An ostomy is a hole made by surgery to allow stool or urine to leave your body through your belly. It’s a new exit route for waste if you can’t poop or pee normally. Your ostomy’s exact spot on your abdomen will depend on your reason for the surgery.
At the hole, a small open end of your ureter or small or large bowel sticks out through your skin. This is called a stoma, and it will look red or pink. It has no nerve endings, so it shouldn’t be painful. Your surgeon will connect a pouch, which collects urine or stool, to your stoma.
Reasons for Ostomy
Your doctor might recommend it to treat serious bowel problems or to let a body part heal after a surgery. You also might need an ostomy if certain organs are diseased or have to be removed.
The reasons include:
- Colorectal, rectal, or bladder cancer
- Trauma or injury to the bowel or bladder
- A serious bowel disorder, such as Crohn’s disease or ulcerative colitis
- A blocked bowel
- Diverticulitis (when tiny pouches in your colon become inflamed)
- An infection
- Fecal incontinence (loss of control over your bowel movements)
Two main kinds of ostomy help remove feces, and one type diverts urine:
Ileostomy. The bottom of your small intestine, called the ileum, is brought up through your abdominal wall to create a stoma. This is often done if you have rectal cancer or inflammatory bowel disease.
Colostomy. If you have part of your colon removed, a colostomy can attach the remaining colon to the outside of your body.
Urostomy. The tubes that carry urine to your bladder are rerouted to your stoma. You might get this if you have cancer or other diseases that cause serious bladder problems.
You have options besides traditional ostomy. One is putting a pouch inside your body to collect the stool, which exits directly through the anus.
A temporary ostomy can be removed later. Even a permanent ostomy can sometimes be reversed.
Before the operation, your surgeon or specially trained nurse will find the best spot for your stoma, usually the flat front part of your abdomen.
The surgery will differ based on the type of procedure you need. Generally, your surgeon takes part of an internal organ, such as the bowel, and connects it to an opening in your abdominal wall.
A nurse or therapist will show you how to care for your stoma and how to empty your waste pouch.
You should be able to get back to your normal activities a couple of months after the surgery. You may need to avoid driving and heavy lifting for 2-3 weeks. After you’ve recovered, you’ll likely be able to go back to most activities except for contact sports like karate or football.
Sometimes you might have problems after an ostomy surgery. They may include:
- Itchy, red, or irritated skin around your stoma
- Bleeding inside your body
- Blockage in your small or large intestine
- Problems with your stoma, such as a hernia (weakening of the abdominal wall) or prolapse (when the bowel pushes through the stoma)
- A vitamin B12 deficiency
- An electrolyte imbalance
- Discharge from your bottom
- Problems absorbing water, vitamins, and other nutrients
- Feeling the urge to poop
Tell your doctor if you have any of these symptoms or any other problems.
Life With Ostomy
It will take time to get used to going to the bathroom in a different way. After the surgery, your stool will come out through the stoma and empty into a disposable bag.
How often you’ll poop or pee will depend on what you eat, the type of procedure you had, and your bathroom patterns before the surgery.
You may need to change your diet to control your bowel movements for a little while after surgery. But you should be able to eat what you want once you fully recover.
You might worry about negative reactions from your friends, family, or sexual partner. When you’re out, your clothing will cover your ostomy, so most people won’t even know about it. Having sex might feel a little different, and you may have to make some adjustments. But you can buy a wrap to keep the bag out of the way. You and your partner can work to make sure that your ostomy doesn’t stand between you and a normal sex life.
If you have a hard time with the social, emotional, and practical changes in your life, talk to your doctor, family, and friends. You might join a support group or work with an enterostomal therapist, who’s trained on the day-to-day issues of living with a stoma. It can be easier for you to adjust when you have support from others.