After Ostomy Surgery of the Bowel

In this section:

What should I expect after ostomy surgery of the bowel?

Most people are able to lead full and active lives and return to most of the activities they enjoyed before ostomy surgery. As you adjust to life after your ostomy surgery, your ostomy nurse will provide education, support, and medical advice.

Your ostomy nurse may cover topics that include

  • understanding changes to your digestive tract 
  • managing waste and gas 
  • eating a healthy diet and drinking enough liquids
  • recovering from surgery and returning to your usual activities
  • coping with practical, social, and emotional issues
  • watching for and preventing complications

How does ostomy surgery of the bowel change my digestive tract?

During ostomy surgery, surgeons remove or bypass

  • all or part of the large intestine. The large intestine usually takes in water from stool and changes it from a liquid to a solid form. The large intestine includes the colon and rectum.
  • part of the small intestine, in some cases. The small intestine usually absorbs nutrients from the foods you eat.

Depending on how much of your large or small intestine were removed or bypassed, you may experience some changes or problems with your digestive tract and how it works.

  • Your stool may be less solid and formed.
  • Your digestive tract may absorb less water and nutrients.
  • You may have digestive symptoms such as gas, diarrhea, or constipation. These symptoms may improve over time as the digestive tract heals and you add more foods to your diet.
  • If your rectum was removed, you may experience phantom rectum. Phantom rectum is the feeling that you need to have a bowel movement, even though your rectum is no longer there.
  • If the lower part of your digestive tract and anus were bypassed but not removed, the bypassed digestive tract may still produce mucus, which may leak or pass from the anus.

Health care professionals can recommend strategies or treatments to help you manage changes in your digestive tract after surgery.

How will I manage waste and gas?

Surgery changes the way the contents of the digestive tract leave your body. Your ostomy nurse will teach you how to manage waste and gas, based on the type of ostomy surgery you had.

Ileostomy or colostomy

If you had an ileostomy or colostomy, your ostomy nurse will help you choose an ostomy pouch—also called a pouching system or appliance. An ostomy pouch is a removable pouch you wear outside your body, attached to the skin around your stoma. The ostomy pouch will collect intestinal contents and gas that pass from your stoma.

Different types of pouching systems are available, and your ostomy nurse can help you choose the system that’s right for you. Pouching systems include a skin barrier—also called a wafer or flange—that sticks to the skin around the stoma and protects the skin from intestinal contents, which can cause irritation. The systems also include a disposable, odor-proof pouch that collects intestinal contents. The skin barrier and pouch may be one piece or two separate pieces. The ostomy pouch is emptied one or more times per day, while the wafer is changed about every 3 days.4

Your ostomy nurse can provide information about

  • how to use your pouching system, including how often to empty and change the pouch or pouching system
  • how to clean and care for your stoma and the skin around it
  • how to check for signs of problems or complications when you change your ostomy pouch

Continent ileostomy

If you had a continent ileostomy, you won’t need to wear an ostomy pouch. Your ostomy nurse will teach you how to insert a tube, called a catheter, into the stoma to drain the internal pouch.

Ileoanal pouch surgery

After ileoanal pouch surgery is complete, the temporary stoma is closed. Stool and gas will leave your body through your anus, as they did before surgery. At first, you will have more frequent bowel movements, up to 15 per day.5 You may have mild bowel control problems and may need to wake up from sleep to pass stool. The newly formed pouch will take several months to stretch and adjust to its new function. Over time, people typically have fewer bowel movements and bowel control problems. On average, people who had ileoanal pouch surgery have about seven bowel movements per day, including one at night.6

Will my diet need to change?

After ostomy surgery, many people are eventually able to go back to their regular diet and eat and drink what they like. In some cases, health care professionals may recommend diet changes based on a person’s medical conditions or the type of ostomy surgery he or she had.

Talk with your doctor and ostomy nurse about healthy eating. Your doctor may refer you to a registered dietitian to help you create a healthy eating plan.

For the first several weeks after surgery, health care professionals may recommend

  • eating a healthy diet that provides the nutrients you need while you recover from surgery
  • drinking enough liquids to prevent dehydration
  • avoiding high-fiber foods such as raw fruits and vegetables, seeds, nuts, and corn
  • avoiding spicy or high-fat foods

Health care professionals may recommend adding new foods to your diet gradually, after you recover from surgery. Just as before ostomy surgery, certain foods are more likely to cause digestive symptoms such as constipation, diarrhea, gas, or stool odor. Keeping a food journal can help you track the foods you eat and how they affect you.

Talk with your doctor, ostomy nurse, or registered dietitian about any digestive problems you have. Health care professionals may recommend diet changes, medicines, or other treatments to manage these problems.

Smiling woman eating dinner in a restaurant.
After ostomy surgery, many people are eventually able to go back to their regular diet.

When can I go back to my usual activities?

For some time after surgery, your doctor may recommend you rest and avoid certain activities, such as driving or heavy lifting. Follow your doctor’s instructions about when you can go back to your usual work and leisure activities.

Once you recover from surgery, you should be able to return to most of the activities you enjoyed before surgery, including swimming and other water sports. Your ostomy nurse can advise you about managing your ostomy pouch, if you have one, during physical activity.

Certain types of activities, such as contact sports and heavy lifting, could risk injury to your stoma. Your doctor or nurse may recommend avoiding these activities or taking steps to protect your stoma and prevent injury.

How can I cope with practical, social, and emotional issues after ostomy surgery?

You may face practical, social, and emotional issues as you adjust to life after ostomy surgery. Your ostomy nurse and other health care professionals can answer your questions and provide information, advice, and support related to a variety of issues, including

  • feelings and emotions, including body image
  • intimacy and sexual activity
  • maintaining personal relationships, including talking about your ostomy surgery with family, friends, and others
  • social life and travel

Support from family members, partners, and health care professionals can help you adjust to life after ostomy surgery. Your ostomy nurse can refer you to community or online resources and support groups that may be helpful as you adjust.

References

Last Reviewed June 2021
Share

This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.