Living With a Colostomy

Medically Reviewed by Carmelita Swiner, MD on December 15, 2021
6 min read

The colon, which is the first 4 feet or 5 feet of the large intestine, is part of your body's digestive system. It absorbs water from waste material (feces) and returns it to the body. It also absorbs any leftover nutrients. Solid waste is then passed through the colon to the rectum. From there, it leaves your body through the anus.

When the colon, rectum, or anus can’t work the way it should because of disease or injury, or when it needs to rest, your body must have another way to get rid of waste. A colostomy is an opening -- called a stoma -- that connects the colon to the surface of the abdomen. This provides a new path for waste material and gas to leave your body. A colostomy can be permanent or temporary.

If you get a colostomy, your medical team will talk to you while you’re still in the hospital after the surgery about how to take care of it and will give you some tips for making adjustments. You’ll have to make some changes to your lifestyle. But with the right education and guidance, you can handle it.

These tips may help you adjust. And keep in mind that colostomy societies and support groups can offer even more assistance.

  • Monitor your medications. Some medicines can cause constipation or diarrhea.
  • Eat a well-balanced diet. Avoid foods that cause a lot of gas, such as cabbage, beans, and some nuts. A dietitian can help you choose a healthy diet that will help you avoid constipation and diarrhea and not interfere with your colostomy.
  • Live your life. A colostomy is not the end of life as you know it. Modern colostomy supplies are designed to lie flat so they’re not obvious under clothing. Most colostomy patients are able to return to work and to many of the activities -- including sex -- they enjoyed before surgery.

Be sure to talk with your medical team about when you can return to everyday activities and about any concerns you have about living with your colostomy.

Colostomy irrigation is a way to manage bowel movements by emptying your colon at a set time. The process involves putting water into your colon through the stoma, causing the colon to empty.

Irrigation is most effective about an hour after a meal, which is when the colon is most likely to be full.

By repeating this process regularly -- once a day or once every second day -- you can train your colon to empty without spilling waste in between irrigations. Colostomy irrigation also can help you avoid constipation.

It generally takes about 6 to 8 weeks for the bowel to become regulated with irrigation. It helps to set a routine and irrigate at the same time each day.

Talk to your doctor about whether irrigation is right for you. People with permanent colostomies whose opening is in the descending or sigmoid portion of the colon are good candidates for irrigation. This is because their stools tend to be more formed.

People with irritable bowel syndrome, stomal problems, or stomas in the ascending or transverse parts of the colon are less likely to have success with irrigation. So it’s not a good option for them.

After your colostomy surgery, you will likely speak with a doctor or clinical nutritionist about exactly how to shape your diet and what to do if you run into problems. Though each case and every person is different, there are some general guidelines that can help keep pain and irritation to a minimum as your colon heals.

  • Eat smaller more frequent meals. For example, have 6 small meals over the course of the day instead of 3 larger ones.
  • Chew your food completely.
  • Eat at a slow pace.
  • Drink 8 to 10 cups of water or other liquids a day.

So, what should you eat? Choose foods with bland flavor and low fiber for a few weeks after your surgery. Add more flavorful and fiber-filled foods back into your diet one at a time to see how they affect your digestion.

Choose lean meats instead of meat with visible fat or fried in oil. Avoid beans and whole grains in favor of more refined grains like white bread, pasta, and rice. And look for simple non-carbonated drinks like water and decaffeinated tea and coffee. Avoid drinks with caffeine or alcohol, as these can irritate your digestive system after a colostomy.

It’s a good idea to approach exercise with caution after your colostomy. Talk to your doctor about what, if any, exercise is safe. In general, walking is safe and effective and a good place to start. You could even build stamina by going up and down the stairs in your house.

Your doctor might suggest walking before you start running after your colostomy. If you run a lot, rubbing or chaffing at the stoma can cause small red marks or sores that look like mouth ulcers around your stoma. A little rest should give them time to heal. Talk to your health care provider if they don’t go away. If it becomes a regular problem, talk to your doctor about a “comfort” pouch that might not rub as much.

Situps and crunches:
There’s a risk of causing a hernia (peristomal hernia) around your stoma if you do situps, crunches, heavy lifting, or any other “core” straining. You can help to prevent this if you maintain a healthy weight. Talk to your doctor before you start this type of exercise or exertion.

It’s possible to swim with a colostomy bag, though it’s best to check with your doctor first. In addition, the bag, or “pouch,” may not be tight enough for swimming. You can test it beforehand: Just sit in a bath for a while and check the snugness of the seal.

Make sure you drink plenty of water when you exercise. Look for a clear or pale-yellow “straw” color in your urine. That’s a good sign that you have enough water in your system. If it gets much darker than that, it can cause problems with your stoma as well as with your general health (dehydration).

  • Leakage: Digestive waste could leak from the colon into your body or onto the skin near the stoma. Your doctor might be able to help with different bags and other tools. In some cases though, you might need more surgery, especially if the leak is inside your body.
  • Skin irritation or infection can result from stool that leaks under the bag or from the bag rubbing against the skin or the stoma.
  • Blockage: Food can build up and block the stoma. You might notice that you’re not passing any waste, and you may have stomach pain, nausea, and vomiting. You might also have swelling around the stoma. Call your health care provider to help clear out any blockage.
  • Retraction: The stoma sinks below the skin after the initial swelling goes down. This can cause leaking if the colostomy bag doesn’t seal against the stoma well enough. Your doctor might be able to help with different appliances and bags, but you may need further surgery.
  • A hernia can develop around a colostomy. You can help prevent this if you use support clothing, like underwear or a belt, and avoid heavy lifting and straining.