Frequently Asked Questions
Ostomates are asked a variety of questions by non-ostomates or new ostomates; maybe lots of questions are in your mind right now. In this section we list the most common questions together with the answers that established ostomates would probably give. Always remember that ostomates are individuals and manage their appliances in their own way. Also colostomates, ileostomates and urostomates are different in many significant aspects and where appropriate an indication will be given to show which type of ostomy is referred to - either (C) for colostomy, (I) for ileostomy or (U) for urostomy.
Q. What do I tell my friends?
A. Only as much as you wish. They may require an explanation for your return to such good health after years of illness (I & U) or they may be aware that you underwent surgery at short notice (C & U). Unless you are irrigating (C) or using night drainage (U) you will not require any special consideration, so only talk about your stoma if you wish. Frankly, if you are seen to be getting on with normal living, your friends will very soon get bored with talk of “my operation”.
Q. Can an ostomate play sport?
A. Yes, all sports are possible including contact sports like rugby. Many ostomates have written articles on their experiences when playing various kinds of sport; fellow players do not need to make allowances and so do not need to be told. Swimming is excellent exercise and you need have no hesitation in participating fully in all water sports or leisure swimming. Enjoy a soak in the hot pools or throw yourself around at aqua aerobics, run a marathon (keep up the fluids), cycle, rock climb, run, tramp........ the world is your oyster.
Q. Does the stoma hurt?
A. A lack of nerve endings in the stoma means that they do not transmit pain or other sensations.
Q. Why haven’t I met any ostomates?
A. Think a minute. Maybe because an ostomy doesn’t show. It can be kept a secret, if you wish. It is possible that some of your best friends are ostomates......you never can tell!
Q. How can I adjust to living without a normal rectum or bladder opening?
A. Remember adjusting to glasses? Dental braces? False teeth? Hearing aids? It is amazing to see what the human body can get used to.
Q. Can I go back to work?
A. Yes, as soon as you have regained your strength, probably in just a few weeks, you will be able to follow your usual occupation. Ostomates are office workers, farmers, teachers, salespersons, home makers, pilots, models, students, pop singers, politicians, factory workers...... the list is endless!
Q. How often must I attend hospital after my operation?
A. You will probably have a check up in 4 to 6 weeks in the Out Patients department and then at 3 to 6 monthly intervals. Eventually, you may be seen on a yearly basis or totally discharged. At any time you can ask to see your stoma nurse or surgeon if a query arises.
Q. Why does the stoma look raw; will it bleed?
A. The stoma is formed by bringing the end of the bowel through the abdominal wall and turning it back on itself like a cuff. It looks “raw” because what you see is the lining of the colon (C) or ileum (I & U). It may occasionally bleed if irritated or rubbed; this is no cause for concern. However, if the stoma bleeds frequently or persistently it may be that the appliance is not fitting correctly and advice should be sought from your stoma nurse to avoid possible ulceration of the stoma.
Q. How do I dispose of my appliance?
A. Refer to local District Council rules.
Q. Does the appliance stay on in the bath or shower?
A. The appliance is waterproof from both within or without, so showering and bathing do not affect it and it can remain in place. However, many ostomates feel that there are certain benefits to the skin if the appliance is removed before showering and the whole area, including the stoma, is washed at this time. Colostomates using a closed pouch can choose to shower after a motion has been passed and the pouch is due for a change. Ostomates using a drainable pouch (I U and some C), have the option on days when the appliance is to be changed, of removing it before showering. This is entirely a matter of choice and many ostomates feel that the probability of the stoma working while the appliance is not in place is not acceptable. As you can see, there are no rules!
Q. Can ostomates wear seat belts when travelling?
A. They can and should. If you were involved in an accident any damage to your stoma would be far easier for a surgeon to repair than a crushed skull or lacerated face. In any case, a properly fitted belt should sit across the hip bones and pelvis and not across the area of the stoma. If you should still feel the need to give your stoma extra protection a simple foam pad may help.
Q. Can ostomates have children?
A. Yes, once incisions have completely healed normal sexual activity can be resumed and pregnancy can be undertaken without ill effect. Female urostomates should seek medical advice before embarking on pregnancy.
Q. How often do I need to empty my appliance?
A. There is no exact answer! For colostomates it may be once or twice a day, and for ileostomates and urostomates it varies up to 7 or 8 times in 24 hours.
Q. Can irrigation be used as a means of management?
A. Only colostomates can use irrigation and then only after medical advice and suitable instruction. It is the strongly preferred procedure of many colostomates and allows the person to control when to have a bowel movement. Some irrigate daily, others find alternate days appropriate - you can forget you’re an ostomate for 24 or 48 hours! Some people experience a few problems; consult your stoma care nurse.
Q. How do I change to a different type of appliance?
A. Through your stoma nurse. You may decide firstly to obtain free samples from the manufacturer (through their advertisements in the N Z Ostomate magazine), and if you then think that you would like to change to using this appliance you should consult your stoma nurse who will assess its suitability for your needs. If she approves then she will show you how to use it to the best advantage and subsequently arrange an ongoing supply.
Q. Will the perineal wound take long to heal? (C and some I)
A. It can take just a few weeks or sometimes over a year for healing to be complete. Different techniques are used for dealing with the empty space where the rectum and anus have been removed. The wound may be left open and firmly packed with gauze; as the wound heals from the inside out, the space gets smaller and smaller and the amount of gauze is reduced. Some surgeons loosely baste the skin together, inserting soft drainage tubes to remove blood and other fluid by either gravity or suction. Whatever the technique, your sore bottom can be more of a concern to you than the stoma!
Q. How can I support my night drainage bag? (U)
A. Place it in a bucket standing on the floor beside the bed. This will keep it in an upright position and help prevent leakage.
Q. How long can I expect to stay in hospital after my operation?
A. 1 to 3 weeks. Once you are able to manage your appliance, you will be allowed to go home and will continue to receive support from the stoma nurse and your Ostomy Society visitor.