What Is a Colostomy and How Do I Manage It?

October 16th, 2024

Written By: Dr. Pavi Kundhal, MD, MBA, FRCSC

Disclaimer: This information is general and may not meet individual needs. For a personalized plan tailored to your unique lifestyle and clinical requirements, book a free introductory call at 437-500-5000.

If you’re facing your first colostomy, you might be feeling overwhelmed or anxious. It’s normal to have lots of questions, especially when something as significant as your health is involved. In this blog, we’ll break down what a colostomy is, why you might need one, and, most importantly, how you can manage it day-to-day. We’ll keep things simple and straightforward because understanding what’s happening to your body shouldn’t be complicated. 

What is a Colostomy? 

A colostomy is a surgical procedure where an opening, called a stoma, is created in your abdomen. This stoma connects part of your intestine, usually the large intestine (colon), to the surface of your abdomen. The purpose of this is to allow waste (poop) to exit your body in a new way when the normal route through your rectum isn’t possible, either due to surgery, injury, or certain diseases like cancer. The stoma can be placed on either the right or left side of your abdomen, depending on whether the small or large intestine is being exteriorized. 

Think of your stoma as a new pathway for your body to get rid of waste. The waste is collected in a bag that you wear over the stoma on the outside of your body. It might sound a bit daunting, but many people live full, active lives with a colostomy. 

When you have a colostomy, it’s usually placed on the left side of your abdomen. In this part of your digestive system, waste is more solid, so since the stoma (the opening created during surgery) doesn’t have muscles to control when you go to the bathroom, you’ll need to use a special pouch to collect the waste. 

There are two main types of colostomy surgeries: End Colostomy and Loop Colostomy

End Colostomy 

If part of your large intestine or rectum has been removed, the remaining part of the large intestine is brought to the surface of your abdomen to create the stoma. An end colostomy can either be temporary or permanent. The temporary version is often used when the damaged part of your bowel is removed, and the rest of your bowel needs time to heal before everything is reconnected. The permanent version is used when it’s too risky or impossible to rejoin the two ends of your intestine. 

Loop Colostomy 

In a loop colostomy, a section of your bowel is lifted above the surface of your skin and secured in place with a small rod. The surgeon then makes a cut in the exposed bowel loop, rolls the ends down, and stitches them to the skin. This creates what’s called a loop stoma, which is actually made up of two stomas joined together. Loop colostomies are usually temporary and are often done in emergency situations or to protect a surgical connection in your bowel while it heals. 

Choosing the Right Colostomy Bag for Your Needs 

When you have a colostomy, you'll usually need to use a closed bag to collect waste. However, if the output from your stoma is more liquid than usual, a drainable bag might be a better option for you. After your surgery, you might start with a clear bag so you and your healthcare team can monitor your output, but as you get more comfortable, you can switch to an opaque (non-see-through) bag, which could also be smaller and more discreet.  

Tip: If you find that your stoma output varies throughout the day, consider keeping both closed and drainable bags on hand. This way, you can switch between them depending on your needs, ensuring you’re always prepared. 

There are two main types of colostomy bag systems you can choose from: One-Piece System and Two-Piece System 

One-Piece System 

In this system, the collection bag and the adhesive baseplate (which sticks to your skin around the stoma) are combined into one piece. It fits snugly around your stoma, making it easy to use and secure. 

Tip: One-piece systems are great for simplicity, especially when you’re just getting used to managing your colostomy. However, because the whole system needs to be changed at once, be sure to change it during times when your stoma is less active, like before meals or early in the morning. 

Two-Piece System 

With the two-piece system, the collection bag is separate from the adhesive baseplate. The bag and baseplate clip or seal together, so you don’t have to remove the baseplate from your skin every time you change the bag. This can be more convenient and gentler on your skin. 

Tip: Two-piece systems can be especially beneficial if you have sensitive skin. Since you don’t have to remove the baseplate each time you change the bag, it reduces the amount of stress on your skin, which can help prevent irritation. 

General Tips: 

  • Bag Size: Consider having different bag sizes for different activities. A smaller bag might be more comfortable and less noticeable when you're out and about, while a larger bag could be more practical overnight or at home. 
  • Odour Control: Some bags come with built-in filters to help manage odours. If this is a concern for you, look for a system that includes this feature. 
  • Practice Makes Perfect: It might take a little time to figure out which system and routine work best for you. Don’t hesitate to experiment with different products until you find your perfect fit. 

Why Would I Need a Colostomy? 

There are a few reasons why you might need a colostomy. Sometimes, it’s because of a cancer diagnosis that requires removing part of your colon. Other times, it might be due to a blockage, infection, or injury. In some cases, a colostomy is temporary, meaning it will be reversed once your body has healed. In other cases, it might be permanent. Your healthcare team will explain the specifics of your situation so that you can understand exactly why this procedure is necessary for you. 

