Ostomy

What is an ostomy?

An ostomy is a surgery that helps your body remove waste when you have damage to your digestive or urinary system. During the procedure, a surgeon creates a small opening in your belly (stoma). This opening goes from an area inside your body to the outside of your abdomen.

The purpose of an ostomy is to change the way pee or poop exits your body. After ostomy surgery, waste drains from inside your body to the outside — and collects in a pouch, or an ostomy bag.

While the term “ostomy” refers to the procedure, “stoma” refers to the actual opening in your belly. Your stoma might be on your upper or lower abdomen, or on the left or right side, depending on your needs.

Types of ostomy

The type of ostomy you need depends on which part of your digestive or urinary system needs to be bypassed:

• Colostomy: Creates an opening that goes from your large intestine (colon) to the outside of your abdomen.
• Ileostomy: Creates an opening that goes from your small intestine to the outside of your abdomen.
• Urostomy: Connects your ureters (tubes that carry pee from your kidneys) to the outside of your abdomen.

Ostomies may be temporary or permanent depending on your specific needs. Temporary ostomies can give your body time to heal after surgeries or other procedures. You might need a permanent ostomy if you have a more serious condition, or if you had your rectum or anus removed.

What conditions are treated with an ostomy?

You might need ostomy surgery if you have certain digestive or urinary issues like:

• An injury affecting your small or large intestine.
• Bladder cancer.
• Bowel obstruction.
• Colon or rectal cancer.
• Conditions that cause gastrointestinal (GI) inflammation, like ulcerative colitis and Crohn’s disease.
• Diverticulitis.

How common is ostomy surgery?

Ostomy surgery is more common than most people may realize. About 1 in every 500 Americans lives with an ostomy.

What happens before ostomy surgery?

Prior to your ostomy surgery, you’ll meet with your medical team to discuss the details of your procedure. During this appointment, your healthcare provider will determine the location of your stoma. They’ll consider factors like your activity level, typical clothing choices and personal preferences. You’ll also learn how to properly care for the stoma (the opening in your abdomen).

What happens during ostomy surgery?

You’ll be under general anesthesia for your ostomy surgery. Your surgeon may create a long incision in your abdomen, or they may do the procedure laparoscopically. Laparoscopy requires smaller incisions, uses a camera to look inside your body and typically allows for faster recovery. Your healthcare provider can let you know which type of incision you’ll have.

Ostomy surgery usually occurs as part of a larger surgery. So, the steps can vary depending on your specific needs. But whether you’re having a colostomy, ileostomy or urostomy, the goal is the same — to redirect waste around damaged or healing portions of your digestive or urinary system and allow it to leave your body through a stoma.

What happens after ostomy surgery?

Most people require a hospital stay. During this time, your medical team will monitor your progress and make sure you’re healing properly. You may need a catheter to drain urine or IV fluids to keep you hydrated.

What are the benefits of ostomy?

In many cases, ostomy surgery is lifesaving. In other situations, it treats a wide range of digestive and urinary diseases and helps people significantly improve their quality of life.

What are the risks of ostomy?

As with any surgery, there can be complications after ostomy surgery.

General risks after surgery include:

• Diarrhea.
• Infection.
• Skin irritation.

Risks specific to ostomy surgery can range from mild to severe and may include:

• Blockage. This can occur when foods that are difficult to digest become stuck in your gastrointestinal tract. Blockages can usually clear on their own when you drink clear liquids to temporarily rest your bowel.
• Electrolyte imbalance. Your large intestine absorbs water, electrolytes and nutrients from the foods you eat. If your ostomy bypasses your large intestine, it can cause a dehydration and/or an electrolyte imbalance. Ask your healthcare provider how to maintain electrolyte balance after an ostomy.
• Hernia. If your abdominal wall becomes weak around your stoma, you could develop a hernia. Stoma hernias often require surgical correction once they’ve become too large.
• Narrowing of the stoma. If your stoma becomes narrowed, it can be difficult for waste to pass through it. This condition often requires surgical repair.
• Phantom rectum syndrome. If rectum removal was part of your procedure, you might still feel the need to make a bowel movement. This condition usually resolves on its own. However, if you have pain associated with phantom rectum syndrome, your healthcare provider can prescribe pain relievers.
• Prolapse. Sometimes, your bowel pushes itself out through the stoma like an accordion. In some cases, a surgeon can push the bowel back in to its place. In other instances, you might need a larger ostomy pouch or surgical correction.

What is the recovery time following ostomy surgery?

All in all, ostomy surgery recovery takes about eight weeks, though you don’t have many limitations while recovering. You should still get up and walk around as you’re able. Staying mobile will aid in healing, prevent infections and help your bowel work more quickly.

Ostomy care and maintenance

After ostomy surgery, you’ll wear an ostomy bag or pouch. Your healthcare provider will show you how to attach, empty and change the pouch. Most ostomy bags or pouching systems come with one or two pieces. The bag also comes with a barrier (which protects your stoma) and a disposable plastic pouch.

How often should I change my ostomy bag?

It depends on the type of pouch system you have. Most people will need to change their ostomy bag every three to seven days. Some will need to change it daily. When changing your ostomy bag, be sure to:

• Wipe away any mucous on your stoma.
• Use warm water, mild soap and a washcloth to clean the skin around your stoma. (Avoid soaps with fragrances and oils.)
• Rinse your skin well.
• Dry the area completely.

In addition to keeping your stoma clean, be sure to examine it daily to ensure it looks normal. If you notice any changes in its size, color or shape, contact your healthcare provider immediately.

When should I call my healthcare provider?

If you’ve recently had ostomy surgery, it can be challenging to know which symptoms warrant a call to your healthcare provider. You should always trust your intuition if something doesn’t seem quite right. Call your healthcare provider right away if you notice:

• Severe cramping that lasts more than three hours.
• A change in your stoma’s size or appearance.
• Nausea and vomiting.
• Excessive bleeding.
• Strange odor.
• A deep cut in your stoma.
• Skin irritation.
• Watery discharge that lasts more than six hours.

Is ostomy surgery reversible?

Sometimes, ostomies are reversible. Once your bowel is functioning properly again, your provider may be able to do ostomy reversal surgery.

Do you still use the toilet with an ostomy bag?

You’ll still use a toilet after your ostomy. You’ll just use it a bit differently. When your ostomy bag is almost full, you’ll either empty it into a toilet or switch it out for a new one. How you do this depends on which system you have.

Your experience also depends on which type of ostomy you have:

• If you had an ileostomy or colostomy, pooping will be different for you. But you’ll still be able to pee the way you used to.
• If you had a urostomy, peeing will be different for you. But you’ll still be able to poop the way you used to.

Can I swim while wearing my ostomy bag?

Yes, you can swim with your ostomy bag. Pouching systems are waterproof. You can wear your ostomy pouch any time you’re in water, as long as it’s sealed properly.

Can you live a long life with an ostomy?

You can live a long, full life after ostomy surgery. This procedure has no effect on your lifespan.

A note from Cleveland Clinic

Hearing that you need an ostomy can feel scary and uncertain. Whether it’s temporary or permanent, having an ostomy is a significant change in your day-to-day life. Talk to a therapist about how you’re feeling. Ask your healthcare provider for additional resources. Consider joining an ostomy support group. Talking with others who are going through the same thing can help you on your journey.

For some people, ostomy is a temporary treatment. For others, it’s a cure.