Colostomy: A Guide

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Colostomy management

Learning to take care of your colostomy may seem hard at first, but with practice and time it will become second nature, just like shaving or bathing.

Think of your colostomy's function as you did your natural bowel movements. You still have the same bowel, just a little less of it. The real change is having the stool come out of an opening made on your belly (abdomen). Learning how to care for your colostomy will help you adjust.

There is no one way to take care of a colostomy. This guide offers you tips and ideas for managing your colostomy. Discuss the ideas with your doctor or ostomy nurse and adapt them to your needs. Give new things a fair trial, but do not keep doing them if they do not make you more comfortable. Use your recovery time to learn and try different things so that you can find what works best for you.

In our society, bathroom needs are kept private. Talking about stool and bowel movements can be awkward or uncomfortable. This is often true for a person with a colostomy. But while you learn how to deal with the changes that have been made, you may need help and advice. A good sense of humor and common sense are needed when changes in body function take place. Be confident. You can learn the new system. Before long you again will be in control.

At first, it will be hard to tell what your stools will be like or when they will come out. The doctor and ostomy nurse will work with you to find the best way to contain the stool so you will not be surprised or embarrassed. There are many ways that this can be done. The choice depends on your type of colostomy, your usual bowel function, and your personal preference.

Care of any colostomy is really not very hard to do, but getting to the point where you feel comfortable takes a lot of learning, a lot of practice, the right supplies, and a positive attitude.

Bowel movements with a transverse colostomy

A transverse colostomy will put out stool no matter what you do. Keep in mind these points:

  • A pouching system (also called an appliance) that will keep you from soiling your clothing is the right one for you.
  • The firmness of your stool is affected by what you eat and drink.
  • Gas and odor are part of the digestive process and cannot be prevented. Still, they can be controlled so that you will not feel embarrassed.
  • Empty the pouch often during the day to keep it from leaking or bulging under your clothes.
  • Change the pouch system before there is a leak. It is best to change it no more than once a day and not less than once every 3 or 4 days.
  • The ostomy output can irritate your skin. You can prevent skin problems by having a correctly fitted pouch system and by using special materials for ostomy care.

For more information on care, see the section called "Helpful hints."

Bowel movements with a descending or sigmoid colostomy

You can treat the bowel movement through a colostomy like a normal movement through the anus; just let it happen naturally. But, unlike the anal opening, the colostomy does not have a sphincter muscle that can stop the passage of stool. This means you must wear a pouch to collect anything that might come through, whether it is expected or not. There are many lightweight pouches you can buy that are hard to see under clothes. They stick to the skin around the colostomy and may be worn all the time, or only as needed.

Some people with a descending or sigmoid colostomy find that by eating certain foods at certain times, they can make the bowel move at a time that works best for them. With time and practice, they may feel so certain of this schedule, they will wear a pouch only when a movement is expected. Some people use only this method to keep bowel movements on a regular schedule, while other use it along with irrigation.

More information on diet and eating is covered later.

Last Medical Review: 03/17/2011
Last Revised: 03/17/2011