4 mins. read

What to expect after colostomy surgery

Colorectal and anal cancer expert Jacquie Peck discusses colostomy care after cancer surgery and what to expect.

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Key takeaways

  • A colostomy is an opening using the colon (large bowel) which is stitched to the abdominal wall. There are many medical reasons that a colostomy may need to be formed, cancer is just one of them.
  • Expect there to be changes to the size of the bag after surgery, but this will settle as you recover.
  • Life with a colostomy will be different than before but it should not stop you doing anything you would like to do, including being active.

There are many medical reasons that a colostomy may need to be formed, not just cancer, and it is thought that 1 in 500 people in the UK are living with a form of ostomy (Colostomy UK, 2021). Here, colorectal and anal cancer expert Jacquie Peck explains what to expect after colostomy surgery.


The difference between ostomy and colostomy

An ostomy is surgery to create an opening from an area inside the body to the outside (Medline 2021). A colostomy is an opening using the colon (large bowel) which is stitched to the abdominal wall. This can either be temporary or permanent. 

The colostomy does not have any nerve endings therefore you should not feel pain from the stoma itself, however you can get discomfort from things such as trapped wind or if the skin surrounding the colostomy becomes sore.

You may have had a colostomy to treat bowel cancer, anal cancer, vaginal or cervical cancer and many non-cancer related issues.

What to expect after colostomy surgery

After colostomy surgery you may feel very tired at first. Your belly may be sore, and you will probably need pain medicine for a week or two. This is all very normal and side effects will start to improve day by day. 

To begin with you’ll be advised to reduce exercises that use abdominal wall muscles

At the beginning, you may find the bag fills with wind rather than stool, but this will settle as the bowel recovers. The stoma itself will also reduce in size over about a 6-week period as the inflammation reduces. 

If your bag is on with a tight seal, there should not be any smell. If you do smell something this would be the time to go to the bathroom to check the seal on your skin. At the beginning it is common to do this regularly but as you become more confident in managing it this will reduce. Stoma bags have been developed over the years and do not need to be changed regularly. Most people will change them every 1 – 2 days pending on the type of bag worn.

Being active while recovering from colostomy surgery

You will be restricted for the first 6 weeks post-operatively, but after this it should not stop you doing anything you would like to do in life. For example, exercise has been shown to help both with the function of the bowel but also helps reduce the effects of cancer treatment (Brown and Gilmore 2020). You can do any type of exercise with a colostomy however, for the first few months, you should reduce exercises that use the abdominal wall muscles. 

Psychologically having a stoma can have an impact on you and getting used to your new ‘plumbing’, as it is often referred to, will take time. You will not become an expert at this overnight and there will be days at the beginning where it misbehaves, leaks or you have other problems. It will not be like this forever. There are people around to help and support you through this and if you are struggling reach out to your stoma care nurse, cancer nurse specialist or Colostomy UK.  They will be able to help with the technical issues of life with a stoma and refer you on for further support if needed. 

While we have ensured that every article is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns, please talk to one of our healthcare professionals or your primary healthcare team.

Colostomy UK, “What is a stoma?”. 2021:  https://www.colostomyuk.org/information/what-is-a-stoma/

NHS, “Living with colostomy”. 2021:  https://www.nhs.uk/conditions/colostomy/living-with/

Medline, “Ostomy”. 2021: https://medlineplus.gov/ostomy.html#:~:text=An%20ostomy%20is%20surgery%20to%20create%20an%20opening,be%20the%20small%20intestine%2C%20colon%2C%20rectum%2C%20or%20bladder

Brown and Gilmore, “Physical activity reduces the risk of recurrence and mortality in cancer patients. Exercise and sport sciences reviews”.  Apr 2020, https://utsouthwestern.pure.elsevier.com/en/publications/physical-activity-reduces-the-risk-of-recurrence-and-mortality-in