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Temporary or permanent stoma: which will yours be? | CION Cancer Clinics
A stoma is temporary when there is still healthy bowel below it to join back to, and permanent when the rectum and back passage have been removed. After a colectomy for colon cancer, most stomas are temporary and are closed at a second, smaller operation some months later. This page explains what decides it, what each kind means day to day, and what to ask your surgeon. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What decides whether a stoma is temporary or permanent?
- Temporary and permanent stomas, compared
- Which kind of stoma might you have?
- What happens between the stoma being made and being closed?
- Three things families ask us, and what is actually true
- What this page cannot tell you, and what to ask instead
- Common questions about temporary and permanent stomas
The short answer
What decides whether a stoma is temporary or permanent?
A stoma is temporary when there is still a healthy piece of bowel below it to join back to. It is permanent when there is not, usually because the rectum and the muscles of the back passage had to be removed with the tumour. After a colectomy for colon cancer, most stomas are temporary.
Temporary means protecting a join
When the surgeon joins two ends of bowel low down in the pelvis, that join needs quiet time to heal. A temporary stoma higher up sends stool into a bag so nothing passes through the join in the early weeks. Once the join has healed and any chemotherapy is finished, the stoma is closed at a second, smaller operation and stool goes back to leaving the usual way.
Permanent means there is nothing to join to
If the tumour sits very low in the rectum, the safest operation removes the rectum and the ring of muscle that controls the back passage. The skin there is closed over. With no lower end left, the colon is brought out on the belly as an end colostomy and stays. This is far more common in rectal cancer than in colon cancer, and it is always planned and explained before the operation, never decided on the day as a surprise.
"Temporary" is a plan, not a promise. A small number of stomas planned as temporary are never closed, usually because the person is not well enough for a second operation or the join did not heal.Side by side
Temporary and permanent stomas, compared
Temporary stoma
Permanent stoma
Made to protect a join lower down while it heals
Made because the lower bowel has been removed
Usually a loop of small bowel, called a loop ileostomy
Usually the cut end of the colon, called an end colostomy
Output is loose and frequent; fluids and salt need watching
Output is soft or formed; the bag is changed less often
Closed at a second operation, usually some months later
Stays for life; a stoma nurse supports you long term
Common after low joins and emergency operations
Common after removal of the rectum and back passage
The four you will hear named
Which kind of stoma might you have?
The name on your discharge summary tells you a lot about whether closure is planned.
Loop ileostomy
A loop of the last part of the small bowel brought to the surface, usually on the right side. The most common temporary stoma. It protects a low join and is closed once the join is sound.
What to expect
- Loose, frequent output
- A bag emptied several times a day
- Closure planned from the start
Loop colostomy
A loop of colon brought out, often on the left. Used to relieve a blockage quickly or to rest the bowel below it. Usually temporary, and easier to live with than an ileostomy because output is thicker.
End colostomy after a Hartmann's operation
In an emergency, the surgeon removes the diseased piece, closes the lower end inside and brings the upper end out. Planned as temporary, but the second operation to rejoin is larger than closing a loop, and some people choose not to have it.
Ask directly whether rejoining is intended, and what it would involve.End colostomy after removal of the rectum
The permanent kind. The rectum and back passage are gone, so the colon is brought out for good. It is sited and marked before surgery so the bag sits flat and out of sight under clothing.
Not sure whether this applies to you?
Ask an oncologistIf yours is temporary
What happens between the stoma being made and being closed?
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Learning the bag in hospital
A stoma nurse teaches you and one family member to empty, change and check the bag before you go home. You leave with supplies and a phone number.
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The join heals
The join below the stoma heals quietly over the following weeks. You eat, walk and recover as after any bowel operation. The pathology report comes back in this period.
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Chemotherapy, if it is needed
If the report shows chemotherapy is advised, it is usually given with the stoma still in place. Closure waits until it is finished, so that a second operation does not interrupt treatment.
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Checking the join
Before closure the surgeon checks that the join has healed. This may be a scan with dye passed through the back passage, or a short look with a camera. A join that has not healed delays closure.
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The closure operation
A smaller operation through the stoma site itself. The loop is freed, rejoined and dropped back inside, and the skin is closed. The stay is shorter than the first operation, and bowel habit takes some weeks to settle afterwards.
Commonly believed
Three things families ask us, and what is actually true
"If it is temporary, why not just skip it and join the bowel?"
