Find care now
If you are experiencing a medical emergency, please call 911 or seek care at an emergency room.

This article was written by Hilary Hancock BSN, RN, CWON.
From the day we’re born, or at least the day we’re potty trained, we come to expect that using the toilet is a fact of life. For people with an abdominal condition or surgery, that can change in a heartbeat, when an ostomy surgically alters how waste is removed from the body.
This can be a challenging adjustment.
About 1 million people in the U.S. live with an ostomy, and about 100,00 ostomy surgeries are performed each year. Studies have shown that it takes an average of three months for a patient to feel comfortable managing their ostomy independently. Often, patients are going through the emotional and physical challenges of another serious diagnosis or treatment while they’re getting used to having an ostomy.
Our patients have a lot of questions, and sometimes they need a shoulder to cry on. That’s why we focus on education, support, and guidance to help them through the adjustment period ahead. From understanding your ostomy to finding support and getting active, we’re here to help patients make this change.
1. What is an ostomy?
An ostomy is a hole in the abdominal wall that a surgeon creates to detour urine (pee) or stool (poop) away from its usual route outside the body. The intestines, or urine-passing tubes called ureters, are connected to this opening to allow waste to pass outside the body.
Surgeons create an opening in the abdominal wall and connect the intestine. Called a stoma, this opening allows waste to pass outside the body and into a special pouch system for collection. This pouch sticks to the skin around the stoma with a gentle but firm adhesive.
There are many reasons why an ostomy could be needed, including:
-
Inflammatory bowel disease such as diverticulitis, Crohn’s disease, or ulcerative colitis
-
Abdominal trauma such as from a traffic accident or gunshot wound
-
A perforation, which is a hole in the intestine
There are three main types of ostomies, depending upon where and why it’s created.
-
Colostomy: Routing the large intestine, or colon, to the abdominal wall
-
Ileostomy: Routing the small intestine to the abdominal wall
-
Urostomy: Urine is routed through the stoma, bypassing the bladder
Related reading: Warning Signs of Bladder Cancer.
2. Is an ostomy permanent?
Ostomies can be temporary, such as when the intestines have been surgically repaired. In this case, an ostomy could be used to divert stool so the intestines can heal and recover. After the patient has healed from the surgery, the intestines can often be reconnected so stool passes through the rectum as usual.
Or an ostomy can be permanent, such as when the bladder or intestines have been surgically removed. Sometimes, patients with cancer must have some or all their affected organs removed. In these cases a stoma can be a new, permanent route for waste.
3. Does an ostomy smell bad?
Ostomy pouching systems have come a long way in the last few decades. Back in the 1990s, pouches weren’t odor proof, and they tended to crinkle like a potato chip bag. Patients were understandably self-conscious, and many avoided social contact.
Today, pouches keep odors inside and they’re made of a soft, quiet fabric. These low-profile systems can be worn under clothing for discretion. Improvements in adhesive technology mean modern pouches are designed to be worn for 3-5 days and shouldn’t irritate the skin when they’re removed.
Related reading: 5 Myths About Gastrointestinal Cancer Debunked.
4. Will an ostomy limit my activities?
No. Adjusting to an ostomy can take time, but once patients’ surgical incisions are healed and they get used to their new toileting procedure there should be no limits on daily life.
At first, adjustments can include becoming comfortable with managing the pouching system, such as knowing when to anticipate emptying the pouch (usually about every three hours) and how many supplies to bring on an outing. Sometimes, changes to nutrition are needed, such as eating more processed foods and fewer whole grains, fruits, and vegetables after ileostomy.
There is stigma surrounding ostomy because, frankly, there is stigma surrounding poop. The truth is everybody does it. We just don’t talk about it. The more we can normalize life with an ostomy, the better it is for everyone.
Many patients love to camp, hike, and swim. Their ostomy doesn’t slow them down. They just bring along their pouching supplies, do a little extra planning, and enjoy the great outdoors.
These days, there are plenty of clothes designed for people with an ostomy. From covers and belts to conceal the pouch to swimsuits and lingerie that let you strut your stuff with confidence, there’s no shortage of active lifestyle products to support life with an ostomy.
There are even ostomy influencers on YouTube and Instagram, such as Hannah Witton and Ostomy Diaries. They’re normalizing ostomy management and showing off their scars and success to help more people get comfortable with their ostomy.
5. What resources can help with my ostomy?
We know that having an ostomy is difficult at first, and we’re here to help. That often means a sympathetic ear and a shoulder to lean on. But soon we move on to learning how to manage your ostomy.
There’s a lot to think about when you’re recovering from surgery, and everyone learns differently. So we show patients videos, talk with them about the details, and provide printed materials with careful instructions and pictures. We connect our ostomy patients with a pouching system supplier, where they can order supplies and receive troubleshooting support.
Before patients go home, we practice using their new pouching system, and make sure it fits properly. We know most people need support at home. We connect every patient with MedStar Health Home Care so a visiting nurse can assist in the early days. Plus, we have a clinic here at MedStar Washington Hospital Center every Wednesday where patients can come for help.
Many patients and family members benefit from the community of support groups for living with ostomies. The United Ostomy Association of America has a tool on their website where patients can find a group near their home, along with many other useful resources.
Living with an ostomy can be tough, especially at first when adjusting to new toileting routines. After time, most patients find they are not limited by their ostomy and can enjoy all the activities they love.