Ostomy: Adapting to life after colostomy, ileostomy or urostomy

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Colostomy

Colostomy

In some cases, after the surgeon removes a portion of the colon, it may be necessary to attach the remaining colon to the outside of the body in a procedure called colostomy. Creating a hole (stoma) in the abdominal wall allows waste to leave the body. A colostomy bag attaches to the stoma to collect the waste.

It takes time to become comfortable with an ostomy — a surgically created opening in your abdomen that allows waste or urine to leave your body.

Many questions may run through your mind as you plan your first ventures outside of your home. Can you go back to work after colostomy? Can you ride your bike if you have an ileostomy? Will everyone figure out you've had urostomy surgery just by looking at you?

You can do many of the same activities you enjoyed before your colostomy or other ostomy surgery.

You can eat whatever you want if you have an ostomy

Have a favorite dish? If you've been given the OK from your doctor to resume your regular diet, eat what you like. If you have a colostomy or ileostomy, you'll find that various foods affect your digestive tract differently.

Just as some foods gave you gas before your surgery, you'll likely experience gas with certain foods now that you have an ostomy. While you may choose to eat gas-causing foods sparingly or only at times when the gas won't make you self-conscious — such as when you're at home, rather than at work — it doesn't mean you shouldn't ever eat gas-causing foods.

Certain foods are more likely to cause gas, diarrhea, constipation, incomplete digestion or urine odor. But which ones have these effects will depend on your body.

If you're unsure how foods will affect you, consider trying them at home, one at a time, before eating them in public. Knowing how each food affects your digestion means you'll spend less time worrying about the food's effects and more time having fun with friends.

It may help to chew your food thoroughly and drink plenty of water.

If you have a urostomy, you might be concerned about urine odor. Certain foods can cause a stronger urine odor, but you can minimize that by drinking water or cranberry juice.

You can participate in sports if you have an ostomy

Unless your favorite hobby is a contact sport with lots of potential for injury, you'll be free to go back to the activities you enjoy after you heal from ostomy surgery. The main danger is injury to the opening where waste or urine leaves your body (stoma), which means rough sports may be out.

If you want to continue these pursuits, ask your doctor or ostomy nurse about special products you can use and precautions you can take to protect your stoma during these activities.

Check with your doctor before you begin lifting weights after your surgery. You may need to wait for your surgical incision to heal before lifting weights, to reduce your risk of complications. Once you're fully healed, your doctor or an ostomy nurse might recommend a device to support your abdomen when lifting weights.

If you're nervous that running, swimming or other athletic activity will loosen your ostomy bag and cause a leak, use a special belt or binder to hold your ostomy bag in place. Check with your local medical supply store or look online for specialty products for active people with ostomies.

You can go back to work if you have an ostomy

You'll need time after your surgery to heal and recover, but you can eventually go back to work. You might choose to ease back into work or talk with your employer about a limited schedule until you feel more confident with your ostomy.

If your line of work involves manual labor or lots of lifting, your doctor may recommend ways to protect your stoma on the job.

Once your doctor says you're ready, consider going back to work. If you're nervous about caring for your ostomy at work, talk to your doctor or an ostomy nurse.

Don't let worrying get the best of you. Returning to work is a good way to transition back to a normal routine, and working again can make you feel good about yourself.

You can tell — or not tell — whomever you want about your ostomy

It's up to you to decide who to tell about your ostomy surgery. It may make sense to tell the people closest to you. These people may be worried about your recovery, and explaining your ostomy may ease their fears. Talking with loved ones is also a healthy way to cope with your emotions.

Acquaintances may be curious about why you've been away from work or know that you were in the hospital and ask about your illness. Think ahead about what to say when questions arise. You could say you've had abdominal surgery or use another basic description without going into details if you're uncomfortable discussing your ostomy with people you don't know well.

Other people will need to know about your ostomy for practical purposes. If you don't have a desk or locker at work to store extra ostomy supplies, for instance, you might need to reveal some details of your ostomy to someone at work so that such arrangements can be made.

Some people keep their ostomy surgery private, and others prefer to tell anyone who asks. Who you tell is up to you, but you may find you're more willing to discuss the details as you become more comfortable caring for your ostomy.

You can hide your ostomy

To you, the ostomy bag attached to you is very obvious. When you look in the mirror, you notice the bag under your clothes. You might think every gurgle and noise coming from your stoma is loud and heard by everyone in the room.

Most people won't notice your ostomy unless you tell them about it. As you get used to your ostomy, you'll figure out tips and ways to keep the bag concealed and the noises to a minimum. Here are some ideas to get you started:

• Empty your ostomy bag when it gets to be one-third full. That way it won't bulge under your clothes.
• Work with your ostomy nurse to find the ostomy pouching system that works best for you.
• If you're worried about the odor when emptying your ostomy bag, ask your ostomy nurse or visit your medical supply store for pouch deodorants or air sprays to minimize odor.

Ask a close friend or loved one whose opinion you trust whether your ostomy bag is visible under your clothes or if the sounds your ostomy makes are as loud as you think they are. Everyone's body makes noises and produces odors from time to time. While it can be embarrassing, don't let a fear of what could go wrong keep you from going about your day.

You can wear whatever you want if you have an ostomy

No clothing is off-limits if you have an ostomy. However, your individual body contour and your stoma's location may make some clothes less comfortable. For instance, tight waistbands or belts might feel restrictive over your stoma. Be open to experimenting with different styles of clothes.

But don't let your ostomy keep you from wearing tightfitting clothes or even your bathing suit. Look into ostomy swimsuits and trunks, which can be found through specialty retailers.

You can go wherever you want if you have an ostomy

It will take some pre-trip planning, but having an ostomy shouldn't prevent you from traveling. If you'll be traveling by airplane, bring extra ostomy supplies and pack them in both your carry-on and checked bags.

Consider carrying a statement from your doctor about your ostomy. This note might explain why you have an ostomy and ask airport security screeners to respect your privacy during searches.

You can have sex and intimate relationships if you have an ostomy

You'll need time to recover after surgery. And depending on what type of ostomy surgery you have, you may experience some temporary sexual side effects, such as erectile dysfunction or vaginal dryness. But sexual intimacy can continue after you have an ostomy.

If you feel less attractive with your ostomy, take your return to intimacy slowly. Maybe you aren't ready to have sex right away. Discuss this with your partner. Suggest starting with touching and kissing. Your partner can help make you feel more comfortable and reassure you that you are just as attractive with an ostomy.

Take steps before intimacy to feel more confident. Empty and clean your ostomy pouch. Check the seal to make sure it's tight. Use an opaque pouch or try a pouch cover. Lingerie and cummerbunds made to conceal a pouch or hold it in place are available from specialty retailers. Ask your ostomy nurse about companies that sell these products.

Certain aspects of sex may change with an ostomy. You might find that some sexual positions put pressure on your ostomy and are uncomfortable. Experiment with new positions, such as lying on your side.

People with ostomies who are dating often worry about when to tell new companions about their ostomies. That's up to you. Some people feel more comfortable getting it out in the open right away, while others want to get to know and trust a potential partner first. Do what feels right for you. Know that rejection is possible, and give a new partner time to consider what an ostomy means to your relationship. Answer questions openly and honestly.

Talk to others with ostomies

Get in touch with other people with ostomies — they sometimes refer to themselves as ostomates. Whether it's a support group in your community or online, getting advice from people who've been there is a great way to boost your confidence. You can ask questions that you might be embarrassed to ask your doctor or nurse. And you can get tips to help you adapt to life with an ostomy.