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Patient education: Colostomy care (The Basics)

Patient education: Colostomy care (The Basics)

What is a colostomy? — A colostomy is an opening in the belly made by a doctor as a way for bowel movements to leave the body not through the anus. To make a colostomy, your doctor will do a procedure to make a small opening in your belly. Then they will connect your large intestine to this opening (figure 1 and figure 2).

A colostomy is sometimes called a "stoma," which is a medical word that means "opening." After a colostomy is made, your bowel movements will come out through the stoma into a bag that is attached to your skin.

What will my bowel movements be like with a colostomy? — You will probably have about 4 to 8 bowel movements a day. Your bowel movements might be less solid than they used to be.

How do I manage my colostomy? — A special nurse (called an ostomy nurse) will teach you how to manage your colostomy. They will teach you:

When and how to empty the bag that collects your bowel movements

When and how to put on a new bag to collect your bowel movements

How to check your stoma for problems

There are different types of colostomy bags. With some types of bags, you empty, clean, and reuse them. With other types, you throw them out after each use.

Some people worry that their bag will leak, or that other people will be able to smell their bowel movements. But this is not common. The bags are made so that they do not leak or smell.

If you have a certain type of colostomy, you might be able to manage it with a process called "irrigation." This is a way to make your bowel movements regular. It involves squirting water into your stoma on a regular basis to cause a bowel movement to happen.

What problems can happen with a colostomy? — Different problems can happen with a colostomy, either right away or years later. Let your doctor or nurse know if you have any of the following symptoms or problems:

Your stoma is swollen or larger than usual.

Your stoma is smaller than usual.

Your stoma leaks more than usual.

You have a rash or sores around your stoma.

The inside of the stoma sticks out through the opening more than usual.

You notice a bulge under the stoma or next to it.

You have sudden belly pain, cramps, or nausea.

You had a lot of diarrhea come out of the stoma and are dehydrated. Dehydration is when the body loses too much water. Symptoms of dehydration include not making as much urine or having dark yellow urine, or feeling thirsty, tired, dizzy, or confused.

You haven't had any gas or bowel movements through the stoma for 4 to 6 hours (during the day). These symptoms could mean that your stoma is blocked.

Do I need to follow a special diet? — Probably not. But you should avoid getting constipated. (Constipation means trouble having bowel movements.) To avoid constipation, you can:

Eat foods that have a lot of fiber (table 1)

Drink plenty of water and other fluids

The foods you eat can affect the odor of your bowel movements, and how solid or soft they are. Certain foods can also make you have more gas. The foods that can affect your bowel movements and gas are listed in the table (table 2).

What will my life be like with a colostomy? — You should be able to live an active and normal life with your colostomy. But many people worry about the following things:

Clothes – You do not need to wear special clothes. Other people won't be able to see your bag under your clothes.

Baths and showers – You can take a bath or shower with or without your bag on.

Sports – You will probably be able to play most sports. You might want to wear a special belt to protect your bag and keep it in place. Doctors usually recommend that people with a colostomy not play certain contact sports (such as football) or lift weights.

Swimming – You can swim with your bag on. Make sure to empty your bag before you swim.

Sex – You can have sex. But you might want to wear a special wrap to protect (and cover) your bag during sex.

Travel – When you travel, be sure to bring extra supplies to manage your colostomy. If you fly, take your supplies in your carry-on luggage.

It is normal to feel sad, upset, or worried when you have a colostomy. If you have these feelings, try to get help. You can talk with a family member, friend, or counselor. You might also find it helpful to go to a support group for people who have a colostomy.

More on this topic

Patient education: Colectomy (The Basics)
Patient education: Colon and rectal cancer (The Basics)
Patient education: Crohn disease in adults (The Basics)
Patient education: Ulcerative colitis in adults (The Basics)
Patient education: Gas and bloating (The Basics)
Patient education: High-fiber diet (The Basics)
Patient education: Constipation in adults (The Basics)
Patient education: Ileostomy care (The Basics)

Patient education: Colon and rectal cancer (Beyond the Basics)
Patient education: Ulcerative colitis (Beyond the Basics)
Patient education: Crohn disease (Beyond the Basics)
Patient education: High-fiber diet (Beyond the Basics)

This topic retrieved from UpToDate on: Mar 03, 2022.
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