Taking care of your ostomy after surgery

When you wake up after the operation you’ll be wearing your first pouch. This will probably be a clear one so that your nurses can check on your new stoma easily. You may also have drips and drains attached to your body. This is perfectly normal and they will be removed with very little discomfort when appropriate.

Your stoma
Your stoma will be moist and pinkish-red in color and should protrude from your abdomen (though it's also common for a stoma to remain flush with the skin surface). It may be quite swollen to begin with but will reduce in size over time – usually 6 to 8 weeks after surgery. Your stoma is a mucous membrane, just like the mucous membrane inside your mouth. There is no sensation in the stoma, so it is not at all painful to touch.  The stoma can bleed a little when being cleaned, especially in the beginning, but this is normal and should stop shortly afterwards.

Your stoma will begin to work shortly after your operation, usually within a few days. At first the output will be a watery liquid and may be strong-smelling as your bowel hasn’t been working for a while. Don’t worry, though, the consistency will thicken slightly and the smell will diminish as you resume a more balanced diet. Your doctor will advise you when you will be able to eat and drink as usual.

Initially, it’s also likely that a certain amount of noisy gas will come from the stoma – again this is perfectly normal. It is not uncommon to feel the use the restroom as you did before. This is normal and should reduce with time. If your anus is still present, there may be some mucus discharge from it.

Urostomy
If you have a urostomy, the stoma will begin to work immediately after your operation. The tubes -- called  "stents" -- placed in the urostomy will be left in place for seven to ten days. At first, your urine may be slightly red, but it will soon return to its usual color.

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After your operation, your stoma care nurse will focus on helping you become confident in taking care of your stoma. It will help to have a close relative or spouse with you for this training.

Your nurse will help you with:

• Learning how to care for your stoma, including what to watch out for
• Re-ordering stoma pouches and accessories
• Your rights regarding reimbursement and other economic support relating to your stoma
• Other practical aspects of living with a stoma, e.g. foods and drink, your social life, travelling and your intimate relationships
• Who to contact when you have questions
• Ostomy association support groups in your area

Ask questions
There will be a lot of new information to take in at once; it may even feel a bit overwhelming. Take your time and ask all the questions you need, as many times as you need to. The more you ask and try things out, the better prepared you will be once you are back at home.

Before you leave the hospital, your ostomy nurse will likely make arrangements for follow-up care to make sure you feel confident caring for your ostomy.

Overcoming challenges
Once you are home, you may experience some challenges caring for your stoma. But remember that your WOC nurse, as well as a dedicated Coloplast Care Advisor, will be more than happy to help you with any issues.

Coloplast also has a support program called Coloplast Care that you may find useful. Coloplast Care was created to help make living with an ostomy easier, and incorporates dedicated advisors and helpful wellness education to help you find a "new normal." To get in touch with a Care Advisor, call 1-888-726-7872.

Enroll in Coloplast Care- now online!

Thinking ahead
After surgery, it’s entirely possible for most people to go back to work. However, when and how you do this really depends on how you feel, the type of work you do, and the stoma operation you had.

Talk to your employer and discuss your options as soon as possible. It may be possible to return to work part time; this could be particularly helpful when you first go back as you may still feel tired and need time to get used to new routines.

Try it out
A few weeks before you go back, do a few trial runs where you dress and plan your day as if you were going to work. Think about your diet and when and how many times a day you may need to change or empty your pouch. This will help you to establish routines and plan your day accordingly. Most importantly, it will make you feel prepared.

Tips

• Speak to your employer as soon as you can
• If possible, build up your working hours gradually
• Check the available changing facilities at work
• Pack a small changing bag that you can take discreetly to the bathroom
• Do trial runs before you start work, thinking about diet and clothing etc.
• If your company provides healthcare insurance, check whether your condition affects the policy

Whatever you decide to do, the most important thing is that you are comfortable with your decision. You may want to explain that you had major surgery because of a serious illness and now wear an ostomy pouch. This often leaves few other questions to be asked and people will see that you have a straightforward attitude towards your condition.

