What is a colostomy?

Explanation of terminology

A colostomy is a surgical procedure in which an artificial opening of the large intestine (colon) is formed on the surface of the skin.

Different types of colostomies

There are basically two different types of colostomy: End colostomy and Loop colostomy.

End colostomy

An end colostomy is created when the rectum, the anus with sphincter muscles and/or the lower part of the colon have to be removed due to illness. This stoma is usually located in the left lower abdomen and cannot be moved back. As a large part of the colon remains intact with this stoma, the consistency of the stool does not normally change compared to before. The only difference is that voluntary emptying is no longer guaranteed.

Loop colostomy

A loop colostomy is a procedure in which part of the colon is immobilised and relieved. Two stoma openings are created in the abdominal wall. One opening for active emptying of the bowel contents and the other to relieve the strained part of the colon. This type of stoma can be easily reversed by detaching the ends of the bowel from the abdominal wall, stitching them back together and moving them back into the abdominal cavity - so the bowel is fully intact again and functions as before.

When does a colostomy become necessary?

A colostomy is always necessary if the lower part of the colon or rectum is damaged, diseased or needs time to heal after surgical removal.

Possible indications for a colostomy

Bowel cancer and anal cancer

Chronic inflammatory bowel diseases, such as Crohn's disease or Ulcerative colitis

Diverticulitis

Traumatic injuries

Faecal incontinence

Genetic anomalies

Challenges following surgery

A colostomy changes your life - this cannot be denied. For the majority of people, such a major change leads to emotional upheaval, both positive and negative. For some, a stoma finally represents the long-awaited and especially painless freedom, while others find it difficult to accept the new accessory. Both are perfectly normal. However, it is important to realise that you will continue to live a fulfilling and active life with a stoma.

Body image and self-esteem

Adapting to changes in your body can be emotionally challenging. Body image is the aspect of self-concept that focuses on our ideas about our physical appearance and how we compare ourselves to others. After surgery, your body is changed, especially because of your new stoma. It is often a long process to become aware of this change, to slowly get used to it and to continue to treat yourself and your body with respect. Your body is not less beautiful because of a stoma!

Psychological counselling and support groups can help you to navigate your feelings and regain your self-confidence.

Nutrition

Eating is a big part of our lives and not only ensures our survival, it also has an effect on our mood. However, a stoma should not affect your enjoyment of food or make you anxious about it.

Most people are supported by their doctor or stoma care nurse after their operation, but food tolerance varies from person to person. Patients often return to their normal diet quite quickly after the surgery, as what they were able to tolerate before the stoma operation can usually also be tolerated afterwards.

The most important things for ostomates are to avoid constipation and foods that cause unpleasant odours, flatulence or excessive bowel movements. However, this does not mean that you have to give up your favourite foods - anything that tastes good and is well tolerated is allowed!

Tips & Tricks:

Make sure you eat a balanced diet: favour easily digestible foods.

Drink enough: approximately 2 to 2.5 litres/day.

Make sure your food is prepared gently and with low fat levels.

Take your time while eating and drinking: chew well and drink in small sips.

Eat at regular times, several meals a day: approximately 3 to 8 meals.

Exercise regularly.

Make sure your body weight is stable. Strong fluctuations in weight can change the position of your stoma and possibly lead to leakages.

Physical activity

Sport is important and keeps you healthy. Sport is also an important part of well-being for ostomy patients and should not be neglected or ignored under any circumstances. But be careful: Exercise immediately after a stoma surgery is strongly discouraged. Your body needs enough time to fully recover!

Which sports are recommended?

Except for extreme sports such as boxing and weightlifting, you can do any sport you feel comfortable with.

Tips & Tricks:

Use a supportive bandage or similar compression garment during sport: This will ensure that your ostomy appliance stays in place and reduce the risk of hernias.

Start slowly: Your body needs to get used to the strain in its new situation.

Make sure you drink enough fluids.

Ostomy care and hygiene

If you have a stoma, skin care is the most important thing. It is essential that you know exactly what causes discomfort on your skin, which products you tolerate best and how you can optimally care for your skin around the stoma. Proper care of the stoma and the skin around it is crucial to prevent complications such as infections or skin irritation.

Tips & Tricks:

Gently wash your stoma and the surrounding skin with warm water.

Avoid using perfumed soaps, lotions and creams as these can irritate your skin and cause itching.

Gently dab your skin with fleece compresses when drying off.

If your skin is already slightly sore, it may be helpful to use a special skin protection lotion.

For travelling: If you cannot use a sink, pack unscented wet wipes for cleaning. Please only use these in an emergency!

If you have any difficulties with sore skin, please speak to your stoma care nurse.

More detailed information on skin care for ostomates can be found here.

Living with a colostomy

Coping with a colostomy can be emotionally and mentally challenging for patients. Don't feel alone, talk to your stoma care nurse, friends or family and loved ones, they can make a significant difference in how you handle this change.

You can find out more about recovery after a stoma surgery here.

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