Tips and Guidance on Managing Your Colostomy 

Adjusting to life with a colostomy can be challenging at first, but with some guidance, you’ll find that you can still do most of the things you love. Here’s a step-by-step guide to help you manage your colostomy as a first-time patient: 

Understanding Your Stoma: 

  • Your stoma is typically round or oval and red or pink in color. It doesn’t have nerve endings, so you won’t feel pain in it, but it’s important to keep it clean and healthy to avoid complications. 
  • At first, it may look swollen, but don’t worry—this usually decreases over time.

Caring for Your Stoma: 

  • Cleaning: Use warm water and a soft cloth to gently clean around the stoma. Avoid using soap that contains oils or moisturizers, as they can irritate the skin or make it harder for the colostomy bag to stick. 
  • Drying: Make sure the area around your stoma is completely dry before attaching a new colostomy bag. Damp skin can cause irritation and make it difficult for the bag to adhere properly. 

Tip: Clean the stoma in a seated or standing position that feels most comfortable for you. Have all your supplies within easy reach to make the process smoother. 

 Changing Your Colostomy Bag: 

  • Frequency: How often you change your bag depends on the type of system you’re using. Some bags need to be changed every 3-4 days, while others are disposable and need to be changed more frequently. 
  • Steps: 
  1. Gather all your supplies before you start. This includes a new bag, a skin barrier or wafer, an adhesive remover, and a mirror if needed. 
  2. Gently remove the old bag by peeling it away from the skin. Use adhesive remover if needed. 
  3. Clean the stoma area with warm water and let it dry completely. 
  4. Apply the skin barrier to protect your skin from waste and help the bag stick. 
  5. Attach the new colostomy bag, ensuring it’s secure and comfortable. 

Tip: Change your bag when your stoma is less active, such as before meals or first thing in the morning. This can help reduce the chance of leaks during the change. 

Managing Diet and Hydration: 

  • Diet: Right after your surgery, your healthcare team might recommend a low-fiber diet to give your bowel time to heal. Gradually, you can reintroduce a variety of foods to see how your body reacts. 
  • Stay Hydrated: Drink plenty of fluids, as your body may absorb less water after the surgery. This helps prevent constipation and keeps your digestive system functioning smoothly. 
  • Gas and Odor: Certain foods might cause more gas or odour. You might want to limit foods like beans, onions, and carbonated drinks. However, you’ll quickly learn what works best for your body. 

 Tip: Keep a food diary to track which foods work well for you and which might cause issues like gas or discomfort. This can be a helpful reference as you reintroduce new foods. 

Skin Care: 

  • The skin around your stoma (called peristomal skin) needs special attention to prevent irritation. Use skin barrier products if necessary and monitor the skin closely for any signs of redness or breakdown. 

Tip: If you notice any irritation or skin breakdown, contact your healthcare team immediately. They can provide treatments or adjustments to prevent further issues. 

Managing Leaks: 

  • Leaks can happen but don’t panic. If you notice any signs of leakage, change your bag as soon as possible to prevent skin irritation. Ensure your bag is fitted correctly and check with your nurse if you need adjustments. 

Tip: Carry a small emergency kit with extra supplies like a new bag, skin barrier, and adhesive remover when you’re out. This will help you feel prepared in case of any issues. 

Dealing with Emotional Adjustments: 

  • It’s okay to feel a mix of emotions after your surgery. Many people experience anxiety or sadness as they adjust to life with a colostomy. Talking to others who have colostomies, joining a support group, or speaking with a counsellor can be very helpful. Remember, you’re not alone, and there are many resources available to support you. 

Tip: Reach out to a local or online support group where you can connect with others who have gone through similar experiences. Hearing their stories and advice can be incredibly reassuring. 

 Getting Back to Normal Activities: 

  • As you recover, you can slowly return to your normal activities. Start with light exercises like walking, and gradually increase your activity level. Your doctor will guide you on when it’s safe to resume more strenuous activities or return to work. 

Tip: Consider wearing a stoma guard or belt for extra support during physical activities. This can give you more confidence to move around freely. 

Packing an Emergency Kit: 

  • Keep a small kit with you that includes an extra colostomy bag, cleaning supplies, and a change of clothes. This can give you peace of mind when you’re out and about. 

Tip: Include items like wet wipes, hand sanitizer, and disposal bags in your kit to make changes on the go easier and more hygienic. 

Reaching Out for Help 

Don’t hesitate to reach out to your healthcare team with any questions or concerns. They are there to support you every step of the way. Whether you need advice on managing your colostomy, dealing with emotional challenges, or finding the right products, help is always available. 

Conclusion 

Having a colostomy is a significant change, but with the right information, support, and care, you can manage it successfully. Over time, you’ll develop your routine and find that life can be just as fulfilling as before. Remember, you’re still you, and a colostomy is just a part of your journey—not the whole story. 

 

This blog is for informational purposes only and should not be considered medical nutrition therapy, medical advice, or a diagnosis. It is not a substitute for professional consultation or recommendations from your healthcare provider. 

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