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Surviving – Even Thriving – with an Ostomy

by Dorothy Doughty, MN, RN, CWOCN, FAAN

Coping with a cancer diagnosis is a huge challenge for anyone – but if your cancer involved the bladder, rectum, or cervix, you may also be coping with an ostomy. An ostomy is an opening on the abdominal wall that provides for elimination of stool or urine. A person with an ostomy must wear a pouch to collect the stool or urine.

This is a major change for anyone, and it is common to have questions and concerns. How will I live with a bag? Will I smell? Will the bag show through my clothes? Can I shower? Am I going to be on a special diet? Can I go back to work? Can I travel? How will my sexual partner feel about me? It is also common (and normal!) to have days when you feel overwhelmed and depressed, and other days when you are angry that this happened to you.

Adjusting to an Ostomy
Be kind to yourself. This is a big adjustment, and the way people adjust is to grieve the way things “used to be” while also learning how to manage things the way they are now. It’s OK to feel sad, and it may help to have people you can talk to. You may want to visit the website for the United Ostomy Associations of America (ostomy.org) – it can be helpful to read the tips and advice provided by others with an ostomy.

It may take you a few weeks to become comfortable emptying and changing your pouch, but it gets easier.

Ostomy pouches are now odor proof, flat, and fairly easy to manage. It may take you a few weeks to become comfortable emptying and changing your pouch, but it gets easier. Once you get the hang of it, you should be able to go back to work, go out to dinner, and get back to your regular routine. Other people won’t even know you have an ostomy unless you choose to tell them.

Daily Activities
You can shower with your pouch on or off. If you shower with your pouch on, you may want to apply waterproof tape to the edges to protect your seal. When you get out of the shower, you can use a hairdryer on the cool setting to dry the back of your pouch.

Clothing
Most people can wear the same type of clothing as before the ostomy. You may want to wear snug undergarments with a little bit of spandex to hold your pouch securely against your abdomen.

Diet and Fluids
If you have a colostomy, you can eat the same foods you ate before, but you need to eat enough fiber and drink enough fluid to prevent constipation. If you have an ileostomy, be careful with foods high in roughage, such as corn, coconut, large seeds, mushrooms, nuts, peels, and popcorn; add these to your diet in small amounts, chew well, and drink plenty of fluids (to keep the fiber from forming a blockage). You should drink at least 10 to 12 glasses of fluid a day to prevent dehydration. If you have a urostomy, you need to drink 8 to 10 glasses of fluid spaced evenly throughout the day.

Gas and Odor
These are common concerns for people with colostomies and ileostomies. Remember, the pouches are odor proof, so odor occurs only when you empty or change the pouch (or if it starts to come loose). To reduce odor when you empty the pouch, add mints or a teaspoon of mouthwash to your pouch each time you empty it. You can also add commercial deodorants to the pouch or spray them in the air before you empty your pouch.

You can reduce gas by limiting gasforming foods like beans or cabbage. Products like Bean-O and Gas-X also help to reduce gas. To muffle the noise, press your arm or hand against your stoma when you feel gas rumbling. Gas coming out of a stoma sounds more like your stomach growling, so you can always just say you are hungry.

What About Sex?
Having an ostomy shouldn’t keep you and your partner from sharing sexual pleasure. It’s helpful to empty your pouch before beginning sexual activity and to use special underwear to cover and secure the pouch. This lets you focus on your partner rather than the pouch. It’s important to talk openly with your partner about your feelings.

Having an ostomy is a big adjustment for anyone, but you can do it. You will find that life with an ostomy can be just as rewarding (though not quite as easy) as life with your original plumbing.

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