In the first few weeks after having a colostomy operation, it is likely that you will be put on a low-fibre diet. This is because surgery causes your bowels to swell, making it difficult to digest fibre. After the swelling has subsided (usually around eight weeks), you will be able to resume a normal diet.
Diet
As you recover you can start to eat a healthy balanced diet that includes plenty of fresh fruit and vegetables (five portions a day).
You should be able to return to the diet you previously enjoyed. If you had a restricted diet you should be able to reintroduce those foods back into your diet that you previously avoided.
Read more about healthy eating and the importance of a eating a balanced diet.
Colostomy equipment
There is a wide range of colostomy appliances available, including:
- a one-piece pouch: bag and flange (part that sticks to your skin) are joined together. The appliance is removed when full and disposed of
- a two-piece pouch: the bag and flange are separate; they are joined together by a connection; the flange can be left on your skin for several days and the bag removed and disposed of several times a day
Your stoma nurse will help you to choose the most suitable appliance for you.
To help reduce skin irritation, colostomy appliances are made from hypoallergenic (non-allergic) material, and contain special filters that ensure that the appliance does not release any unpleasant odours.
There are also additional products that can make living with a colostomy more convenient, including:
- support belts and girdles
- deodorisers that can be inserted into your appliance
- protective skin wipes
- adhesive remover sprays
- protective stoma rings
- specially designed underwear and swimwear
Your stoma care nurse will be able to advise you on the most appropriate equipment to manage your colostomy successfully.
You will not have to pay prescription charges for permanent colostomy equipment. However, you will have to pay prescription charges for a temporary colostomy unless you are over 60 years old. Read more about prescription charges and help with health costs.
If you have to pay prescription charges, it will probably be more cost-effective for you to buy a prescription prepayment certificate (PPC), which entitles you to a discount on repeat prescriptions.
Irrigation
Irrigation is an alternative to wearing a colostomy appliance. It involves washing out your colon with water either every day or every other day.
This involves gently inserting a small device into your stoma and attaching it to a bag full of water and an irrigation sleeve, which acts in a similar way to a colostomy pouch.
You slowly move water into your colon so that it washes it out and moves the stools into the irrigation sleeve. The equipment can be disposed of once the process is complete. A cap is used to cover your stoma in between irrigations.
Advantages of irrigation include:
- You choose when you want to perform irrigation.
- You don't have to wear a colostomy appliance (but may have to wear a small cap).
- You should be able to enjoy a more varied diet.
- You should experience less flatulence (gas).
Disadvantages of irrigation include:
- It's a time-consuming process that takes 45 to 60 minutes to complete, usually on a daily basis.
- To achieve the best results, irrigation should be carried out at the same time every day which could cause you problems when you are away from home on holiday or with work.
Also, while some people don't have any problem with irrigation, others find it unpleasant. It is possible to go back to using a colostomy pouch if you find that irrigation is not suitable for you.
Irrigation may not be possible in some circumstances. For example, people with Crohn’s disease or diverticulitis are unable to irrigate their colon as it is too damaged. Irrigation is also not suitable for people who are having a course of chemotherapy or radiotherapy.
Irrigation probably isn't advisable for young children as it's quite time-consuming.
Smell & wind
Many people worry that their colostomy will give off a smell that other people will notice.
All modern appliances have air filters that have charcoal in them. The charcoal is an odour eater, therefore this neutralises the smell. Most people will be aware of the smell of their colostomy because it is their own body. However, someone standing next to you will not be able to smell the stoma.
Immediately after your surgery your colostomy will make excess wind and noise. This will slowly reduce as your bowel recovers.
Your stoma nurse can advise you of products that you can use to help reduce any smell and dietary advice to reduce wind.
Medication
Many medicines are designed to dissolve slowly in your digestive system. Having a colostomy shouldn't alter the effectiveness of your usual medication. If you do notice any tablets in your appliance, notify your pharmacist or GP who will recommend an alternative medication for you to take.
Exercise
In the weeks following surgery, it is usually recommended that you do some gentle exercise to help you recover.
How you recover will determine how much exercise you can do. If you feel any pain, stop immediately.
Work
Once your bowel has healed, there is no reason why you can't return to work. If your job is particularly strenuous and involves a lot of heavy lifting, you may need to wear a support belt or a girdle. Your stoma nurse can advise you about this.
It's likely to take several months before you're ready to return to work. It you've had laparoscopic surgery you may be able to return to work sooner than after an open operation. However, it all depends on how you recover and the type of work you do. Whenever you do return you are likely to find it very tiring. It's a good idea to discuss the potential options with your employer before having a colostomy operation.
Some employers may be happy to provide a degree of flexibility, such as allowing you to work part-time or at home, until your strength improves. Your employer may also be able to provide additional support, such as giving you access to changing facilities or adjusting your work responsibilities so that you don't have to do lots of heavy lifting.
You don't have to tell your work colleagues about your colostomy (unless you want to). Some people find it's a good idea to tell one person in your workplace in case you need any support or advice.
Travel
There's no reason why you can't travel freely when you've had a colostomy, although you will probably need extra time when planning your journey.
Most stoma companies have a small information leaflet that you can carry with you at all times, which is available in several different languages.
Your stoma nurse can give you advice about travelling with a stoma. It's recommended that you have travel insurance.
One essential item for people with a colostomy is a RADAR key. This provides you with access to public disabled toilets so that you can change your colostomy appliance when you need to.
You can get a RADAR key by contacting the Colostomy Association, which is a leading UK charity and support group for people with a colostomy.
When travelling abroad, it's a good idea to take plenty of colostomy supplies with you because you may have difficulty getting hold of them in another country.
Sex
There are several practical issues that could arise after having a colostomy, which could have an impact on your sex life and your relationships.
Women
Women who have had their rectum removed, may find that having sex in the traditional "missionary position" is painful because the rectum no longer supports the vagina during sex. Trying different positions may help.
After surgery, many women also find that their vagina is much dryer which can also make sex uncomfortable. Applying a lubricating jelly before having sex may help.
Having weight placed on your stoma during sex can be painful, so you may want to avoid positions that could cause pain. Alternatively, you could protect the stoma with a cushion or pillow.
Your stoma nurse will be able to give you more advice.
Men
Following a colostomy, some men find that the blood supply and nerve endings to their penis have become damaged. This can make it difficult getting or maintaining an erection (erectile dysfunction).
There are several ways to treat erectile dysfunction, including taking a medication called sildenafil, which helps increase the blood supply to the penis.
Other, sex-related issues
Aside from the practical issues, you may be concerned about body image, self-confidence and how your partner may react to your colostomy, which can also have an impact on your sex life.
However, it's important to stress that many people who have a colostomy enjoy good sex lives but it can take several months to build up the confidence and trust to make this possible.
If you have a long-term partner, you may want to ask them if they want to see your stoma and colostomy equipment. Some people’s partners want to take an interest but others may find it too upsetting, at least in the short-term. There is no right or wrong way to react so try not to take a refusal as a personal rejection.
If the appearance of your stoma and colostomy equipment is off-putting during sex, you can always cover them with a nightgown or boxer shorts.
Other tips that may help improve your sex life include:
- changing your appliance before having sex
- changing your appliance to a small stoma cap before having sex
- covering the appliance with a satin or cotton cover (if the feel of the appliance against your skin is a distraction during sex)
- keeping your sense of humour: embarrassing mishaps often occur during sex, whether or not you have a colostomy
