Ostomy surgeries involve creating an opening in the abdomen to allow waste to pass into a special pouch outside the body. While there are several myths and misconceptions surrounding this procedure, modern techniques and proper ostomy care make it possible for you to live a healthy, active life after recovery. Here, we'll discuss why ostomy surgeries are performed, along with a comprehensive checklist to help you prepare for the big day.
In this article, you'll learn:
- Why ostomy surgery may be needed and the conditions it treats
- The different types of ostomies, including colostomy, ileostomy, and urostomy
- What happens during ostomy surgery, and how long the procedure takes
- A complete ostomy surgery preparation checklist to help you feel ready and confident
- Key ostomy surgery recovery and care tips for proper stoma management
- What to expect from ostomy reversal surgery and the long-term outlook
Why Might Someone Need an Ostomy Surgery?
Ostomy surgeries are considered life-saving procedures and are performed when part of the digestive or urinary system is no longer working as it should. The surgery is done so that the defective part of the small intestine or large intestine can be bypassed, allowing waste to leave the body through an opening in the abdomen called a stoma. An ostomy can be temporary or permanent, depending on the underlying medical condition and how much of the intestinal or urinary tract is affected. Your healthcare provider will discuss all of your options and long-term prognosis with you before scheduling, but don't hesitate to ask questions or for clarification.
Some of the most common medical reasons for needing an ostomy include the following:
- Inflammatory Bowel Diseases (IBD): Chronic conditions like Crohn’s disease or ulcerative colitis can damage sections of the intestines, making normal digestion difficult or unsafe. An ostomy can help rest the bowel and prevent infection or perforation.
- Colorectal Cancer: When cancer affects the lower part of the colon or rectum, surgeons may need to remove a portion of the intestine and create a colostomy to allow waste to exit the body.
- Diverticulitis: Severe or recurrent inflammation in small pouches of the colon can lead to infection or rupture, sometimes requiring a temporary colostomy while the bowel heals.
- Traumatic Injury: Accidents or abdominal injuries that damage the intestines or bladder may make an ostomy necessary for recovery.
- Birth Defects or Congenital Conditions: Some babies are born with abnormalities in the intestines, bladder, or anus that require a temporary ostomy soon after birth.
- Bowel Obstruction or Ischemia: When blood flow to the intestines is blocked or a section becomes severely obstructed, surgeons may create an ostomy to divert waste and prevent tissue death.
The underlying reason for ostomies will also impact the type of surgery you receive, which will be discussed in detail with your surgeon and medical team.
Different Types of Ostomy Surgeries
There are several different types of diversion surgeries, each of which is designed to help your body safely eliminate waste. Each type is differentiated based on which part of the digestive tract or urinary tract needs to be bypassed. The three different types of ostomies are as follows:
Colostomy
A colostomy surgery is performed when a section of the large intestine (colon) or rectum needs to be bypassed or removed. During this procedure, the surgeon brings part of the colon to the surface of the abdomen to form a stoma, allowing stool to leave the body into a colostomy bag attached to the skin.
Ileostomy
An ileostomy is created when the small intestine (ileum) is brought through the abdominal wall to form a stoma. Waste passes directly from the small intestine into an ileostomy pouch, bypassing the colon completely.
Urostomy
A urostomy diverts urine away from the bladder when it must be removed or bypassed. In this procedure, the surgeon uses a small section of the intestine to create a urinary diversion, bringing it to the skin’s surface to form a stoma. Urine then flows continuously into a urostomy bag attached to the abdomen.
Ostomy Surgery Preparation Checklist
Before the day of surgery, you will need to go through the following step-by-step checklist to help you get ready for the upcoming procedure. Your doctor or ostomy nurse can help you with these steps, but they're crucial to ensuring you're prepared, both physically and emotionally.
- Schedule a preoperative consultation with your surgeon and ostomy nurse (WOCN) to discuss what type of ostomy you’ll have.
- Review your medical history and medications. Tell your care team about all prescriptions, supplements, and over-the-counter medicines you take.
