Patient education: Living with a colostomy (The Basics)

What is a colostomy? — A colostomy is an opening in the belly made by a doctor as a way for bowel movements to leave the body not through the anus. To make a colostomy, the doctor does a procedure to make a small opening in the belly. Then, they connect the large intestine to this opening (figure 1 and figure 2).

The hole in the skin is sometimes called a "stoma." This is the medical term for "opening." Bowel movements will come out through the stoma into a bag that is attached to the skin.

What will my bowel movements be like with a colostomy? — How often you have bowel movements varies. Your bowel movements might be less solid than they used to be. You might also occasionally have a bowel movement the "regular" way, through the anus. This is normal.

How do I take care of the colostomy? — A special type of nurse, called an "ostomy nurse" or a "wound, ostomy, and continence nurse," will teach you how to:

●Empty the bag

●Change the bag

●Take care of your skin

●Check your stoma for problems

There are different types of colostomy bags (figure 3). With some types of bags, you empty, clean, and reuse them. With other types, you throw them out after each use.

Some people worry that their bag will leak, or that other people will be able to smell their bowel movements. But this is not common once you get used to using a bag. The bags are made so that they do not leak or smell.

If you have a certain type of colostomy, you might be able to manage it with a process called "irrigation." This is a way to make your bowel movements regular. It involves squirting water into your stoma on a regular basis to cause a bowel movement to happen.

What problems can happen with a colostomy? — Different problems can happen with a colostomy, either right away or years later. Let your doctor or nurse know if you have any of the following symptoms or problems:

●Your stoma is swollen or larger than usual, or the inside of the stoma sticks out through the opening more than usual.

●You have a bulge under the stoma or next to it.

●Your stoma is smaller than usual.

●Your stoma leaks more than usual.

●You have a rash or sores around your stoma.

●You have sudden belly pain, cramps, or nausea.

●You have more diarrhea coming out of the stoma than normal – This can cause you to lose too much fluid, which can lead to problems. Symptoms of fluid loss include not making as much urine or having dark yellow urine, or feeling thirsty, tired, dizzy, or confused.

●You haven't had any gas or bowel movements through the stoma for a while, and you have bloating, nausea, or pain – These symptoms could mean that there is a blockage in your intestine.

●The stoma starts turning purple or black instead of pink.

●Your stoma is bleeding or has bloody fluid coming from it.

Do I need to follow a special diet? — Probably not. But you should avoid getting constipated. (Constipation means trouble having bowel movements.) To avoid constipation, you can:

●Eat foods that have a lot of fiber (table 1).

●Drink plenty of water and other fluids.

The foods you eat can affect the odor of your bowel movements, and how solid or soft they are. Certain foods can also make you have more gas. The foods that can affect your bowel movements and gas are listed in the table (table 2).

What will my life be like with a colostomy? — You should be able to live an active and normal life with the colostomy. But many people worry about the following things:

●Clothes – You do not need to wear special clothes. Other people won't be able to see the bag under your clothes.

●Baths and showers – You can take a bath or shower with or without the bag on.

●Sports – You will probably be able to play most sports. You might want to wear a special belt to protect the bag and keep it in place. Doctors usually recommend that people with a colostomy not play certain contact sports (such as football) or lift weights.

●Swimming – You can swim with the bag on. Empty the bag before you swim.

●Sex – You can have sex. But you might want to wear a special wrap to protect (and cover) the bag during sex.

●Travel – When you travel, bring extra supplies to manage the colostomy. If you fly, take your supplies in your carry-on luggage.

It is normal to feel sad, upset, or worried when you have a colostomy. If you have these feelings, try to get help. You can talk with a family member, friend, or counselor. You might also find it helpful to go to a support group for people who have a colostomy.

More on this topic

Patient education: How to care for an ostomy (The Basics)
Patient education: Colectomy (The Basics)
Patient education: Colon and rectal cancer (The Basics)
Patient education: Crohn disease in adults (The Basics)
Patient education: Ulcerative colitis in adults (The Basics)
Patient education: Gas and bloating (The Basics)
Patient education: High-fiber diet (The Basics)
Patient education: Constipation in adults (The Basics)
Patient education: Living with an ileostomy (The Basics)
Patient education: Colostomy or ileostomy reversal (The Basics)

Patient education: Colon and rectal cancer (Beyond the Basics)
Patient education: Ulcerative colitis (Beyond the Basics)
Patient education: Crohn disease (Beyond the Basics)
Patient education: High-fiber diet (Beyond the Basics)