Adjustment to Life with an Ostomy

Patients can also be provided with numerous resources for reinforcement and follow-up on their own, including support groups, handouts with tips for ostomy care and lifestyle recommendations, and phone numbers and online connections to explore additional issues and support for adjustment to life with an ostomy.

Practical and lifestyle issues can be addressed during counseling sessions. For instance, supplies should be stored in a cool, dry place and not be left in a closed car during warm months because this could change the wafer and pouch integrity. Supplies should also be ordered well in advance of need in order to prevent being without them.

Traveling habits may not need to be dramatically changed by well-adjusted ostomy patients. However, preparation is a key factor to make sure that ostomy supplies are always available. For instance, it might be best to take ostomy supplies in carry-on luggage during a flight rather than risk being without supplies that may be lost by airlines, or possibly needed during the flight. Climate change and water safety may also be issues to be aware of, and may need to be addressed when traveling outside of the United States.

Some patients may require dietary changes. This is most common in patients with non-cancer reasons for colostomies (such as Crohn’s disease), but may also be important to reducing flatus (gas) or other annoyances. New ostomy patients may be advised to reduce fiber intake, such as fruits, vegetables, and whole grains. Tolerance to foods seems to be very unique to each individual and may require some “trial and error” testing by the patient. In situations where the patient has gas or stoma irritation caused by their diet, the patient should be instructed to simply avoid some of these foods. For instance, spicy foods that contain chili pepper or cinnamon or citrus juices may irritate the stoma and cause some inflammation. Some foods can increase odor and typically include asparagus, garlic, fish, and other foods. Foods that may add to constipation can be consumed with plenty of fluids or substituted with other foods. Foods that appear to lead to diarrhea may also be very individual, but may include high-fiber foods, milk, prunes or other chemically irritating foods, alcohol, and high fat foods. Dietary management of diarrhea might include increases in foods with pectin (bananas, potatoes, instant oatmeal, applesauce), and others. Rehydration will be especially important in these cases and can be achieved using diluted juices, rehydration drinks, and plenty of fluids. 

Sexuality changes are among the most common concerns and complaints by new ostomy patients who have been sexually active. In some cases, physical damage to nerves involved in sexuality may be of concern. In other cases, psychological concerns about body image and potential for pouch leakage may hinder sexual activity. The WOCN, psychologist, and social worker can provide some support and tips for adjusting to sexual activity with an ostomy. Birth control and family planning may also be features of ostomy patients of reproductive ages.

Costs of supplies have also been a major ongoing concern for ostomy patients. Social workers and nurses can assist in connecting patients with resources for financial assistance and help with supplies.

Patients who adjust well to living with an ostomy also tend to have support through connection with ostomy support groups and associations. In some cases, an ostomy may be a way to relieve painful symptoms of Crohn’s disease. Patient education, mental health and emotional support may help to assist patients with adjustment to their ostomy and living normal lives—these are all features of successful ostomy management.