The bowel edge is folded back and stitched to the skin.
A temporary support rod or bridge may sometimes sit beneath the loop to help hold it in place. If used, the surgical team removes it after a few days. The exact approach depends on the condition, the anatomy and whether the operation is planned or urgent.
This is a high-level explanation, not a procedure for self-treatment. The surgeon should explain what will happen in the individual operation.
What does a loop colostomy look like?
A new stoma may look large, red and swollen immediately after surgery. This early appearance is temporary and changes as the stoma heals.
Over time, it may look like two roundish, pinkish rings placed together. It may appear puffier or flatter, rounder or more oblong, and the openings may look like one larger opening rather than two. The exact appearance varies from person to person and depends partly on where the colon was divided.
A change in the stoma’s regular size or color should be discussed with the care team or ostomy nurse. Do not compare a healing stoma with photographs or another person’s stoma and assume the same appearance is expected.
What happens after loop-colostomy surgery?
After surgery, the person recovers in a postoperative area until awake from anesthesia and then spends the next several days in the hospital. The length of stay depends on the condition, the surgical approach and recovery.
Eating generally resumes gradually. The first stage may be clear liquids, followed by fuller liquids or a soft diet and then solid food as bowel function returns and the care team allows.
A wound, ostomy and continence nurse teaches how to live with a colostomy pouch and care for the stoma. Pain medicines are gradually reduced, wounds heal and bowel output begins to regulate. It may take several days before the first bowel movement through the stoma.
What does daily stoma care involve?
Stoma care includes learning how the pouching system fits, how to protect the surrounding skin and how to recognize changes that need advice. The ostomy nurse demonstrates the specific products and steps for the person’s stoma.
A pouch that does not fit well can allow stool to contact the surrounding skin and cause irritation. Output may vary with the section of colon used, and the team can explain what changes are expected during healing.
Do not improvise a new care routine for persistent leakage, skin breakdown, unusual output or difficulty emptying the pouch. Contact the ostomy nurse or clinician so the fit and plan can be assessed.
What are the benefits of a temporary loop colostomy?
The main benefit is that it can allow an injured, infected, obstructed or healing section of bowel to rest while the person continues to pass stool through the stoma. Diverting output may reduce contamination and help protect tissues during recovery.
The loop design keeps the two bowel ends partially connected, which can make reconnection easier after healing. However, reversal depends on the original condition, the person’s recovery and the surgical team’s assessment. A loop colostomy should not be treated as automatically reversible.
What are the risks and complications?
Like other operations, loop colostomy surgery can involve reactions to anesthesia, breathing problems under anesthesia, injury to nearby organs and infection.
The stoma itself can develop complications. Skin irritation from contact with stool is common and may improve when the pouch fits better. Scar tissue or slow bowel movement after surgery can contribute to blockage. A retracted stoma sinks below the skin surface, while a prolapsed stoma protrudes too far; either can make it harder to seal a pouch.
A parastomal hernia is a bulge that forms when bowel pushes through weakened abdominal muscles around the stoma. It can grow over time and may obstruct output.
Possible complication | What it may involve |
Skin irritation | Stool leakage or an ill-fitting pouch irritates the skin around the stoma. |
Blockage | Scar tissue or slow-moving bowel may prevent output from passing. |
Retraction | The stoma sinks below skin level and may make pouch sealing difficult. |
Prolapse | The stoma protrudes farther than usual and may interfere with pouch fit. |
Parastomal hernia | Bowel bulges through weakened muscles beside the stoma and may affect output. |
Infection | May involve the surgical site, abdomen or surrounding tissues. |
Anesthesia or breathing problems | Can occur during or around the operation. |
Nearby-organ injury | Abdominal organs or tissues can be injured during surgery. |
A complication is not a personal diagnosis. The care team can determine whether a change is expected healing, a pouch-fit problem or a condition requiring prompt assessment.
When can a loop colostomy be reversed?
Reversal depends on recovery from both the colostomy surgery and the condition that led to it. Some people may be ready within weeks or months, while others may not be ready for several years.
Follow-up visits allow the healthcare provider to monitor healing and decide whether reconnection is safe. The provider schedules reversal when the person and bowel are ready. A loop colostomy may remain in place if reversal would be unsafe or if the original condition has not resolved.
