How to Live (and Thrive) with an Ostomy

Medically reviewed by Kimmie Ng, MD, MPH

An ostomy, or stoma, is a surgical opening in the skin that functions as an alternate way to remove waste products from the body. An ostomy may be necessary for a variety of reasons, including bowel disease, birth defects, and cancer.

There are three different types of ostomy: ileostomy, colostomy, and urostomy.

Ileostomy and colostomy

An ileostomy and a colostomy are required when a part of the intestine needs to be removed or bypassed due to:

  • Blockage or damage
  • A ruptured colon
  • A need for part of the large intestine needs to be removed

Most commonly, patients with colorectal cancer may need either an ileostomy or a colostomy. Any cancer that causes disease to the bowel (i.e., peritoneal metastases) may result in a necessary ostomy, but even that is rare.

Cancer-related ileostomies and colostomies may only be needed for a few months while the colon or rectum heals, but some patients may need a permanent ileostomy or colostomy.

Urostomy

A urostomy creates a permanent opening called a stoma (a pathway from the bladder to the outer abdomen). Patients with bladder cancer may have all or part of their bladder removed during treatment, a procedure called a cystectomy. In this case, the urine is redirected using a urostomy. Women with cervical cancer may also need a urostomy.

Can I live a normal life with an ostomy?

Yes! You can live a normal life with an ostomy. You can still work, travel, stay active, and enjoy your favorite foods.

Will I be able to return to work?

You can perform most jobs with an ostomy. While jobs that involve heavy lifting could cause a stoma to herniate or prolapse, many people with stomas do heavy lifting. As you return to work, it can be helpful to tell your employer or a friend about your ostomy; this can help educate others while preventing any problems.

Can I shower?

When it comes to bathing, water won’t affect your ostomy. While you can shower with or without your pouch, it’s recommended that you take a bath with a pouch. You can also use soap, but make sure to rinse your skin well, as it may interfere with the skin barrier sticking to your skin.

Will it impact what I eat?

Your ostomy nurse will give you tips and advice for what you can eat after your surgery, but chances are you can return to your normal diet not long after your operation. There are some foods you should be mindful of eating, as they can be hard to digest and can cause blockages. These include:

  • Nuts
  • Seeds
  • Popcorn
  • Dried fruit
  • Mushrooms

It is also important to drink lots of fluids (such as water) to stay hydrated. After an ileostomy, you lose more fluids daily because fluid is not reabsorbed into the large intestine. You can also drink tea and coffee, and alcohol is fine in moderation.

Can I work out?

Staying active is an important factor when it comes to maintaining a healthy lifestyle. Although there are a few safety measures to consider, an ostomy shouldn’t prevent you from playing sports or exercising. Many athletes, who are runners, weight lifters, and skiers (to name a few) have ostomies.

When it comes to safety measures, you should take extra precautions when choosing to participate in contact sports due to possible injury to the stoma or having your pouch slip. Talk to your doctor about the best ways to stay active.

Can I travel?

Your ostomy won’t prevent you from traveling, whether it’s in a car or on a boat, but there are some tips to keep in mind to ensure smooth sailing.

  • Bring extra supplies; they may not be easy to find once you get to your destination. It can also be beneficial to do some research on where to find supplies once you get there.
  • Carry an extra pouch or two if traveling by plane. Keep it in your carry-on bag in case your luggage gets lost.
  • Wear your seatbelt! It won’t harm the stoma.
  • Determine how many changes you’ll need before your trip.

What about intimate relationships?

Intimacy can be an important part of a relationship, and your ostomy shouldn’t prevent you from being intimate with a partner. If you’re feeling nervous about your ostomy, here are some tips:

  • Empty the pouch beforehand.
  • Discuss any concerns you have with your partner. If you’re feeling self-conscious or anxious, talk to your partner about it; it’s possible they’re feeling nervous as well. Women may consider wearing a short slip or nightie, intimacy wraps, etc., while men might wear a wrap or cummerbund around the midsection to secure the pouch.
  • Don’t worry about loosening the pouch or hurting the stoma. Body contact during sex usually won’t affect either of these.

Typically, after an ostomy surgery, sexual function in women does not change other than the possibility of pain during sex. Men may have trouble getting or keeping an erection. However, these problems usually improve with time.

The Dana-Farber Sexual Health Program for Cancer Patients and Survivors offers private counseling, consultation, and education to help you cope with these changes and find solutions.

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