What is an ostomy and when is it necessary in IBD?

An ostomy is a surgical procedure that creates an outlet for faecal matter directly into an ostomy device. Drainage of faeces to the outside is achieved by connecting the small intestine (ileostomy) or the large intestine (colostomy) through the abdominal wall via this pouch-like ostomy device.

An ostomy can be short-term (temporary) or lifelong (permanent) and can have different aspects and locations, depending on the anatomical area where it has been performed and the disease itself. Some of the reasons why it may be necessary are: diverticulitis, cancer, obstruction, injuries, congenital defects or IBD.

What does an ostomy pouch look like?

The ostomy pouch can be of different sizes, shapes, transparent or opaque depending on the patient’s needs and preferences.

• One-piece pouch: There are one-piece pouches that are very easy to put on and take off, offer maximum flexibility and are not visible under clothing. This type of device should usually be changed 1-2 times a day.
• Two-piece pouch: these are often used when there is a possibility of irritation as they have a base or plate that protects the periostomal skin for a longer period of time (2 or 3 days) allowing the pouch to be handled independently as often as necessary without coming into contact with the stoma.

Ostomy pouches, whether one-piece or two-piece, have filters that trap the smell of gas and faeces in the pouch and also prevent water from getting into the pouch during showering or bathing.

What does having an ostomy pouch involve?

Using an ostomy pouch is the best way to manage bowel movements after certain types of surgery on the colon or small intestine. This will require certain care and maintenance that will be explained in detail by the nursing staff to avoid any complications. It is important to closely follow the instructions provided depending on the type of pouch and ileostomy/colostomy you have had.

If you have had a permanent ostomy, you may also need some time to adjust and incorporate it into your daily life. The placement of a pouch is a change in body image that may cause some rejection, so there is no need to worry if you feel you need time to see the positive side of this resource. At the end of the day, an ostomy is a solution to serious health problems that allow us to improve our well-being. Rely on your nursing team if you need both practical and emotional support. They are professionals with extensive experience in this field and will certainly be able to offer you some recommendations that will help you in this process.

It is also advisable to talk about it openly with our family and social environment and give them the opportunity to accompany and support us in our daily life of living with an ostomy pouch in ordinary situations such as exercising, going to the beach or sharing intimacy with our partner.

Can I do sport if I have an ostomy pouch?

Sport is always recommended for your health and having an ostomy pouch does not make it an exception. The only exception is that it is not recommended to practice contact and/or impact sports that may pose a risk to the stoma. Neither is it recommended to significantly increase the abdominal musculature to the point where it can affect the stoma. For some sports it may be recommended to protect this area. Consult your medical team if you have any questions.

Water sports are not a problem as ostomy pouches are fitted with filters to protect them from water entry. If possible, it is also advisable to protect the ostomy pouch from the sun. ¹

1. –Ostomy: IBD & Me | Crohn’s & Colitis Foundation