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Living with a colostomy

BMJ Group Medical Reference

Learning to live with a colostomy can be daunting. But you're not alone. There are thousands of people in the UK who have had surgery so that bodily waste (either faeces or urine) can pass through a new opening.

If you have colon or rectal cancer, you may need a colostomy because the muscles that control your bowel movements have been removed. Your surgeon will create a new opening for your colon (usually on your abdomen) so that your faeces can be collected in a bag called a colostomy bag.

Having a colostomy should not stop you doing anything you used to do. But you will have to change your routine and get used to changing the bag that collects your bowel movements.

You'll get plenty of help adjusting to having a colostomy. While in hospital, you'll probably be seen by a nurse who deals just with caring for people who have had this operation. He or she will advise you about what to expect after your operation, show you how to look after the opening in your abdomen and teach you about all the special equipment you'll need. And when you get home, a nurse will check on your progress to make sure you feel confident about what you need to do.

You may be able to decide with your surgeon where on your abdomen to have your bowel open out. The opening should be in a spot that you can see and reach easily. Your doctor or nurse will offer advice on the best place for it. After that, you'll need to get used to the bag and how to empty and change it. Bags are much lighter and smaller than they used to be. They shouldn't show through your clothes. The bag will lie flat against your body, and you can choose between disposable and reusable varieties. Most are also fitted with a charcoal filter so they don't smell.

The worst thing for many people with a colostomy is the sight of the stoma. This is the spot where your colon opens onto your abdomen. It will look wet and glossy, rather like the inside of your mouth. It is delicate, and can bleed and give off white stringy mucus.

Another thing you'll notice is that your stools are not semisolid like they used to be, but runny. This is because when your bowel movements pass through your colon, the tissues there remove most of the water and channel it back into your body. When your bowel movements no longer pass through your colon, your body doesn't absorb this liquid, so your stools are much more watery.

Because of this, you need to beware of leakage around the stoma. This can irritate your skin and lead to infection. You can avoid leaks by making sure your bag fits closely. Check your bag size regularly as your stoma may shrink, especially in the first few weeks after your operation.

Here are some tips on managing your colostomy from day to day.

  • Always wash your hands before emptying or changing your bag.

  • Clean the skin around your stoma whenever you change your bag. Use only water and a little soap, unless your doctor or nurse advises otherwise.

  • Empty the pouch when it's one third full, and before you go to bed.

  • Keep all your supplies within easy reach when you go to the toilet.

  • When you remove your bag, cover the stoma with a piece of tissue to stop any leakage.

  • Contact your doctor or nurse if your stoma bleeds heavily, turns black, becomes swollen, or smells strongly.

  • If you have problems with wind and rumbling noises, try to avoid foods that give you wind, such as broccoli, cheese, beans, and beer.

  • Get plenty of exercise as this can help reduce wind.

  • If you're having problems with your bag smelling, try eating foods that have a natural deodorant, such as apple sauce, cranberry juice, and yoghurt.

  • Join your local colostomy group. You can get useful tips and advice from other people who have a colostomy. And these people can be a valuable source of moral support too.

Last Updated: October 01, 2013
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.

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