Life After Colostomy

What is a Colostomy?

During colostomy surgery, the end or a portion of the colon is brought through an opening on the surface of the abdomen (belly). The part of the bowel you see on your abdomen is called the stoma. The stoma may be located on the right side (ascending colostomy), center (transverse colostomy), or left side (descending or sigmoid colostomy)of your abdomen. The location will depend on the reason for your colostomy. The stoma is where the stool will now pass from your body. The stoma may or may not stick out from your abdomen. A healthy stoma is moist and red or pink in color. There are no nerve endings in the stoma, so it will not hurt when touched. It is normal for the stoma to be large and swollen after surgery, however it will shrink to a smaller size within five to six weeks. Your stoma may move slightly, which is a normal process that pushes stool through the colon. Just like your gums sometimes bleed when you brush your teeth, your stoma may also bleed slightly. However, if your stool is bloody, or you have constant bleeding,you should contact your doctor. Since the colostomy has no sphincter muscles, you will not be able to control your bowel movement(when stool comes out). You will need to wear a pouch to collect the stool. 

The location of your colostomy will influence the consistency of your output.

• If located in the transverse colon, the stool consistency is typically pasty.

• If located in the sigmoid colon, the stool will be similar to a usual bowel movement.

The nature and frequency of the output may be affected by food and fluid intake, as well as some medications and treatments prescribed by your doctor. Temporary colostomy – the doctor can reconnect the colon and close the stoma. Permanent colostomy – the colon cannot be reconnected and closed. Some permanent ostomy surgeries require the removal of the colon and rectum, yet there may still be a feeling of the need to have a bowel movement. This is normal and should ease with time. If you still have your rectum, mucus may build up and pass from the rectum the same way as a bowel movement. Mucus is produced to help the stool pass through (even if no stool is being passed). Your surgeon or WOC Nurse can explain your type of surgery

After the Operation

When you wake up from surgery you will be wearing your first ostomy pouch. The pouch may be clear so the doctors and nurses can check on your new stoma. You will have an intravenous line (IV) dripping fluid into your veins. You may also have a tube that goes through your nose and into your stomach, to keep your stomach empty. Drain tubes around the incision site are also common. Your stoma will begin to function three to seven days after surgery. The first output will be mostly gas or liquid stool. The stool will thicken and become more solid as you begin to eat more foods. There may be a lot of gas from your stoma at first, however, this should decrease over time. During the first few days, you will only be given fluids to drink. Food will slowly be added to your diet as your bowel function returns to normal. Colostomy surgery is a major operation, so it is normal to feel weak for a while. You may experience pain from the surgery, and medication can be prescribed by the doctor to help you feel more comfortable.

Going Home

When you get home, you should be able to resume the life you led before the operation. Here is some helpful advice: Obtaining Supplies Upon leaving the hospital, your WOC Nurse will provide you with information on how and where to get your supplies. Your doctor will write a prescription for your ostomy product supplier, as well as a list of the supplies you will need. Be careful not to store your pouches in direct sunlight or near heat. This may cause the barrier that attaches the pouching system to your skin to break down. If stored in cool temperatures, let the barrier return to room temperature before using. 

Diet

Unless your doctor has prescribed a special diet, you should not have to change your diet. Over time you will become aware of foods that produce more gas than others. Examples of some foods that can cause gas are:

  • beer,
  • dried beans,
  • broccoli, cabbage,
  • cucumbers, 
  • carbonated beverages.

Products can be bought at the drugstore or grocery store to reduce gas. Always check with your physician before taking medications. Some ways to decrease gas are by:

  • eating slowly
  • not talking with food in your mouth
  • not drinking through straws
  • not chewing gum

Odor

Some foods can cause more odors in your stool. They may include:

  • fish
  • cheese
  • eggs
  • beans
  • cabbage family (i.e. onions, broccoli, brussel sprouts)

Experiment to see how they affect you. Liquid deodorizers, such as Coloplast® O.A.D.®,can be put in your pouch; taking certain oral medications can also help prevent odor. Your WOC Nurse can advise you of specific products available.

Constipation/Diarrhea

You may become constipated or have diarrhea, just as you did before surgery. If you become constipated, try eating more fiber (vegetables, fruits, and brans)and drinking more water. It is okay to take a mild laxative; however, check with your doctor first. If constipation becomes a problem, talk to your doctor or WOC Nurse.

If you become ill with a stomach virus, this can give you diarrhea. Treat it the same as before you had surgery, and remember to drink plenty of fluids – you might try a“sports” drink to replace fluids and electrolytes.

Bathing and Showering

You may choose to bathe or shower with your pouch on or off. If you shower with your pouch off, choose a soap that is oil- and residue-free. These types of soaps will not interfere with the adhesion of the barrier.

Exercise and Sports

Exercise is good for everyone, including people with a colostomy. Once your strength returns, you can enjoy exercise and activities as you did before the operation. Check with your doctor before exercising or playing contact sports. Special small pouches can be used when swimming and playing sports, if desired.

Intimacy

You should speak with your surgeon regarding any effects your surgery may have on sexual function. Your ostomy  does not limit or prohibit sexual activity. Intimacy can play an important role as you take steps to resume the life you had before surgery. Note: there are special products and accessory choices available for intimate moments

Travel

Travel should not be restricted due to your colostomy. Remember to pack all of your supplies for the journey, and make sure you have more than enough supplies for the duration of your trip. Keep your supplies where you can easily get to them. If you are flying, take supplies in a “carryon” bag, in case you become separated from your checked luggage.

 

Supply Check list

  • pouches
  • barriers - if using a two-piece system  
  • soft paper towels
  • wipes
  • strip paste
  • powder or other accessories
  • scissors (if using a cut-to-fit system) 
  • stoma guide
  • plastic bag (to discard pouch, if necessary)
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