A colostomy is a surgical procedure that creates an opening (stoma) on the abdomen’s surface to divert the large intestine, allowing waste to exit the body into an external pouch. This procedure is necessary due to various conditions, such as colorectal cancer, severe inflammatory bowel disease, or traumatic injury, often when the lower colon needs to rest or be bypassed. This article explores the realities of long-term living with a colostomy, offering insight into prognosis, daily management, and health considerations.
Longevity and Prognosis
The presence of a colostomy itself does not determine a person’s lifespan; for many, life expectancy is virtually identical to those without one. The most significant factor influencing prognosis is the underlying medical condition that necessitated the surgery. When performed for non-malignant conditions, such as severe injury or inflammatory bowel diseases, the procedure is often life-saving and does not shorten the remaining years of life.
Advancements in surgical techniques and ostomy appliance technology have made it possible for many individuals to live decades after receiving a permanent colostomy. For conditions like colorectal cancer, the stage of the disease and the success of the treatment are the primary determinants of survival, not the stoma itself. The procedure frequently extends life by successfully treating or managing a severe condition.
Daily Life Management and Adaptation
Adapting to life with an ostomy involves integrating the pouching system into everyday routines, which is highly manageable with modern products and techniques. Dietary adjustments are common, though most people can return to a relatively normal, healthy diet once they have recovered from surgery. Learning which foods affect output consistency, cause gas, or produce odor helps individuals manage their pouching system more easily. Chewing food thoroughly and maintaining adequate hydration are important habits that help prevent blockages and maintain digestive health.
Specialized clothing is generally not necessary, as modern pouches lie flat and are discreet under most standard clothing. Some individuals may opt for higher-waisted garments or specialized support wear for added security. Physical activity is encouraged, as it contributes to overall health and well-being. After the initial recovery period, most people can resume activities like walking, cycling, and swimming. Wearing a support belt or binder during exercise helps reduce the risk of developing a parastomal hernia near the stoma site.
Travel is entirely feasible, though it requires careful planning to ensure an adequate supply of ostomy products is packed, ideally split between carry-on and checked luggage. For air travel, carrying a doctor’s note explaining the need for the medical supplies can ease passage through airport security screenings. Social and intimate relationships can continue as before, as the pouching system is secure and discreetly managed. Open communication with partners and support from a certified Wound, Ostomy, and Continence Nurse (WOCN) can address any concerns regarding body image or intimacy.
Addressing Long-Term Health and Complications
While a colostomy allows for a full life, it introduces the potential for specific long-term medical complications that require ongoing vigilance. The most common late complication is the development of a parastomal hernia, where a portion of the intestine protrudes next to the stoma. Regular core-strengthening exercises, often including clinical Pilates, and the consistent use of an abdominal support garment can help mitigate this risk or prevent an existing one from worsening.
Peristomal skin irritation, or dermatitis, is another frequent issue, often caused by leakage from the pouch or improper use of the skin barrier. Working closely with a WOCN is crucial for ensuring the correct fit of the appliance and maintaining healthy skin around the stoma.
Less common, but more serious, complications include stoma prolapse (where the bowel telescopes out further than normal) or stoma retraction (where the stoma sinks below the skin level). Regular follow-up with the WOCN and the surgical team is important to monitor and address these issues promptly. Patients must also monitor their output for signs of obstruction or significant changes in consistency. Maintaining good overall health, including proper hydration and nutrition, is a long-term strategy for minimizing the risk of ostomy-related complications.