Managing your colostomy

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. It’s not hard to do, but getting to the point where you feel comfortable takes learning, practice, the right supplies, and a positive attitude.

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.

There’s no one way to take care of a colostomy. This guide offers you tips and ideas that you can discuss with your doctor or ostomy nurse and adapt to your needs. Give new things a fair trial, but don’t keep doing them if they don’t 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. 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’ll come out. The doctor and ostomy nurse will work with you to find the best way to contain the stool so you won’t 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.

Bowel movements with a transverse colostomy

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

  • The right pouching system (also called an appliance) for you is one that will keep you from soiling your clothing.
  • 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. But they can be controlled so that you won’t feel embarrassed.
  • Empty the pouch when it’s about 1/3 full to keep it from leaking or bulging under your clothes.
  • Change the pouch system before there’s a leak. It’s 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 help prevent skin problems by having a correctly fitted pouch system and by using special materials for ostomy care.

For more on care, see Caring for a Colostomy.

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’s expected or not. There are many lightweight pouches 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’ll 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 in Eating  and Digestion With a Colostomy.

In its original form this document was written by the United Ostomy Association, Inc. (1962-2005) and reviewed by Jan Clark, RNET, CWOCN and Peg Grover, RNET. It has since been modified and updated by:

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: December 2, 2014 Last Revised: December 2, 2014

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