Because a low join that leaks is one of the most serious things that can happen after bowel surgery. It means infection inside the belly, an emergency operation and very often a permanent stoma. A temporary stoma is the price of avoiding that.
"Permanent means the surgeon could not remove the cancer."
The opposite is usually true. A permanent stoma after removal of the rectum is made because the whole tumour and a wide margin around it were taken out. Margin means the rim of healthy tissue around what was removed. It says nothing about spread.
"Once you have a colostomy, normal life is over."
People with permanent colostomies work, travel, farm, pray and attend every family function. Many learn to empty the bowel at a set time each day so the bag is empty for most of the day. The first months are an adjustment, and a stoma nurse walks you through them.
Being straight with you
What this page cannot tell you, and what to ask instead
This page cannot tell you which kind of stoma you will have, or whether a stoma planned as temporary will in fact be closed. That depends on where your tumour sits, how the join heals, what the pathology report says and how well you recover. Your surgeon can answer each of those for you.
Questions that get a straight answer
Is my stoma planned as temporary or permanent? If temporary, what has to happen before it can be closed, and roughly when? Will chemotherapy come first? What would make you decide not to close it? And if it is permanent, who will teach me to manage it and who do I call when something goes wrong at home?
Whose decision this is
Whether a stoma is made, and whether it is later closed, is decided by your treating team with you. Tell them what matters in your life, whether that is work in the fields, long bus journeys, prayer or caring for grandchildren. Those details change how the operation and the closure are planned. What the family should not do is push for a join the surgeon thinks is unsafe.
If you were told your stoma is permanent and the reason was not clear, ask for a second conversation. It is a normal request.Questions we are asked
Common questions about temporary and permanent stomas
How long will a temporary stoma stay?
Usually some months. The join has to heal, the pathology report has to come back, and any chemotherapy after surgery has to finish first. Closure is then planned once the surgeon has checked the join. Ask your surgeon for a rough window rather than a date, because it moves with your recovery.
Can a temporary stoma become permanent?
Yes, in a small number of people. The usual reasons are a join that did not heal, a second operation that is judged too risky, or a person who finds the stoma manageable and chooses not to go through closure. Your surgeon should tell you if closure is looking unlikely, rather than leaving you waiting.
Is the closure operation as big as the first one?
Closing a loop stoma is smaller. It is usually done through the stoma site itself with a short stay. Rejoining after a Hartmann's operation is larger, because the surgeon has to find the closed lower end inside the belly. Ask which of the two applies to you.
Which is harder to live with, an ileostomy or a colostomy?
An ileostomy needs more attention. Output is loose and frequent, and you can lose fluid and salt quickly in hot weather or with a stomach upset. A colostomy produces thicker output and is changed less often. Neither stops you working or travelling once you are used to it.
Why is my stoma on the right when the cancer was on the left?
Because a temporary loop ileostomy is made from the small bowel, which sits on the right side of the belly. It is placed well away from the join it is protecting. The site was chosen for where a bag sits flat, not for where the tumour was.
Will I need chemotherapy before the stoma is closed?
Only if the pathology report says chemotherapy is advised. If it is, it is usually given while the stoma is in place, and closure waits until it is finished. If no chemotherapy is needed, closure can be planned sooner. The stoma itself does not decide this.
Can I pray, fast and attend functions with a stoma?
Yes. Bags sit flat under ordinary clothes and hold in smell. Many people empty the bag before prayer and manage without difficulty. Fasting needs care with an ileostomy because of fluid loss, so talk to your stoma nurse about how to do it safely.
Is the closure operation covered by Aarogyasri or insurance?
Stoma closure is a separate admission and is usually covered as a linked procedure under most schemes and policies, but the details vary. Call the helpline with your card and the first discharge summary and we will check the cover before the date is fixed.
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Sources
- NHS — Ileostomy
- NHS — Colostomy
- Cancer Research UK — Surgery for bowel cancer
- American Cancer Society — Colostomy guide
- American Cancer Society — Ileostomy guide
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Will I Wake Up With a Stoma?When a stoma is likely in the first placeStoma Reversal: When and HowThe closure operation in detailBowel Function After Stoma ReversalWhat to expect once the stoma is closedLife With a Colostomy BagDaily life if the stoma staysStoma Nurses and Ostomy Support in HyderabadWho helps you once you are home
Talk to us
Told you will have a stoma and not sure which kind?
Send us your scans and the surgeon's note, or call the helpline. A surgical oncologist will explain what is planned and what closure would involve. One helpline serves every CION centre.