What is a colostomy?

Understanding your colostomy and what to expect

A colostomy is an opening formed from your colon (large bowel) and is brought out onto the abdomen, stitched to the skin and opened to form your stoma (colostomy). Your colostomy may be an end (often referred to as permanent) or loop (often referred to as a temporary stoma).

Your surgeon will discuss this in detail with you before your operation and will be able to tell you the type of colostomy they are planning for you.

It is worth noting that sometimes a temporary stoma may become permanent and you may even decide yourself not to undergo reversal surgery. Equally, an end stoma can sometimes also be reversed. Your surgeon and specialist stoma nurse will discuss this with you.

Why you might need a colostomy

A colostomy can be required at any age and is needed as a solution for many different medical conditions including:

• Cancer
• Crohn’s Disease
• Ulcerative Colitis
• Trauma
• Continence issues
• and many others.

Is a colostomy painful?

• Your colostomy has no nerve-endings so you shouldn’t feel any pain or sensation from it.
• The area directly around your stoma may feel sore or uncomfortable during the post-op period, often due to the stitches securing the colostomy to the abdomen, but this will subside

Preparing for surgery

• Understanding the procedure can help you feel more in control.
• Feeling apprehensive is normal; knowing what to expect pre- and post-surgery can help put your mind at rest.
• Before surgery, your surgeon will discuss the need for a stoma, and your specialist stoma nurse will talk about where it will be sited.

Think where you’d like your colostomy to be sited

• Your stoma nurse will help choose the best site for your stoma.
• Consider:
  • Where your clothes sit on your waistline.
  • Where skin naturally folds or creases when sitting.
  • Physical activities you enjoy (e.g., golf, bowling).
  • The type of clothes you like to wear.
• The marked site acts as a guide; occasionally, it may not be possible to bring your stoma out at that exact spot.

Prepare for recovery

• The stronger you are going into surgery, the faster your recovery will be afterwards.
• You will attend a pre-operative clinic for advice on preparing for surgery.

Packing for hospital

• Average hospital stay after abdominal surgery is 5 days (may vary).
• Your hospital will provide a pre-op information guide on what to bring.
• Keep in mind hospitals no longer provide toiletries for patients.

This section covers the first few weeks as you adjust to life with a colostomy.

Waking after surgery

• You’ll have drips and tubes attached to your body - this is normal and usually removed within 24–48 hours.
• As anaesthetic wears off, you may feel tired and groggy.
• Recovery time varies for everyone - don’t panic if it takes longer.
• You’ll wear a drainable clear pouch so the surgical team can monitor your stoma.
• Nurses will assist with initial care.

Learning stoma care

Over the next few days, the specialist team will:

• Show you how to keep your stoma clean.
• Explain different pouch types.
• Advise on nutrition and hydration to reduce dehydration risks.
• They’ll also guide you on post-op care to help regain strength.
• Mental wellbeing is as important as physical health - talk to your team if you have concerns.

When will my colostomy start to work?

• It may start working shortly after surgery or take several days—this is normal.
• Output may be loose/watery at first, then fluctuate before settling into a normal stool consistency.
• Drainable pouch needs emptying about 6–8 times per day.
• Once output normalizes, nurses may recommend a closed pouch:
  • Most people change this once, twice, or three times per day.
• Your stoma nurse will advise on timing and technique.
• Over time, you’ll develop a routine that fits your lifestyle.

1. Corona, L. Adams, K. Ostomy.org. Living with a Colostomy. Accessed Nov 2022. https://www.ostomy.org/wp-content/uploads/2022/11/UOAA_Living_with_a_Colostomy_Guide-2022-11.pdf