Understanding Your Ostomy

May 03,2019 |

It doesn’t matter who you are, where you live, or what you do… life happens. Sometimes, you’re faced with making a choice between difficult decisions and other times you don’t have a choice. In those circumstances, the best way to move forward and live a full life is to understand the changes that come when things do happen. This is especially true when you need an ostomy. In this article, we’ll dive into everything you need to know about understanding your ostomy.

What is an Ostomy?

First and foremost, what exactly is an ostomy? An ostomy is a hole made by a surgeon that allows stool and/or urine to leave your body through your belly1. This surgery is needed for a number of different reasons, but primarily occurs as a result of a malfunctioning urinary or digestive system2. Placement varies and ostomies are either temporary or permanent, both of which depend on the underlying reason and diagnosis.

Regardless of the reason, ostomy surgeries save lives.

While it will be difficult to imagine the changes that come with an ostomy surgery, it’s important to remember that life might not be possible without it. In the most common cases, ostomies are needed due to birth defects, cancer, inflammatory bowel disease, diverticulitis, incontinence, and more2.

This type of surgery is done when needed and at any age, but in no way lowers your life expectancy. It simply indicates the start of something new. We’ll talk about living with an ostomy later, but it’s always reassuring to know that even though it is a huge lifestyle change, you’re not alone.

What is a Stoma?

After the surgery, a piece of your ureter or small or large bowel will stick through your skin and connect to an external pouch1. This opening is called the stoma. The stoma is where a pouch or bag is connected after continent diversion surgeries. When patients have problems with their ostomy surgery, it’s usually something to do with the stoma. Because of this, it’s a good idea to get familiar with your stoma so you can describe any changes to your doctor. A regular stoma will appear red/dark pink in color, moist, and shiny3.

After your surgery has healed, get comfortable with your stoma. Look in the mirror while you move around and see how it changes. This will help you get a better understanding of your stoma and is crucial to detect changes. Pay attention to the following3:

  • Is the surrounding skin flat with no wrinkles or creasing or are there skin folds and wrinkles? Where are the wrinkles?
  • What shape is your stoma? Is it round, irregular, or oval?
  • Is there one opening or are there two?
  • What color is it?
  • What position is it at?
  • Is it flush to your skin level or slightly raised or sunken?
  • Where is your stoma on your body?
  • How big is your stoma?
  • Where does urine or stool come out of your stoma?
  • What does your output from the stoma (called effluent) look like?

Call your doctor immediately if you find any changes in your stoma or if it has a brown, black, or darkish maroon/blue color.

It will take some time to understand the language used in ostomy surgeries, but over time it will get easier. Make sure you pay attention to the stool and urine (effluent) that comes out of your stoma and keep a detailed description for your health records.

Different Types of Ostomies

There are different types of ostomies used depending on the underlying reason for the surgery. There are a few types that are more common than others, but all of them are considered continent diversion surgeries.

Here are the most common types of ostomies performed today.


Most people have heard of a colostomy—it’s one of the most frequent types of ostomy surgeries performed. A colostomy occurs when a piece of the colon or rectum is removed2. To ensure a functioning digestion tract, the remainder of the colon is brought to the abdominal wall so that stool is exited through the body safely2.

Temporary colostomy surgery is done when areas of the body need to heal and is easily reversed. Permanent colostomies are performed when disease affects the end part of a colon or rectum4.


Urostomy surgery is performed when urine needs to be diverted away from a diseased or defective bladder2. Either a section at the end of the small bowel (ileum) or at the start of the large intestine (cecum) is removed and relocated so that urine passes from the kidneys directly outside the body2.

There are a number of different types of urostomies that are done, each one depending on the reason for surgery. Most urostomies are permanent and result in the complete removal of the bladder.


This surgery involves bringing a piece of the small intestine known as the ileum outside the abdominal wall5. Temporary ileostomies are done when surgeries in other areas of the digestive tract need time to heal and are reversible5.

Permanent ileostomies are performed when the large intestines need to be removed and reconnection isn’t possible5. This is a common surgery done for people who have Crohn’s disease.


A j-pouch is a surgically created internal reservoir that’s created using an individual’s very own small intestine2. It creates an alternative way for your body’s digestive tract to function.

Due to the nature of this surgery, it’s done in multiple steps. When done successfully, patients return to using the bathroom regularly, without surgical assistance2.

In addition to the more common types of ostomies listed above, there are a number of other types of ostomy surgery. These are rare and not as common, but still occur. If you’d like to learn more, click here.

What to Expect in Surgery

Ostomy surgeries are performed under general anesthesia, so you won’t be awake during the process. Your surgery and surgical process with be different depending on the type of ostomy you need. You and your doctor will discuss underlying causes and work with a surgeon to get you prepared.

Since it is an invasive surgery that changes how your digestive tract functions, it will take a while for things to heal. Usually, doctors recommend waiting a few months after surgery to resume all of your normal activities1. Once you’ve recovered, all of your every day activities can be resumed—except for any high-contact sports.

As with all surgeries, there are possibilities for complications. After surgery, pay attention to your stoma and the surrounding skin. If you notice anything weird, tell your doctor. If you have stomach problems or feel the urge to use the bathroom, tell your doctor. It’s always better to be safe than sorry with major surgeries so if you’re not feeling yourself or if you notice anything strange, it never hurts to pick up the phone.

Living with an Ostomy

If you’ve gone through surgery and are living with a permanent ostomy, there are a few things to understand. First of all, everyone who goes through this surgery faces the same emotional concerns. It will be challenging, but since ostomies are life saving procedures, it’s important to remember the bigger picture.

The largest challenge that most people work to overcome is body image and self-esteem concerns. Since ostomies lead to a physical bag, people face fear of criticism and outside speculation. They experience the fear of loss in a sense that they’re losing their regular life. Instead of bottling these fears up, it helps to find support.

Physiological Adaption

The most common phases of physiological adaptation after having an ostomy surgery include shock or panic, denial, acknowledgement, and resolution6.

Throughout the rehabilitation process, there will be opportunities to express concerns, fears, and feelings in general. However, life will continue after the rehabilitation process and if you feel like you need continued emotional support, there are resources available. Take some time to look into peer support groups, find people in your area that have also had an ostomy, and continue to do the things that make you happy.

A large change in self-care will be needed after your ostomy. You will be taught how to master the process of caring for your stoma and expelling waste, but if you ever have any questions don’t hesitate to call your doctor.

Finally, life after ostomy means that you’re going to need a few additional supplies in your medicine cabinet. At Byram Healthcare, we’re committed to helping improve the life of people living with an ostomy and offer a wide range of ostomy supplies and support systems. If your insurance doesn’t cover ostomy supplies, Byram is happy to offer discounts to help save you time, money, and hassle. Learn more about our ostomy care and educational support today!!