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Heather Lee, BSN, RN

What to Expect when your Doctor Recommends an Ostomy

What Is an Ostomy?

An ostomy (also called stoma) is a hole in your belly created by a surgeon. This hole allows waste, such as stool or urine, to exit your body. Some illnesses or problems with your intestines or bladder can result in the need for a stoma. Surgeons create stomas by pulling a section of bowel through the skin and sewing it into place. This surgery creates a colostomy or ileostomy (to pass stool), or a urostomy (to pass urine).  



Ostomy FAQs

  • About 750,000 to 1 million people in the US live with an ostomy. 

  • Approximately 150,000 people have surgery each year in the US to create a new stoma.

  • Ostomies can be either permanent or temporary. Temporary ostomies allow a part of your intestines to heal. Once this happens, your surgeon will reconnect your intestines and remove your stoma. Some stomas are permanent, for instance, when the bowels or bladder are not able to be reconnected.

  • Once they heal from surgery, people with ostomies have no activity limitations. With a little extra planning, ostomates live completely normal lives.

  • Many people find their quality of life improves when they get their ostomy. Often, their disease symptoms lessen or completely stop once they have a stoma.

Common Reasons to Need an Ostomy

  • Having an obstructed bowel (for instance by a tumor or abscess).

  • Cancer resulting in bowel or bladder removal. 

  • Severe bowel diseases such as Crohn’s disease or Ulcerative Colitis.

  • Severe trauma to the bowels (for instance, from a car accident or gunshot wound)

Steps Leading to Ostomy Success



Pre-marking

Before your surgery, it is advisable to see a certified ostomy nurse for pre-marking. Pre-marking is the process of selecting the most ideal spot on your belly for stoma placement. The ostomy nurse will take into account your body shape, your skin folds, and how you like your pants and belt to fit. (S)he will also consider where you are least likely to have problems with your ostomy bag leaking. The ostomy nurse will place a sharpie mark on your belly for your surgeon to follow during surgery.


Surgery and Hospitalization

Most people stay in the hospital for 3 to 10 days following their ostomy surgery. During your hospitalization, nurses change your ostomy appliance (the bag). They also provide teaching about how to care for your stoma. When it’s time to go home, you will be given a small amount of supplies. Going home with an ostomy can feel like the scariest part of the process. The next step ensures a smooth transition to caring for your ostomy on your own.


Post-hospital Follow-Up with an Ostomy Nurse

After you go home from the hospital, the recommendation is to follow up with an ostomy nurse. These appointments usually take place in an outpatient clinic setting. During these appointments, the ostomy nurse assesses the health of your stoma and the skin around it. There are a wide variety of ostomy product options.


Your ostomy nurse will recommend products designed for your belly shape, ostomy type, and any problems you might be having. The nurse will treat problems that arise, for instance, skin breakdown from stool leaking, and will also teach you how to care for your stoma independently. Most stomas shrink in size for the first 4 to 6 weeks after surgery. The nurse will select appropriate products during this shrinking process. Once your stoma is done shrinking and your final product selection is complete, the nurse will order supplies for you from a medical equipment company.



Supplies

Most ostomy supply orders last for one year. The order is sent to a DME (durable medical equipment) company who then mails your supplies to you every 30 days. Once you are discharged from the ostomy nurse, your supplies can be ordered annually by your primary care doctor. However, if unexpected problems arise, you can request a new referral to go back and see the ostomy nurse again.


Resuming Regular Life

Once you have received your ostomy teaching and supplies, you will be independent with your ostomy care! Some people feel comfortable managing life with an ostomy on their own. Others benefit from meeting with an ostomy support group, such as the UOAA. Whatever you are most comfortable with, know that your life is not limited by having an ostomy.



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