Colostomy living
Informed by recognized medical guidance
Overview
A colostomy is a surgical opening on the belly called a stoma. One end of the colon (large bowel) is brought through this opening, and stool collects in a pouch. This can be temporary or permanent.
Key facts
- The stoma has no nerve endings, so it does not hurt.
- You can still eat, swim, work, and exercise with a colostomy.
- The pouch is water-resistant and odour-proof when sealed properly.
- Stoma nurses teach you how to care for it step by step.
Yes. Many thousands of people live with a colostomy. It is a common procedure in bowel surgery, and with support, people adjust well.
Anyone of any age may need a colostomy. It can be needed in babies, children, and older adults. It is a treatment for a bowel condition, not a result of personal choices.
Symptoms
- Bright red blood pouring from the stoma or pouch.
- Sudden severe belly pain with a swollen, hard belly.
- The stoma becomes very dark, purple, or black.
- No output from the stoma for 24 hours with nausea or vomiting.
- ⚠The stoma visibly slips far out (prolapse) or retracts deeply inward.
- ⚠The skin around the stoma is raw, bleeding, or has an open sore.
- ⚠You have a high temperature with abdominal pain or chills.
- ⚠The pouch cannot stick because of persistent leaks or skin breakdown.
Common symptoms
- Soft or liquid stool output into the pouch, especially in the first weeks.
- Passing gas from the stoma, which is normal.
- Slight redness or dampness on the skin around the stoma if the pouch leaks.
- A feeling of the pouch filling up and needing to be emptied.
Symptoms in children
- Children with a colostomy can attend school, play, and swim normally.
- They may need extra reassurance and gentle explanations about the pouch.
- Your stoma nurse and child’s care team can provide age-appropriate guidance.
Symptoms in older adults
- Older adults may need help with dexterity, vision, or energy when changing the pouch.
- Your stoma nurse can recommend pouching systems that are easier to handle.
- It is important to keep the skin around the stoma clean and dry to prevent soreness.
Causes
Main causes
- Bowel cancer requiring removal of the rectum or lower colon.
- Inflammatory bowel disease, such as ulcerative colitis or Crohn's disease, when medicines are not enough.
- Bowel obstruction or perforation (a tear) from severe illness or injury.
- Birth defects affecting the bowel in infants.
- Trauma from an accident that damages the bowel.
Risk factors
- Long-standing ulcerative colitis.
- Family history of colorectal cancer.
- Previous radiation therapy to the pelvic area.
- However, many people who need a colostomy have none of these risk factors.
When to see a doctor
See a doctor urgently if:
- A change in the size or color of the stoma that is concerning but not severe.
- Persistent skin soreness or rash around the stoma despite careful pouch changes.
- Constipation that does not get better with dietary changes.
- Recurring leaks that interfere with daily activities.
Book a routine appointment if:
- Keep your regular follow-up appointments with your surgeon or stoma nurse.
- They check the stoma and skin and help adjust your supplies.
- Also keep up with routine health checks and recommended screening.
Diagnosis
A colostomy is not a diagnosis — it is a treatment. Before surgery, your healthcare team evaluates your bowel condition using your medical history, examinations, and imaging. A stoma nurse marks the best place on your belly for the stoma during planning.
Tests that may be done
- Colonoscopy to look inside the large bowel.
- CT scan or MRI to get detailed images.
- Blood tests to assess your general health.
- Biopsy to check tissue samples for disease.
What to expect at your appointment
Before surgery, you meet the stoma nurse, who explains what the stoma looks like and how to use the pouch. Most people stay in the hospital for a few days. The nurse helps you with your first pouch change and teaches you step by step as you recover.
Treatment
Living with a colostomy centers on the pouching system and daily care. You wear a pouch (sometimes called a bag) over the stoma to collect stool. It is waterproof and odour-proof when sealed correctly. You empty and change it as needed. Most people learn to manage it on their own within a few weeks.
Self-care at home
- Clean the skin around the stoma with warm water and dry it well before placing a new pouch.
- Cut the pouch opening to fit closely around your stoma — no larger than a few millimetres.
- Empty the pouch when it is about a third to half full to prevent leaks or pulling on the skin.
- Use protective wipes or powders if the skin becomes sore, and ask your stoma nurse for advice.
- Dispose of used pouches and wipes according to local guidance — your nurse will explain.
Medical treatments
Your healthcare team may recommend supportive treatments appropriate for your situation, such as medicines to soothe the bowel, laxatives for constipation, or anti-diarrhoeal medicines. Only use medicines your doctor prescribes. Some products can help reduce gas, but always ask your stoma nurse or pharmacist first.
When is surgery considered?
You may have a further operation if your colostomy is temporary and the bowel can be reconnected once healed. Complications like a parastomal hernia (a bulge around the stoma) may also need surgical repair. Your surgeon will discuss if any additional procedure is right for you.
Living with this condition
Day to day, you can do almost everything you did before. Emptying and changing the pouch becomes a routine. Loose-fitting clothes can be comfortable, and there are special support belts if needed. You can shower, bathe, swim, and exercise with the pouch on.
Lifestyle tips
- Return to work, travel, and hobbies when you feel ready.
- Talk openly with close people about your colostomy — it often reduces worry.
- Carry a spare pouch and wipes when you go out.
- Tell airport security that you have a stoma; you may need a manual check instead of a scanner.
- Join a local or online ostomy support group for tips and encouragement.
Diet and exercise
You do not need a special diet after a colostomy. Chew food well, drink enough fluid, and eat regular meals. Some foods, like beans, onions, and fizzy drinks, may cause extra gas — adjust based on what works for you. Exercise such as walking, swimming, and gentle abdominal activities is safe and healthy. Ask for guidance before heavy lifting to avoid a hernia.
Mental health and emotional wellbeing
Adjusting to a colostomy can bring mixed feelings, including sadness, embarrassment, or worry. These feelings are normal and usually improve over time. If you feel anxious or low for more than a few weeks, speak to your GP or stoma nurse. If you ever have thoughts of harming yourself, call your local emergency number or a crisis helpline immediately.
Prevention
A colostomy is a treatment for existing bowel problems, so you cannot prevent it once you need it. However, you can reduce the chance of needing one by keeping your bowel healthy — eating plenty of fibre, staying active, not smoking, and limiting alcohol — and by attending bowel cancer screening if eligible. Early detection can sometimes make a colostomy unnecessary.
Vaccines
Keep your routine vaccinations up to date to protect your overall health.
Screening programmes
Bowel cancer screening, often using a home test kit, can help find early problems before they become serious. Ask your doctor from what age you should be screened.
Complications
If left untreated
- Skin irritation or breakdown around the stoma.
- Infection of the skin or stoma.
- Bowel blockage from food or scar tissue.
- Parastomal hernia (a bulge around the stoma).
- Prolapse (the stoma slips further out) or retraction.
Long-term outlook
A colostomy is a change, not a limitation. With practice and a good support team, most people return to a full, active life. Your stoma nurse and doctors will guide you, and confidence grows with time.
Find support
International organisations
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
Related conditions
Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 31, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.