Living with an Ostomy: How Does it Change Your Daily Routine?

Preparing to resume regular diet  

• Keep a food diary 
• Add new foods slowly 
• Note how often you need to empty your pouch 
• Note how each food affects the ostomy output 
• Develop a meal routine 

Pouch change routines 

• Ileostomy system wear time is about 3-4 days 
• Colostomy pouching system wear time is about 5 days 
• Urostomy wear time is 4-7 days 

Changing the system should be done when the stoma is least active. For many with ileostomies, that’s the first thing in the morning before eating or drinking anything. Some with a colostomy have decreased output later in the day. Urostomies are active all the time but early morning before drinking anything is best.  

If you are changing the system in the morning, be sure to allow extra time on the days of pouch changes, before going to work.  

Pouchkins Drainable Pediatric One-Piece Ostomy Pouch

Hollister M9 Ostomy Odor Eliminator Spray

ActiveLife One Piece Drainable Pouch

Planning for pouch emptying routine 

Be sure to empty your pouch before leaving the house. This will delay the need for emptying in public. If you are out for the day, plan on emptying your pouch when it is 1/3 to ½ full. This will reduce the bulging of the pouch. Eat foods that you know won't bother the stoma output much. For example: 

• Avoid foods that cause increased gas 
  • Asparagus, Brussel sprouts, cabbage, cauliflower, peas, broccoli 
  • Carbonated beverages, beer 
  • Beans, onion 
  • Consider Beano or Phazyme tabs at the start of each meal to decrease gas 
• Avoid those that increase odor 
  • Asparagus, broccoli, onions, peas, dried beans 
  • Eggs, fish, garlic 
  • Alcohol 
• Avoid those that thin the stool 
  • Fried or spicy food 
  • Grape or prune juice 
  • High sugar foods 
• Avoid those that do not digest well 
  • Cabbage, celery, mushrooms 
  • Apple peels, skin of fruits or veggies, dried fruit, pineapple 
  • Coconut, corn, popcorn 
  • Seeds, nuts 
• Foods that reduce odor  
  • Buttermilk, cranberry juice, parsley, yogurt 

Along with knowing your diet effects, products are available to help with odor when emptying your pouch in a public rest room.  

• Pouch deodorants and lubricants 
• Air fresheners/sprays 
• Charcoal tabs taken orally 

Clothing options 

The first few weeks after surgery, most are wearing loose, comfortable clothing. As you start to venture out, you may need to consider a different style.  No clothing is off limits but keep in mind, some of your clothing may feel less comfortable after having ostomy surgery. Tight clothing and belts may feel restrictive. Experiment with clothing styles. Depending on stoma placement, a different style may be warranted. Consider: 

• Longer, flowy tops 
• High-waisted slacks 
• Pleated trousers 
• Aline dresses that flare at the waist 
• Wear patterns or dark colors 
• Under garments to minimize the outline of the pouch 
  • Wrap, Stealth belt 

Remember, looking down at your clothing you may see the ostomy pouch but others looking at you don’t see it from their perspective. Most people will not know you have an ostomy unless you choose to tell them. Who you tell is up to you. 

Returning to a work routine 

Returning to work is a great way to get back to routine. You can transition or ease into work slowly. Start with ½ days, giving time for you to feel more confident with the ostomy at work. This will minimize the need for pouch emptying until you feel more comfortable in your work environment.  

Colleagues at work will be happy to see you and many will ask how you are. Some may have questions about your surgery. Before returning, plan your response. Again, you don’t need to tell anyone about the ostomy.  

Resuming activities as part of your routine 

If you were active before your stoma surgery, you can resume your activities after healing. Some precautions may need to be taken depending on the activity.  

• Yoga 
  • Yoga pants offer support for the pouch 
• Contact sports 
  • Wear a stoma guard to prevent injury to the stoma 
• Weight lifting 
  • Check with your doctor first 
  • Wear a support belt or binder 
• Running 
  • Wear a support belt, bike shorts, or Spanx  
• Swimming 
  • Be sure your pouch is intact for a few hours prior 
  • Consider adding waterproof products 
  • Elastic barrier strips 
  • Sure Seal ring 
  • Hy-Tape 
  • Look for ostomy specific swim wear/trunks 
  • Dry-Pro waterproof ostomy cover 
• Gardening 
  • Uses smaller containers for carrying away clippings 

Travel routines 

• If travel routine for you, a little pre-planning goes a long way.   
  • TSA travel card 
  • Pack extra supplies. A good rule is to pack almost double what you usually would use. Having enough supplies will help you feel more confident and worry free.  
  • Take ostomy supplies in your carry-on bag. 
  • Always carry a travel pouch with a change of pouching supplies for emergencies. Other supplies you’ll need are flushable wipes for cleaning (make sure they do not contain aloe or moisturizers as this will prevent your next pouch from adhering well). Don’t forget your moldable rings, paste, barrier strips or other accessories you may need.  
  • Using a public bathroom can be intimidating for a new ostomate. Here are a few tips to help: 
  • Before emptying your pouch, place a small, thin layer of toilet tissue in the water to prevent splashing 
  • Try spraying poo-pourri into the water before emptying. These are available in travel sizes for easy carrying 
  • Internal deodorants are available to reduce output odor. Devrom is Chlorofresh is another internal deodorant. 
  • Foods that help reduce odor are parsley, yogurt, and buttermilk 
  • Deodorant drops can be placed in the pouch each time you empty. Many are available in travel sized packets. Coloplast Brava, Hollister Adapt or M9, or ConvaTec Diamond gelling sachets are a few examples. Devko tablets can be placed in the pouch for odor control as well.  
  • Biologic odor eliminator sprays for air freshening are available in 1-2 oz sizes for travel.  
  • For those with an ileostomy, gelling agents will help thicken output. I already mentioned ConvaTec’s Diamond gelling sachet, but others are available as well. Ile-sorb made by Cymed, Nu-sorb powder made by Nu-hope, or Gel-X tablets made by Secure Health Products.  
  • If traveling out of the country, be sure to learn or write down important questions such as “where can I find a restroom?” 

Returning to intimacy 

If you have had a partner through your illness and ostomy surgery, before resuming intimacy, talk to them about your concerns. Most likely, they have concerns too. Take care of your body and learn how to manage the ostomy before planning intimate encounters. Once ready to participate in sexual activity, here’s a few tips: 

• Empty your pouch prior to becoming physical 
• Consider a pouch deodorant  
• If wearing a transparent pouch, consider a pouch cover (this will offer more self- confidence) 
• Consider wearing a wrap around your pouch (it will hold the pouch close to your body) 
• Those with colostomies can often use a stoma cap rather than a full-sized pouch 
• Never use the stoma for penetration 
• Conventional positions are most often possible (type of surgery may affect this) 
• Start slow and gentle 

Returning to a regular routine seems difficult in the beginning. As you become expert with your ostomy, routine is easy. It makes management ROUTINE! 

Author Profile: Christine Kijek, Registered Colorectal Nurse

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