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Colorectal Cancer: Ostomy


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Sometimes treating diseases of the digestive or urinary systems involves removing all or part of the small intestine, colon, rectum or bladder. In these cases, there must be a new way for wastes to leave the body. The surgery to create the new opening in the abdomen is called an ostomy.

There are many different types of ostomy. The three basic types of ostomies are:

  • Ileostomy: The surgeon removes the colon and rectum and attaches the bottom of the small intestine (ileum) to the stoma.
  • Colostomy: The surgeon removes the rectum and attaches the colon to the stoma.
  • Urostomy: The surgeon attaches the ureters - the tubes that carry urine to the bladder - to either the small intestine or to the abdominal wall.

The opening is called a stoma.

  • The stoma will be pink or red and moist because of the blood supply to it. It is usually swollen for the first few weeks after the operation. Then it will shrink to its permanent size in 6 to 8 weeks..
  • There is no feeling in the stoma because of the lack of nerve endings. That means you will not feel pain, light pressure or any temperature sensation in the stoma.

It takes a while to get used to having an ostomy. Patients report that it can take about ten days to get used to having an ostomy. 

As soon as your body heals, you can resume everything you enjoyed doing before the surgery – including exercise, sitting in a hot tub, and sexual activity. 

Presumably, before you left the hospital you learned how to care for the stoma, the skin around the stoma, an ostomy bag and the health of your altered digestive tract. If you didn’t learn  this information from an oncologist or a nurse specially trained as an enterostomal therapist (ET) nurse, consider contacting an ET nurse. They know all the latest techniques. (To find an ET nurse in your area, at offsite link. click on “Patient Information” then “Find A Nurse In Your Area”).

After an ostomy:

  • You will be able to engage in all activities you were able to do before the ostomy.
  • You will not be able to feel or control your urine or stool as it leaves your body through a stoma.
  • It is advisable to watch what you eat and drink because different foods and drinks may cause gas, odor and/or a change in the thickness of your stool. Changing your diet can help minimize these side effects - both the foods you eat and the way you eat them. Only trial and error can determine what diet is best for you since each patient and type of surgery are different. 
  • Think about taking probiotics every day, either in yogurt or as a supplement in pill or capsule form. Patients report that probiotics help reduce gas and additional movements. Check with  your doctor before starting any supplement, vitamin, herb or over-the-counter medication.

Experience indicates that it is helpful to talk with other people with ostomies (ostamates) about their experiences. Ostomates can also give you tips you may not have learned from the ET. For example, most people find it easiest to clean the stoma and surrounding skin when the digestive tract is least active. For many people, this in the morning before breakfast.  You can find other ostomates through: 

  • The buddy program at the Colon Cancer Alliance. For contact, click here. offsite link
  • The “visitor” program of the United Ostomy Associations of America (800.826.0826)
  • A local or online support group for colorectal cancer ostomates
  • Your oncologist
  • A social worker at your treatment center

Additonal information you should know includes foods to eat and how to eat them, how to take care of the stoma, the skin around the stoma, how to choose, empty and clean appliances that attach to the stoma, the health of your altered digestive tract, how to travel with an ostomy and how to have sex with an ostomy. Information about each of these subjects is covered in other sections of this document.

Ostomy supplies are generally covered by health insurance – private policies, Medicare Part B and Medicaid. You will likely have to pay something – whether it is a set co-pay or a co-insurance percentage. There may be a limit on quantities you can purchase each month.

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