Ask what healing milestones, tests or treatment decisions must be completed before reversal can be considered. Do not interpret the existence of a loop colostomy as a guarantee that normal bowel routing will be restored.
When should someone contact the care team?
Contact the general clinician or ostomy nurse for persistent constipation or diarrhea, persistent nausea or vomiting, blood in stool, a change in the stoma’s regular size or color, unusual foul odors from the stoma or a blockage in output.
Severe, rapidly worsening or alarming symptoms should be handled according to the discharge plan and local urgent-care instructions. Before leaving the hospital, ask which symptoms require a routine call, an after-hours call or immediate medical attention.
Change to report | Why it matters |
Persistent constipation or diarrhea | May indicate a bowel-function or hydration problem. |
Persistent nausea or vomiting | Can accompany obstruction or another complication. |
Blood in stool | Needs clinical assessment in context. |
Change in stoma size or color | May signal a stoma or blood-supply problem. |
Unusual foul odor | Can indicate leakage, infection or another issue requiring assessment. |
Blockage in output | May represent an obstruction and should not be managed by guesswork. |
What questions should someone ask before surgery?
Topic | Questions to discuss |
Purpose | Is the goal diversion, decompression or protection of a healing bowel section? |
Original condition | What caused the need for the loop colostomy? |
Location | Which part of the colon will be used, and where will the stoma sit? |
Approach | Is laparoscopic or open surgery planned, and why? |
Eating and drinking | What are the exact preoperative instructions? |
Stoma care | When will an ostomy nurse teach pouch and skin care? |
Output | What changes in stool, mucus or output should be expected at first? |
Complications | Which signs require a call or urgent assessment? |
Support | Who can help with pouch care, transportation and household tasks? |
Reversal | What must heal before reversal can be considered? |
Follow-up | When are the next appointments and who should be contacted after hours? |
Conclusion
A loop colostomy creates a temporary route for stool through a stoma while a section of bowel rests, heals or is decompressed. It is usually temporary, but the time in place and the possibility of reversal depend on the original condition, healing and overall health.
Recovery involves gradual eating, pain management, learning pouch and stoma care, monitoring output and attending follow-up. A new stoma can look different while it heals, and complications such as skin irritation, blockage, retraction, prolapse and parastomal hernia need the right clinical or ostomy-nurse guidance.
The best next step is a focused discussion with the colorectal surgeon and ostomy nurse about the reason for diversion, the planned stoma location, the care routine, warning signs and what must happen before reversal can be considered.
Frequently Asked Questions
Is a loop colostomy temporary?
Usually. A loop colostomy is often created to let a section of bowel rest and heal, and it may be in place for weeks, months or years. Reversal depends on recovery and the original condition; it is not guaranteed.
What is the purpose of a loop colostomy?
It may divert stool away from a healing or injured section of bowel or decompress an obstruction so output can leave through the stoma.
What is a stoma?
A stoma is an opening created through the abdominal wall. In a colostomy, part of the colon is brought to the opening so stool can leave the body into a pouch.
What comes out of a loop colostomy?
The upper opening is connected to the small intestine and is where stool exits. The lower opening remains connected to the lower bowel and may release mucus.
What conditions may need a loop colostomy?
Examples include diverticulitis, ulcerative colitis, Crohn’s disease, large-bowel obstruction, partial colectomy and severe anorectal or perineal injury or infection.
What is the difference between a loop colostomy and an end colostomy?
A loop colostomy brings a partially opened bowel loop to the skin so two connected openings sit together. An end colostomy brings one bowel end to the skin and usually closes or leaves the lower end inside.
What is the difference between a loop colostomy and a loop ileostomy?
A loop colostomy redirects the colon. A loop ileostomy redirects the ileum, the last section of the small intestine. Both may be temporary, but they are different operations.
Does loop colostomy surgery use general anesthesia?
Yes. The operation is performed under general anesthesia. It may be laparoscopic or open, depending on the condition and surgical complexity.
How long does loop-colostomy surgery take?
The time varies with the condition, urgency and approach. The treating team can explain the expected operating-room and hospital timeline.
What is laparoscopic loop-colostomy surgery?
Laparoscopic surgery uses small abdominal incisions and a lighted camera. It may be preferred when possible, while emergencies or more complex conditions may require open surgery.
