What is an Ostomy?

If your intestine has had a disease or an injury, it may need time to rest and heal, or it may need to be removed. If this happens, you may be given an ostomy. An ostomy allows waste to safely leave your body without passing all the way through your intestines.


To create an ostomy, part or all of your colon is removed. A surgeon brings a piece of your intestine through a small opening in your abdomen. This opening is called a stoma. A stoma in the colon is a colostomy. A stoma in the small intestine is an ileostomy. Body waste passes through the stoma instead of the rectum. A disposable pouch is placed over the stoma to collect the body waste.

Thousands of people of all ages, ethnic groups, and walks of life have ostomies. For many people, the process has saved their lives. Most go on to be healthy and productive.

If you have a colostomy, most of your intestine is still there. You will absorb about the same amount of nutrients, and your stool will be thick.

If you have an ileostomy, you no longer have a colon. You will absorb nutrients, but will need to replace electrolytes with what you eat and drink. Ileostomy stool is often mushy.

Ostomy terms to know

  • Colostomy: A surgically created opening of the large bowel, which forms a stoma and diverts body wastes.
  • Enterostomy: Surgical formation of an opening into the digestive tract.
  • Ileostomy: A surgically created opening of the small bowel, which forms a stoma and diverts body wastes.
  • Ostomy: A surgically created opening which is made through the abdominal wall to divert body wastes.
  • Peristalsis: The normal motion of the bowel that moves bowel contents through the bowel.
  • Peristomal skin: The skin around the stoma.
  • Stoma: The visible portion of the intestine that is surgically brought out to the skin through the opening in the abdominal wall during your ostomy surgery.

Understanding Your Stoma

The stoma is the part of the intestine that you see on your abdomen. The surgeon forms the stoma by rolling the end of the intestine back on itself, like the cuff of a sleeve. The edges of the stoma are sewn to the skin to hold it in place. Body wastes then pass to the outside of the body through this opening.


Here are a few characteristics of your stoma:

  • It's red.
  • It may bleed a little.
  • It's always moist.
  • Sometimes it moves.
  • Its shape changes over time.
  • It has no feeling.
  • You can't control it.

Caring For Your Ostomy

At first, caring for your ostomy may seem like a lot of work. With practice, though, it will become a natural part of your day.

Getting help

You have a lot to learn at first. To get started, you may need help with:

  • What products work best for you. There are many sizes and options to choose from, and it will take a few tries to decide what you prefer.
  • Where to buy your supplies. You need to make sure your supply company is covered by your insurance or Medicare plan.
  • How to care for your ostomy. This booklet covers some basic ideas. You’ll probably have plenty of other questions as you get started.

Luckily, there are many places to go for help, so don’t try to do this alone! Here are some places to get help:

  • Your ostomy nurse at the hospital will get you started. Your nurse will help you 1) find what products work best for you, 2) buy supplies, and 3) care for your ostomy. Be sure to stay in touch with this or another nurse to help you along the way.
  • Support groups. There are many people around you who have gone through this already. The resources section on the last page of this booklet lists support groups and web sites.
  • Your supply company. They may have an ostomy nurse on staff. Be sure to ask.
  • Other materials. If you were given a video or other training materials by your nurse, be sure to use them. These can be very helpful.

Pouches and Barriers

The pouch and barrier are the two basic supplies for caring for your ostomy. Together they prevent odor and protect the skin around your stoma. There are a few different types for you to choose from.

The pouch holds waste.

  • A drainable pouch has an opening at the bottom. This type of pouch is used most often with stomas that have mushy or liquid output. It can be emptied and reused for three to five days.
  • A closed pouch does not open at the bottom. This type is used with stomas that output stool, which can be difficult to squeeze out of a drainable pouch. It is thrown away after each use.

The skin barrier seals the pouch to the skin around the stoma.

  • On a one-piece system, the barrier is already attached to the pouch. You seal them to your skin at the same time.
  • On a two-piece system, you put the barrier on your skin first, then attach the bag in place over it.

Both one-piece and two-piece systems can be used with either drainable or closed pouches.

Skin Protection

The skin around a stoma is called peristomal skin. It should look much like any other skin. Sometimes, however, this skin can become red and raw. It’s easier to prevent skin problems than to treat them after they happen. To keep your peristomal skin healthy, follow these steps:

  • Change the barrier properly.
  • Keep your skin clean.
  • Use skin protection products if nececssary.
  • Make sure the hole in the barrier is cut or molded to the right size.

Irritated Skin Care

Your peristomal skin may become irritated by one of the following:

  • Contact with stool or adhesives, or an allergic reaction to one of your ostomy products.
  • A barrier and pouch that have been left in place too long.
  • A barrier that has been removed too forcefully and irritated the skin or the hair follicles.
  • Skin that has been scrubbed too hard.
  • A fungus or yeast rash caused by persistent skin moisture or from antibiotics.

