Understanding Ostomy : Surgery, Risks, and Living with an Ostomy Bag

An ostomy is a surgery that creates an opening, known as a stoma in the abdominal wall. This stoma goes from an area inside the body to the outside. Ostomy helps in treating certain diseases of the urinary or digestive system. Although the reasons for ostomy could vary, the most common causes are colon cancer and irritable bowel syndrome.^{(1, 2)} Ostomy are also essential in cases of severe pelvic or abdominal trauma resulting from accidents or injuries.

This surgical procedure creates a new way for waste to be left out of the body. Usually, ostomy removes fecal waste (poop) and urinary waste (pee). These bodily wastes are allowed to pass into a prosthetic known as an “ostomy bag” or a “pouch” on the outside of the body, or even an internal surgically created pouch.

Before an ostomy surgery, you will have to discuss the details of the procedure with your medical team. Doctors will talk with you about your lifestyle, your clothing choices, and personal preference, and determine the location of your stoma.

During this appointment, you will also learn how to take care of the stoma. Additionally, you will also learn about various types of ostomy appliances that can improve your quality of life.

An ostomy is a surgical procedure that is performed under general anesthesia. The surgeon would create a long incision in the patient’s abdomen, or they would perform the surgery using smaller incisions (laparoscopy).

The steps of ostomy vary depending on the specific needs of the patients. Some of the most common types of ostomy procedures are:

1. Colostomy
2. Ileostomy
3. Urostomy

In a colostomy, the diseased portions of the colon are removed. Then the remaining colon is brought to the abdominal wall and attached to the skin to form a stoma. Then a colostomy bag is pouched around the stoma.

In the case of Ileostomy, the ileum (the lowest part of the small intestine) is attached to the stoma. Here, the intestine is brought through the abdominal wall to form a stoma. Finally, an ileostomy bag is attached to the stoma.

In Urostomy, the tubes carrying urine to the bladder are attached to the stoma. The two most common urostomies are ileal or cecal conduit procedures. Either a part at the ileum (end of the small intestine) or at the cecum (the beginning of the large intestine) is surgically removed and relocated as a passageway, (known as a conduit) for urine to pass out from the kidneys through a stoma. This procedure might include the removal of a diseased bladder.

Most individuals will have to stay in the hospital after an ostomy. However, the hospital stay varies by stoma and surgical approach. Usually, it varies from a day or two. During these one or two days of hospital stay after the surgery, your medical team will examine you and ensure that you are healing properly. You might need an intravenous drip to keep you hydrated. Additionally, a catheter would also be placed to drain urine.

There can be certain risks associated with an ostomy surgery. They can be mild, moderate, or severe. Some of these risks include diarrhea, hernia, narrowing of stoma, skin irritation, bleeding, infection, blockages, vitamin B12 deficiency, electrolyte imbalance, and rectal discharge.

Recovering from an ostomy surgery takes about eight weeks. Though one has to limit their activity after an ostomy, they should still walk around because staying mobile helps in healing, prevents infection, and also aids the bowel work more quickly.

Someone who has had an ostomy will have to wear an ostomy bag or pouch. Most ostomy bags come with one or two pieces, the bag also comes with a barrier (which protects the stoma) and a disposable plastic pouch.

Some ostomy bags are designed to be changed regularly. However, most people will need to change their ostomy bag every three to seven days. When changing the ostomy bag or pouch, be sure to wipe away any mucous on the stoma, rinse your skin well, and completely dry the area.

Therapeutic procedures might not only treat diseases but also affect the quality of life in patients.⁽³⁾ Although, in many cases, ostomy surgeries help in treating and reducing pain and discomfort in patients, in a few other cases they intensify suffering, and result in severe stress because of skin irritation, pouch leakage, reduction of pleasurable activities, and depression or anxiety.⁽³⁾

However, one should know how to live with an ostomy bag, and adapting to the new lifestyle after an ostomy surgery, is the key to leading a satisfactory and convenient life.

One can wear the same type of clothes that they normally used to wear before the ostomy surgery. Ostomy bags or pouches are designed to blend in and fit close to the body. Additionally, some pouches have an odor-barrier film that traps bad smells.

The skin around the ostomy should be kept clean and dry. Avoid applying any product that contain alcohol as it can cause dry skin. Talk to your doctor or an ostomy nurse about any other special bathing considerations for the ostomy surgery.

One will be able to do the normal day-to-day activities after an ostomy. Reasonable activity will not hurt the stoma. However, make sure not to go for intense workouts immediately after the surgery.

With an ostomy, you will not be able to control when gas or stool moves into the pouch. Based on the type of ostomy and your diet, the amounts of stool and gas that go into the pouch will vary.

So, try to avoid foods that cause gas, such as cabbage, beans, onions, and spicy foods. Also, be aware of foods that might cause constipation or diarrhea. In addition to this, remain hydrated.

It is best to empty the ostomy bag when it is less than half full and keep your ostomy supplies with you all times. This will help in case of a leak or any other issue.

Ostomy is a surgical procedure that helps in treating diseases of the digestive and urinary systems. The surgery creates a stoma or opening in the abdominal wall and creates a new way for bodily waste to be left out of the body. After an ostomy, one has to wear an ostomy bag. Although living with an ostomy bag could be difficult, adjusting to the new lifestyle after an ostomy will help in improving the quality of life. 

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