Family and friends
Being open and honest with the people close to you can help you get back to the life you had before your stoma surgery. In the beginning, it’s important for the people closest to you to understand that although you are back home, recovery from major surgery will take time.

Children
If you have young children or grandchildren you may feel that they are too young to understand. However, children tend to cope well if they are given the information in a simple way. Children will often pick up on secrets and hiding the truth from them can sometimes make them think a situation is more serious than it really is.

At work
Many people are concerned about telling work colleagues. And just like with family and friends, who you tell and what you tell them is entirely up to you. However it’s usually advisable to ensure that at least one person knows you have an ostomy. Then, in case there are any problems or issues, you will have someone to talk to. 

It is important to keep your skin healthy. Contact between stoma output and skin causes skin irritation that can affect how well the barrier on the appliance sticks to your body. This creates a vicious circle of more leakage and even more irritated skin – which is important to avoid.

Keep your skin healthy
These six steps will help you keep your skin healthy: 

1. Make sure your skin is clean and completely dry before applying the barrier
2. Adjust the hole in the adhesive so that it exactly fits around your stoma
3. Make sure that there is full contact between the barrier and your skin – use a bit of light pressure with your hand
4. Change your appliance as soon as you feel any discomfort or itching
5. Check the size of the stoma regularly, especially if you have a hernia
6. Make sure to use the stoma appliance and accessories most appropriate for your body profile 

To help you better understand your stoma appliance and discuss your needs with your stoma care nurse, here is a glossary of commonly used terms.

Barrier: The part of an ostomy pouching system that attaches the appliance to your skin while you are wearing it. The adhesive must ensure close contact with the skin surface and protect it so that output from your stoma does not touch the surrounding skin.

Coupling system: This attaches the barrier to the pouch in a two-piece appliance, allowing the pouch to be changed without changing the barrier. It can either be mechanical, or adhesive.

Convexity: A specially shaped baseplate with an oval shell that puts light pressure on the skin around the stoma. It is designed to accommodate a stoma that is difficult to manage, for example, a retracted stoma that lies below the skin.

Extended wear adhesive: An adhesive that can be worn for a longer time period, or if there is “aggressive” output from your stoma. Some types of ileostomy or urostomy can have output that breaks down standard adhesives too quickly. Extended wear adhesives are generally used with two-piece appliances.

Filter: From time to time, your stoma releases gas. The filter included in the appliance has a deodorizing action which helps ensure there is no odor, one of the things that people often worry about. It also controls the release of the deodorized wind, so that your bag doesn’t inflate (which is also called ‘ballooning’).

Non-return valve: Urostomy appliances have a non-return valve to stop urine from flowing back to the stoma and help prevent urinary infections.

After a stoma operation, your body profile may change for a number of reasons. These may include:

• Weight gain or loss as you recover from the illness that caused the operation
• Folds or scarring of the skin around your stoma
• Hernia development connected to your stoma

If your body profile changes, it’s important that you make sure your stoma pouch still fits snugly.

Find the right product
A tight seal between the appliance and your skin is essential to good stoma care. If, for example, the area around your stoma changes from being regular to being more inwards, it may be time to switch to a convex appliance. You may also need to use additional accessories.

Our online self-assessment tool, BodyCheck, will help you figure out your current body profile and whether your body has changed significantly. It has suggestions for the right appliances and accessories for you.


It’s always a good idea to consult with your ostomy nurse about how your pouch fits and which accessories might work for you.

There are two main types of ostomy pouching systems:
One-piece systems consist of a pouch and barrier that are permanently attached to one another. When it needs to be changed, the whole appliance is removed, making this system suitable for frequent changes.

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Two-piece systems involve a separate pouch and baseplate. In these systems, the pouch can be removed and changed without having to change the baseplate as well. There are two ways to connect the baseplate and pouch:
A mechanical coupling fixes the pouch to the barrier by snapping together. A locking system makes an audible 'click', confirming that is locked securely.

