Ostomy Treatments & Care

When you're being treated for a disease like colorectal cancer, an ostomy is a lifesaving procedure that creates a new path bypassing your diseased or injured intestines. But if you need an ostomy, you probably have lots of questions and concerns. How will having an ostomy affect your life? Will it be difficult to care for? Will people notice?

During an ostomy, a surgeon moves part of your colon to a new opening on your abdomen. The opening is covered with a securely attached bag. Whether it’s temporary or permanent, redirecting your colon is a big change. New routines can make you nervous or embarrassed at first.

It’s common to wonder about life after an ostomy. But after an ostomy, you’ll get used to your new normal. And, no one can tell you’ve had the procedure, unless you choose to tell them. You can enjoy life and be just as active as you were before. With a little learning and a lot of support from your UVA Health team, most people are surprised at how hassle-free it can be.

Why Choose UVA Health for Ostomy Treatment

At UVA Health, we offer advanced care before, during, and after surgery for diseases of the anus, colon, and rectum. Our colorectal surgery services include ostomy procedures with personalized education, care, and support. We offer award-winning services for colorectal cancer and other conditions. We use advanced techniques that offer less discomfort and a faster recovery.

You’re cared for by a team of specialists that includes doctors, nurses, physical therapists, nutrition specialists, a wound ostomy team and others. We’ll help you learn all you need to know about ostomies and ostomy care. You’ll have access to a class before surgery and guidance during and after your hospital stay. We’ll make sure you have everything you need before you go home.

Our services include Enhanced Recovery After Surgery (ERAS).This program keeps you and your family at the center of your recovery.

Types of Ostomies

Most people have either a colostomy or an ileostomy. When an ostomy is temporary, surgeons choose a more easily reversed approach. A temporary ostomy can help parts of the digestive tract heal after an infection, illness, or surgery.

Colostomy

During a colostomy, a surgeon redirects part of your colon through a newly created opening (called a stoma) on your belly.

Instead of continuing from your colon through your rectum and anus, with a colostomy, bowel movements go out through the stoma instead. Most colostomies are permanent. They can offer a more convenient way to manage bodily waste than ileostomies.

Colostomies can help treat:

• Colorectal cancer
• Crohn’s disease
• Diverticulitis (inflammation of intestinal pouches that can cause tears or holes)
• Fecal incontinence (leaky bowel movements)
• Sacral wound (skin injury near the lower back or spine)
• Spinal cord injury
• Traumatic injury

After a colostomy, you may have a bowel movement once a day or more. Depending on your procedure, you’ll wear a pouch or bag that attaches with adhesive to your abdomen.

Ostomy bags come in one or two-piece styles. Most have a plate (wafer) that sticks to the belly. The bag attaches or is already attached to the wafer. The pouch hangs close to your body. It holds bowel movements until you can empty the pouch into a toilet.

Ileostomy

Surgeons use the last part of your small intestine (ileum) for this type of ostomy. You may be recommended an ileostomy for a temporary ostomy because it’s more easily reversed than a colostomy.

Ileostomy bowel movements are more liquid than colostomy bowel movements. You have to empty your ileostomy fluids more often, typically 4 times a day or more. It’s common to replace the pouch every 4 days.

Ostomy Approaches  

Surgical approaches vary depending on your condition and treatment plan.  

Your providers will discuss the benefits and risks of each approach.

• Loop ostomy: We pull a loop of the colon out through the surface of your belly. We make a hole in the loop and connect the colon to a new opening (stoma) on the surface of the belly. After surgery, both stool and mucous come out of the colon through the stoma instead of the anus. A loop ostomy is more easily reversed than other ostomies.
• End ostomy: We divide part of the colon and bring one end through a stoma on your belly. The other end is surgically closed and stays in your body. In some cases, the other end is used to create a second stoma for mucus or an internal pouch for stool collection. You can drain the pouch with a tube (catheter).
• Continent ileostomy: We loop part of the ileum back to form a pocket (Kock pouch) and valve inside of your abdomen. You can insert a catheter tube into the valve to drain waste from the pouch. This procedure is less common due to a higher risk of complications that might need additional treatment.

What to Expect With a Stoma

After surgery, you’ll have redness and swelling around your stoma. The area will heal over the next few weeks. We’ll show you how to protect and clean your wound. 

Your stoma will look like a small, slightly raised pink or red area of skin on your belly. It may feel moist, but the skin around it should be firm and dry.

We’ll help you choose the best style and size for the wafer and pouch. This is an important step. If the fit is too loose, it can leak. If it’s too tight, it may cause irritation. You might also need a new fitting if you lose or gain weight. 

Ostomy Care & Management

We’ll show you how to care for your stoma, pouch, and supplies, such as catheter tubes. An ostomy bag that you wear outside of your body should fit closely to your belly. Unless you wear tight-fitting clothes, it won’t be obvious to others.

You’ll empty it several times a day at first. Once your body adjusts, you’ll empty it less often. If you have an internal pouch, we’ll show you how to drain it and protect the area around it.

Ostomy Medical Supplies

Ostomy appliances and styles vary. Pouches come in 1 or 2 pieces. The wafer is an adhesive base that sticks to and protects your skin. It has a small hole that fits around the stoma.

An attached or detachable pouch or bag connects to the wafer. We’ll talk with you about your options. We’ll also show you how often to change and replace your bag. You’ll learn about reusable and disposable ostomy bags and products, such as:

• Pouches, pouch covers, and supportive belts
• Adhesive tapes
• Cleansing wipes
• Skin barriers, such as protective lotions, powders, and pastes

Emptying & Changing an Ostomy Bag

Most people empty the pouch when it’s about a third of the way full. Emptying the bag more often can help prevent skin irritation or leaking. Some pouches open at the bottom and drain into the toilet. Other styles open at the top and need to be detached before emptying. It’s common to replace a pouch every few days. If you notice leaking, change the bag right away.

Follow your doctor’s directions closely. It’s important to keep everything clean to prevent irritation, infection, and other complications. Wash your skin with warm, soapy water. Gently pat your skin dry before attaching the pouch.

Your care team can recommend alcohol-free skin care products that won’t irritate or dry your skin. Avoid oily products that loosen adhesives. Hot or humid weather, heavy exercise, and sweating can also loosen adhesives. You may need more frequent changes, an ostomy belt, or extra adhesive tape.

When to Contact Your Provider

Tell your ostomy nurse if you notice:

• Swelling, soreness, itching, leaking, or bleeding
• Signs of infection, such as discolored skin, pus, smelly discharge, or fever
• Signs of dehydration, such as dry mouth and feeling lightheaded
• Changes in bowel movements or diarrhea that don’t go away
• Skin bumps or rashes 
• Abdominal pain