If you’ve had an ostomy – a surgery that reroutes the way waste leaves your body – for ulcerative colitis (UC), the idea of exercise can seem intimidating. You might worry whether you’ll injure yourself, damage your new opening, called a stoma, or have an embarrassing leak.
At the same time, this type of surgery can be life-changing for people with conditions like UC. You’ll likely have less pain and won’t need so many trips to the bathroom. This could make working out seem more doable than before your operation.
Not only that, getting fit helps you recover from surgery. It also improves your mental and physical well-being. That’s important when you’re adjusting to the challenges of life with an ostomy.
Is Exercise Really a Good Idea?
When you’ve just had surgery, you need to limit your activity for a while. Take your cues from your doctor. You’ll need to start slow and work your way up. For most people, simple walking is a good place to start.
But once you have the go-ahead from your doctor, it’s a good idea to step things up. Regular exercise has physical and mental rewards for everyone, especially when you’ve had an ostomy. The benefits include:
- A healthy weight and stronger muscles, which can prevent complications
- Improved circulation, which aids healing
- Mental health benefits that can help you live confidently with your condition
- A stronger immune system, which will help you manage your condition.
Armed with some basic knowledge about how to manage your stoma, you can exercise safely.
Where Should I Begin?
For the first couple weeks after surgery, try to walk for 15 to 20 minutes at least two or three times a day if your doctor says that’s OK.
Other simple exercises you can try at home include :
- Arm raises: Sit up straight on a chair. Slowly raise one arm above your head while holding your pelvic floor muscles firm. (Your pelvic floor muscles are those you engage to hold back pee or a bowel movement.) Repeat with the other arm.
- Pelvic tilts: Lie on the floor on your back with your knees bent (use a mat for comfort). Starting at the base of your spine, slowly curl your lower back a little way off the floor. Return to start position.
- Leg lift: Lie on your back on the floor. Hold your pelvic floor firm as you slowly bring one knee up so your leg forms a right angle at your hip and knee. Lower the leg slowly, then repeat with the other leg. (Don’t try this one for 8-12 weeks after surgery.)
- Knee roll: Lie flat on your back with your arms out to your sides. With your legs bent, tighten your pelvic floor as you gently roll both knees a little way to one side (don’t go all the way to the floor). Repeat to the other side.
What if I’m Ready for More?
Once you’ve gone through the initial healing period from your surgery, nearly any exercise or hobby you enjoyed before should be safe. If you weren’t active before, a physical therapist or trainer can help you get started.
Your doctor will probably tell you to avoid lifting anything heavier than 10 pounds, at least for the first couple of months or so after surgery. That helps you avoid a hernia.
If you feel good and your doctor approves, some of the activities you can go back to include:
- Running (if you build up slowly and work on your core strength)
- Fitness classes such as Zumba
What Should I Avoid?
Lifting weights can put a strain on your healing tissues after your surgery. If you want to resume weight lifting, talk to your doctor or ostomy nurse about a binder or hernia prevention belt to support your abdomen while you lift.
Sit-ups and crunches can be uncomfortable with an ostomy bag, also called a stoma bag. They also put strain on your belly area that could raise your risk for a hernia. Try gentle alternative ab exercises like pelvic tilts or knee rolls instead.
If you want to play a sport that involves contact, you’ll need to wear a protective stoma cover. If there’s a risk of being hit in the abdomen, let your teammates know about your stoma.
If your immune system is compromised, it might be best to avoid public gyms and pools.
Taking a few precautions can make you more confident about working out with your stoma and pouch. For instance:
- Empty your stoma bag before each workout.
- Know ahead of time where the nearest toilet is in case you need to stop your activity to empty your pouch.
- Adjust your meal or workout times so that your body will produce less waste while you’re exercising.
- If you’re worried your pouch might come loose or leak while you’re swimming, test it out in a bathtub first to make sure it stays sealed.
If you’re worried about your pouch moving around while you exercise:
- Use extenders to attach it more securely.
- Wear an ostomy belt or support garment.
- Wear a cotton pouch cover so sweat doesn’t make it come loose or chafe your skin.
The workout clothes you choose can make a difference:
- Look for waistbands that are high enough to go above your stoma or low enough to sit below it. The waistband shouldn’t put pressure on the stoma bag, which can cause problems with how it fills.
- Dark-colored clothing can mask leaks from your bag if they happen.
- In women’s swimsuits, a skirt or ruffle can help conceal your pouch. Men may look for a higher waistband or longer leg, or they might wear bike shorts under their swimsuit.
Be prepared for accidents:
- Depending on your type of ostomy, you might have discharge from your rectum when you exercise. A pad in your underwear can catch any mucus or blood.
- Keep spare supplies on hand in case you have a leak – clothes, wipes, an extra stoma bag.
What Can Go Wrong?
Exercising after an ostomy is safe. But a few issues can crop up.
Dehydration is a common problem, particularly after an ileostomy, a type of ostomy. Learn the signs and watch for them:
- Dry mouth
- Muscle or stomach cramps
If you’re getting enough fluids, your urine should be the color of straw. Drink plenty of water while you work out. If you hydrate with sports drinks, dilute them with water to reduce your sugar intake.
Your stoma could become irritated by exercise and develop small sores that look like mouth ulcers. If these don’t clear up on their own, see your doctor.
Stomas have a lot of blood vessels near the surface and can bleed easily. Blood around your stoma is not necessarily a serious issue – your pouch may have rubbed the area and caused irritation. But blood coming from inside the stoma could be a sign of a serious problem. Call your doctor if this happens.
One of the most serious complications for people with stomas is a parastomal hernia. That’s when a loop of your intestine bulges out of your abdominal wall, which was weakened by surgery. If you notice a lump behind your stoma, see your doctor.
To avoid a parastomal hernia:
- Avoid weight lifting until you’re cleared by your doctor.
- Maintain a healthy weight.
- Strengthen your abdominal muscles with exercise.
- Wear support garments while you work out.