An adhesive coupling attaches the pouch to the barrier with a secure, flexible adhesive system.

Types of pouch
There are three main types according to which kind of ostomy you have:

• Closed
• Drainable
• Urostomy

Closed pouches are generally used if you have a colostomy as the stool is usually more solid. When full, closed pouches are designed to be removed and replaced rather than being emptied and reused.

Drainable pouches are generally used if you have an ileostomy as the stool is usually more liquid to pasty. Sometimes, drainable pouches are used if you have a colostomy. Drainable pouches are easy to empty and do not have to be replaced as often as closed pouches.

Urostomy pouches are used if you have a urostomy to handle urine output. The pouch can be emptied when necessary and changed when required. A urostomy pouch can be connected to a collecting bag, to avoid having to change the pouch during the night.

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”My doctor kept talking about ostomy surgery, but I knew that surgery meant I would be wearing an ostomy bag. At first, I couldn’t imagine having a bag on my stomach for the rest of my life. Eventually, my condition got so bad I could not leave my bed. I could no longer do the things I enjoyed- like riding my horse. At that point, I just wanted my life back. I decided to have ostomy surgery. At first, it was hard getting used to wearing a bag, but I wasn’t going to let my disease or my ostomy control my life. I wanted to get back to my passion- horseback riding. Today, I can say that I’m on the right track; I’ve started horse jumping again and I hope to be back competing in the summer of 2016. I’ve come a long way and even though my body will never be the same, I am still me. I still have the same hopes and dreams-and my ostomy won’t stop me from achieving them!”

-Joannie Houde, Canada

Read more about exercising with an ostomy

My first trip out

“My first trip was to the hospital café with visitors and my 14-year-old daughter. While there, I went to the restroom as my pouch needed emptying. I can remember feeling really proud of myself and realizing that life would go on after ostomy surgery.”
Ann

“I was quite weak after the operation, but even in the first month, I used to go out for a daily walk to regain my mobility and sense of well-being.”
Samaira

My first vacation

“I went to Turkey four months after surgery. I carried lots of spare ostomy pouches in my carry-on (in case my suitcase got lost). I wore a one-piece swimsuit with a sarong. The biggest issue was getting my ostomy pouch to stick after a shower – when it was very hot and steamy.”
Ann

“11 months after my operation, I went to Australia to see our family. The flight was no trouble and the flight attendant looked after us well. I brought a travel card  with us to explain my condition so we didn’t have to wait in line.”
Rosemarie

Going back to work

“I returned to work after three months. I remember taking spare clothes to the office. My biggest issue was my pouch making embarrassing noises in meetings.”
Ann

“I was on leave for the first three months after my surgery to regain my strength. Afterwards, I had a phased return to work and gradually upped the work time, to get used to being back. In the beginning I was very tired, so this was a good way of returning to work.”
Fiona

“I retired from my driving job with the ambulance service and now work on a voluntary basis at a cancer support service which my friend set up. We offer cancer patients pampering treatments to give them a feeling of well-being.”
Hazel

Getting back to life

“With time, I realized that people couldn’t see I was wearing a pouch, and I could do all the things I had done before the surgery. There is no hobby or activity that I did before that I can’t do now.”
Fiona

“At first it was very hard. But with the help of my husband and friends, I pulled through. Now I can change the pouch myself and do all the normal things I did before my operation. Sometimes I even forget I have a pouch.”
Rosemarie

“The main thing is to go back and do the things you were doing prior to your surgery. Keep in touch with your WOC nurse. I know they are busy, but if you’re feeling down, they will try to help. Think about the important things in your life and focus on them. Join support groups or subscribe to magazines. A stoma shouldn't hinder your life, although it may sometimes feel like this, even after a year.”

Samaira

*These patient testimonials demonstrate successful results. Individual results may vary. Speak with your healthcare professional to determine what product solution is right for you.