If your peristomal skin becomes irritated, treat it right away. To treat the irritation, create a crust that will make a barrier to absorb fluid from the irritated skin and still allow your barrier to stick. Here’s how:

  1. Wash the skin and pat it dry.
  2. Sprinkle stoma powder on the irritated skin. Brush off excess powder to leave a light dusting. (Depending on the type of skin problem you have, your nurse may recommend a different type of powder to use.)
  3. Optional: Dab or pat the powdered skin with a skin-barrier wipe or water. To avoid burning, use a no-sting skin preparation product or one that is alcohol-free. Or, you can just use stoma powder alone.
  4. Repeat, if instructed to by your ostomy nurse.
  5. Allow it to dry, and then apply the barrier

If your skin is irritated and you have created a crust to help it heal, you may have to change the pouch and barrier more often. Moisture, powder, and skin preparations from a deeper wound often keep the barrier from sticking.

If your skin continues to break down, becomes extremely irritated, and gets sores, see your doctor or ostomy nurse.

Eating to Stay Healthy

For the first six to eight weeks after your surgery, you’ll need to eat less fiber. Later, you can eat most everything you used to.

During the first six to eight weeks, both your intestines and your stoma may be swollen. High-fiber foods may clump together and cause blockages in the small intestine that will not easily pass through the stoma. Blockages can be dangerous.

Eventually, you’ll probably be able to return to a normal diet that includes the vitamins and nutrients you need to stay healthy. At first, though, follow the tips below and in this table.

  • Chew foods well. This will help you digest foods more easily.
  • Be sure to drink something with every meal. This helps food pass through the intestine more easily.
  • Drink at least eight to ten glasses of fluids a day.
  • Eat four to six smaller meals per day.
  • Eat small servings. Eat your largest meal at noon and a smaller meal in the evening. This will help reduce your stool output at night.
  • After six to eight weeks, gradually increase the fiber in your diet until you reach the amount needed for bowel control.

Eating to prevent food-related problems

Just as before your surgery, the foods you eat will affect the amount of gas and odor you produce. They’ll also affect whether you have constipation or diarrhea. With an ostomy, however, it’s especially important to control these things. Learning the way different foods affect you will help you have a better experience with your ostomy.

Constipation and Blockage

With an ostomy, you’re more likely to experience constipation, blockage, or dehydration. Your body also absorbs medicine a little differently than it used to. Understanding these issues can help you prevent common problems.


Constipation can affect anyone. Normally the colon absorbs water into the body. When all or part of the colon is removed and an ostomy is created, a lot of water passes out of your body before it is absorbed. A person with an ileostomy can become dehydrated much more easily. Dehydration can contribute to constipation in a person with a colostomy.

Other factors also contribute to constipation. Stool consistency also depends on what you eat, how often you eat, your emotions, and sometimes medicines. Medicines that can cause constipation include those taken for pain, to relax muscles, to calm nerves, and medicines that contain iron.


Blockage is a condition that affects people with an ileostomy. A blockage happens when foods clump together in your small intestine and clog it.

If you have an ileostomy, a blockage can become an emergency. A prolonged blockage could cause your intestine to rupture. If the blockage lasts more than two or three hours, or if you start to vomit, call your doctor right away, or go to the nearest hospital emergency room.


Before you had an ostomy, medicine was absorbed into your body through your intestines. Now it has less time in your intestines to be absorbed. Anyone prescribing medicines for you needs to do so with this in mind. They also need to know what medicines you’re taking related to your ostomy.

  • Remember to let your pharmacist, doctor, and dentist know that you have an ostomy.
  • If you have an ileostomy, do not take “long acting,” “sustained release,” or “enteric-coated” medicines. Also avoid medicines in hard-capsule form. If your doctor and your pharmacist know you have an ileostomy, they can order the kind of medicine that your intestine will handle best.
  • If you have an ileostomy, don’t use laxatives. Your bowel movements will already be soft and semi‑liquid. Make sure your doctors know that you have an ileostomy so that they won’t give you laxatives before a test or surgery.
  • Some ostomy patients use bismuth preparations for odor control. If you are scheduled for an x-ray of your bowel, you must stop taking the bismuth for 24 to 48 hours before the test. Bismuth shows up on x-rays and it may be necessary to do the test over again if there is bismuth in your bowel.
  • If you have questions or concerns about any medicine you are taking, talk with your doctor or pharmacist.

Other Things to Consider

  • Work. Ask your surgeon when it will be ok to return to work and other activities and about any special considerations you need to be aware of. Ask specifically about any concerns around contact sports such as football or soccer.
  • Travel. Carry your supplies on in your carry-on bag when flying. The United Ostomy Association of America, Inc. (UOAA) has a downloadable TSA card to help alert the security team to your specific needs.
  • Swimming. Swimming or even hot tub use is ok with an ostomy. For your protection as well as the protection of others, use a waterproof tape around the edges to help provide extra security and empty it prior to entering the water.

Support and Resources

© 2018 Intermountain Healthcare. All rights reserved. The content presented here is for your information only. It is not a substitute for professional medical advice, and it should not be used to diagnose or treat a health problem or disease. Please consult your healthcare provider if you have any questions or concerns.