What is open loop-colostomy surgery?
Open surgery, or laparotomy, uses one larger abdominal incision to reach the organs. It may be needed in emergencies or more complicated cases.
How does a new stoma look?
It may look large, red and swollen at first. As healing continues, it often changes to two pinkish, roundish openings together, although appearance varies.
Who teaches stoma care?
A wound, ostomy and continence nurse, often called a WOCN or ostomy nurse, teaches pouching, skin care and practical daily management.
What happens after loop-colostomy surgery?
Eating usually progresses from clear liquids to fuller liquids or soft foods and then solids as allowed. Pain medicine is reduced gradually, wounds heal and output begins to regulate.
What are common loop-colostomy complications?
Possible complications include skin irritation, blockage, retraction, prolapse, parastomal hernia, infection, anesthesia reactions, breathing problems and injury to nearby organs.
What is a parastomal hernia?
It is a bulge formed when bowel pushes through weakened abdominal muscles near the stoma. It can grow and may interfere with output or pouch fit.
When can a loop colostomy be reversed?
Some people may be ready within weeks or months, while others may not be ready for years. Reversal is considered after recovery from the operation and the original condition, and it is not automatic.
Can a loop colostomy stay permanently?
Although it is usually temporary, it may remain if reversal is not safe or the original condition does not resolve. The care team determines the plan.
How do I prepare for loop colostomy surgery?
You may need to stop certain medicines or supplements, follow a special diet or take a bowel-cleansing solution, and have your stoma site marked before surgery. [2] Smoking, alcohol and caffeine may affect how you heal, so ask your team about them. Plan for a hospital stay of a few days, arrange for someone to cover home and work duties, and bring a robe, slippers, toiletries, loose clothes to wear home and something to pass the time. [2]
When should someone call an ostomy nurse?
Call for persistent constipation or diarrhea, persistent nausea or vomiting, blood in stool, unusual stoma size or color changes, foul odors or a blockage in output.
What should someone ask before leaving the hospital?
Ask how to empty and change the pouch, protect the surrounding skin, recognize warning signs, obtain supplies, manage medicines, contact the ostomy nurse and understand the follow-up and possible-reversal plan.
Related Reading
References
NHS. Recovery and lifestyle changes after a colostomy. NHS website. Last reviewed December 18, 2024. https://www.nhs.uk/tests-and-treatments/colostomy/recovery-and-lifestyle-changes-after-a-colostomy/
Mayo Clinic Staff. Colostomy: Surgery, Bags and Stoma Care. Mayo Clinic. May 16, 2025. https://www.mayoclinic.org/tests-procedures/colostomy/about/pac-20583139
Yang S, Tang G, Zhang Y, et al. Meta-analysis: loop ileostomy versus colostomy to prevent complications of anterior resection for rectal cancer. Int J Colorectal Dis. 2024;39(1):68. PMID 38714581. https://doi.org/10.1007/s00384-024-04639-2
Podda M, Coccolini F, Gerardi C, et al. Early versus delayed defunctioning ileostomy closure after low anterior resection for rectal cancer: a meta-analysis and trial sequential analysis of safety and functional outcomes. Int J Colorectal Dis. 2022;37(4):737-756. PMID 35190885. https://doi.org/10.1007/s00384-022-04106-w
Kroese LF, de Smet GHJ, Jeekel J, et al. Systematic review and meta-analysis of extraperitoneal versus transperitoneal colostomy for preventing parastomal hernia. Dis Colon Rectum. 2016;59(7):688-695. PMID 27270522. https://doi.org/10.1097/DCR.0000000000000605
Cleveland Clinic. Loop Colostomy: Procedure, Recovery, Risks & Benefits. Cleveland Clinic. Last updated January 10, 2023. https://my.clevelandclinic.org/health/treatments/24589-loop-colostomy
Disclaimer
This article is for general educational purposes and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional with any questions about a medical condition or treatment.
A colorectal surgeon and ostomy nurse should tailor the diagnosis, operation, stoma care, pouching products, diet, medicines, activity, warning-sign guidance and reversal planning to the person’s health, goals and risks. Do not use this article to self-diagnose, manage a stoma without guidance, change medicines or decide whether reversal is appropriate.
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