Ostomy FAQs
Below you’ll find answers to the questions most asked about Ostomy.
Ostomy Basics
What is an ostomy?
An ostomy is an opening surgically created in the abdomen to allow stool or urine to be expelled through a stoma.
What is a stoma?
In ostomy surgery, the surgeon brings the end of the bowel or ureter, or a piece of the bowel (in some urostomies), through an incision in the abdominal wall. The piece of bowel or ureter that sticks out is called the stoma. The stoma is typically red or pink. It can be round or oval, protruding or flush with the skin.
Why do people need ostomies?
When your urinary or digestive system isn’t working normally, or when part of the digestive system must be surgically removed because of injury or disease, ostomy surgery can be a life-saving procedure. People get ostomy surgery because of birth defects, cancer, inflammatory bowel disease, diverticulitis, incontinence, pelvic trauma, spinal cord injury, and many other medical conditions.
Are ostomies permanent or temporary?
That depends on the patient. Some people get temporary ostomies to allow the bowel to heal after surgery, a blockage, trauma or illness. These are later reversed. For other people, an ostomy is permanent.
What is a colostomy?
A colostomy is created when a portion of the colon or the rectum is removed and the remaining colon is brought to the abdominal wall. Waste exits through the stoma, into your ostomy pouching system.
What is an ileostomy?
An ileostomy connects the small intestine to an opening in the abdomen (the stoma), where waste drains into an external ostomy pouch. Ileostomies are typically performed when illness, injury or other problems prevent the large intestine from processing digested food.
What is a urostomy?
A urostomy allows urine to drain from the body when the bladder is not functioning. Typically, the ureters are connected to an internal tube made from a piece of the small intestine. Urine passes from the kidneys to this tube and drains from the stoma, where it is collected in a urostomy pouch.
Can you control the flow of urine when you have a urostomy?
No. Urine drains continuously when you have a urostomy, so a pouch must be worn to collect it.
Can you control your bowel movements when you have a colostomy?
The stoma has no muscles or nerve endings, so it can’t control the flow of output. However, some people with colostomies choose to irrigate their colon daily by washing it out with water. By doing this, they’re able to regulate their bowel movements.
Ostomy Care
How can I prevent peristomal skin irritation?
Irritation and injury are common problems with the skin around the stoma. To keep the peristomal skin healthy, it’s essential to prevent leaks from the stoma. Wash your skin with water or gentle soap every time you change your skin barrier, and dry it thoroughly. Don’t use any lotions or ointments, although you can apply stoma powder if the skin is weepy.
Learn more: Caring for Your Peristomal Skin
How can I prevent leaks from my ostomy system?
Leaks from the stoma can injure the peristomal skin, so a secure seal is vital. To prevent leaks, make sure the opening of your skin barrier is no more than 1/8 inch (3-4 millimeters) larger than the base of your stoma. Clean and dry your skin carefully before applying the barrier. Use stoma paste or a barrier ring to ensure a leakproof seal. If you’re having problems with recurring leaks, consult your healthcare provider.
My stoma is getting smaller. Is that normal?
The stoma typically shrinks in the first 6-8 weeks after surgery. That’s why it’s important to measure your stoma when fitting your ostomy pouching system.
If your stoma shrinks or swells rapidly, or there’s a sudden change in its appearance, call your healthcare provider. If your stoma ever appears hard, dry, cold to the touch, flaccid, or a different color (dark red, purplish, dusky blue, gray, brown, or black) you should seek emergency medical care right away.
Read more: Stoma Measuring Guide
What should I do if I notice a problem with my stoma or ostomy?
If you notice a minor problem with your stoma or peristomal skin, reach out to your WOC nurse or healthcare provider.
You should contact your healthcare provider right away if you notice:
- A change in stoma color, from pink-red to purple, black or pale
- The stoma appears dry
- An increase or dramatic change in stoma size
- The stoma retracting or elongating
- Excessive bleeding from the stoma opening
- Bleeding between the stoma and skin
- Pain or sores on your peristomal skin
- Unusual bulging around your stoma
- A strong odor from the stoma
- Urine that’s bloody or foul-smelling
- An absence of bowel movements for more than 2 days
- You’re feeling dizzy or lightheaded
- Any unusual abdominal pain or continuous nausea and vomiting
You should call 911 or go to the emergency room if you notice rapid or dramatic changes in stoma color, or if you’re experiencing symptoms of severe cellulitis, such as high fever, chills, vomiting, and areas of skin that are red, hard, swollen, hot or painful.
How often do you have to empty a colostomy pouch?
The timing varies by person, but expect to empty your pouch 2 to 4 times per day, on average. You’ll want to empty your pouch when it’s 1/3 to 1/2 full.
How often do you have to empty a ileostomy pouch?
Because ileostomy output is more or less constant, most people empty their pouches 4 to 10 times per day. You’ll want to empty your pouch when it’s 1/3 to 1/2 full.
How often do you have to empty a urostomy pouch?
Typically, people drain the urine from their pouch every 2 to 4 hours, but this depends on how much you drink. Empty your pouch when it’s 1/3 to 1/2 full.
How can I prevent my ostomy pouch from detaching?
First, make sure you’re emptying your pouch often, when it’s 1/3 to 1/2 full. If you wait too long, the weight of the pouch can pull it away from your body. You may also want to change your pouching system more often, or wear an ostomy belt to help hold it in place. If the flange of your two-piece pouching system keeps detaching, try a one-piece system instead.
What is pancaking?
Pancaking means the output from an ileostomy or colostomy gets compressed and stuck at the top of your ostomy pouch. This can cause leaks or even make your pouching system detach. If you experience pancaking, try using lubricating deodorant drops to lubricate the inside of the pouch so the contents flow more easily.
Living With an Ostomy
Do you have to change your diet after an ostomy?
In the weeks after your ostomy surgery, you’ll want to stick to a bland, low-fiber diet as your digestive system heals. Eventually, you should be able to eat most of the foods you enjoyed before your ostomy, although you may want to avoid foods that cause gas, strong odors or indigestion.
Can you exercise when you have an ostomy?
Yes. People with an ostomy can do just about any exercise they choose, although they may need special accessories or accommodations. Talk to your healthcare provider before beginning a strenuous exercise routine or contact sport. Lifting heavy weights or straining may put you at risk of a peristomal hernia.
Can you bathe or shower when you have an ostomy?
Yes. You can bathe or shower with your pouching system on or off, whichever you prefer. Water will not enter or harm your stoma. Don’t use soaps that contain lotions or oils on your peristomal skin. If you shower with your appliance on, then cover the filter with a sticker to keep it from getting wet.
Can you travel when you have an ostomy?
Certainly! Traveling may require some advance planning and packing, but having an ostomy will not prevent you from going anywhere you want to go.
Read more: Traveling with an Ostomy
Will people notice my ostomy pouch?
Typically, people won’t know you’re wearing an ostomy pouch unless you tell them. If you’re worried about it, you can wear an ostomy pouch cover or wrap, or wear high-waisted, patterned clothing to conceal your pouching system.
