Does a colostomy have to be permanent?

Permanent no. A colostomy does not have to be permanent. But some patients are better off if it is permanent if the anal sphincter is weak or if the stool is frequent etc. Individual choices need to be made. You are in iowa city so jefffields at u iowa in gastroenterology can help guide you.
No. But it depends on what type of colostomy was made and why it was made. Some colostomy surgeries are a permanent type, especially if the surgery was for a very low rectal cancer near the anal opening. Some people are too ill to have a second surgery to remove the colostomy. But some colostomies can be reversed or removed. Each person's situation is different.