- Ask questions about what to expect during and after surgery, including pain management, recovery time, and stoma care.
- Meet with a stoma care nurse to discuss stoma site marking; the best location on your abdomen for your new stoma (important for comfort and pouch security).
- Ask to see examples of ostomy pouches and supplies so you’re familiar with how they work before surgery.
- Watch educational videos or request printed guides on ostomy care and how to change an ostomy bag.
- Follow any dietary instructions provided by your surgeon. You may need to follow a clear liquid diet 24 hours before surgery or take a prescribed bowel prep.
- Stay hydrated; drink clear fluids up until the fasting cut-off time.
- Stop certain medications (such as blood thinners, aspirin, or herbal supplements) if directed by your doctor.
- Avoid alcohol and smoking in the days leading up to surgery to support better healing.
- Set up a comfortable recovery area with easy access to the bathroom, bed, and essentials.
- Stock up on ostomy supplies and loose-fitting clothes that won’t rub against your abdomen.
- Prepare easy-to-digest meals (soups, broths, soft foods) for the first week post-surgery.
- Keep a small mirror handy; it helps you see your stoma when changing the pouch.
- Arrange for help with chores, childcare, or pet care during your first few weeks of recovery.
- Remember that it’s normal to feel anxious or uncertain.
- Focus on the positives: ostomy surgery can significantly improve your health, comfort, and quality of life.
- Follow fasting instructions exactly; usually, no food or drink after midnight.
- Shower with antibacterial soap as directed by your care team.
- Remove jewelry, nail polish, and makeup.
- Pack a hospital bag with essentials for a few days post-op.
- Arrive early to allow time for check-in and preoperative prep.
- Confirm the stoma site marking with your surgeon or ostomy nurse one last time.
What Happens During Ostomy Surgery?
An ostomy surgery can be performed either using open surgery or laparoscopic surgery, depending on the underlying condition and overall health. You will be put under general anesthesia for the operation. The surgeon will then make an incision in the abdominal wall to access the affected area. They will bring a section of the intestine or urinary tract through the incision and fold it back on itself to form a stoma. The stoma is then stitched into the skin, creating a small opening where waste can exit the body. A temporary ostomy pouch may be fitted to the stoma for immediate post-op, and the remaining incisions are closed.
How Long Does Ostomy Surgery Take?
On average, ostomy surgery takes between one and four hours, depending on the complexity of the situation. The length of time it takes to perform the surgery can also depend on the type of procedure and your overall health.
Ostomy Surgery Recovery and Care
Recovery from an ostomy surgery usually takes several weeks, with most patients staying in the hospital for a few days after the procedure. During this time, your care team will monitor your stoma and introduce you to basic ostomy care skills.
At home, focus on gentle activity, eating small, balanced meals, and keeping your stoma and surrounding skin clean and dry. Follow your doctor’s stoma care tips, like emptying your pouch when it’s one-third full and using skin barriers to prevent irritation. With proper post-surgical ostomy management, most people adapt well and regain their normal routines within a few months. Although it can take a bit longer to mentally adjust to living with an ostomy, there are several resources available to help.
Ostomy Reversal Surgery and Long-Term Outlook
In circumstances that allow for it, ileostomy and colostomy surgeries may be reversible. This is only possible once the intestines have healed and regular bowel function returns. During ostomy reversal surgery, the surgeon reconnects the intestine so waste can pass naturally again. Recovery times vary, and it may take several weeks for your digestive system to adjust.
In almost all cases, a urostomy surgery is a permanent procedure that can't be reversed. If you have any questions or concerns about this, your doctor can help you better understand the prognosis.
The United Ostomy Associations of America (UOAA) is a great resource for new ostomates to find information on everything from how to care for your stoma to finding an ostomy support group near you. Byram Healthcare is also here to help simplify life with an ostomy, and we carry a wide range of ostomy pouching systems and other high-quality ostomy products that can be discreetly delivered to your door. Contact us today to get started with your order or learn more about our educational resources.
