Coping with a colostomy for anal cancer

If you have your anus, rectum and lower colon removed, poo has to pass out of your body through an opening (stoma) made in your tummy (abdomen). Doctors call this a permanent colostomy. 

Gaining confidence in looking after your colostomy may take time and practice. Your stoma nurse can give you any support and advice you need.

Getting used to your colostomy

During surgery to remove the cancer, your surgeon brings the end of your colon out onto the surface of your tummy (abdomen). You wear a bag over the colostomy to catch the poo.

It can take time to get used to having a colostomy. You will need to think about your feelings about having it. And adjust to looking after it. But most people learn to do this. Your stoma nurse can give you advice and support you at all stages.

If you don't have a stoma nurse, ask your GP or surgeon to refer you. The nurses may be based at your local hospital. In some places they have community stoma nurses and you may see them at a local clinic.

When you first go home after surgery, your stoma nurse may see you at home. Or they may see you back at the hospital.

Your body image and mood

It is normal to feel worried about how you will look if you need to have a colostomy. You may also worry about how other people react. You might worry that having a colostomy will affect your confidence. But being in charge of the practical elements of your stoma care can make you feel more in control and confident.

While you are in hospital the stoma nurse will teach you how to look after your colostomy. It might be helpful for a close friend or family member to be there too. Then you can both get used to your colostomy and can ask the nurse questions.

Having a colostomy shouldn’t stop you doing the things you want to. You may just have to make some temporary practical changes. Such as if you want to go on holiday. Then you may want to arrange an earlier delivery of supplies. Talk to your stoma nurse if you are worried how having a stoma will affect your plans.

Once you get home, help is still available if you need it. You might have problems or questions about looking after and dealing with your colostomy. Or you may feel low or depressed. Your GP or stoma nurse will either be able to help you or put you in touch with someone who can.

As you learn to cope with your colostomy, it will affect your daily life less. You may also find that you feel more positive and less sad once you get back to the things you enjoy in life.

Bowel Cancer UK or Colostomy UK can also give support.

Working

Having a colostomy usually doesn't interfere with most jobs. It might affect your work if it involves heavy digging or other kinds of manual work. Ask your stoma nurse for advice if your job is very strenuous.

Sports and hobbies

A colostomy doesn't have to stop you from doing sports or hobbies. All sorts of physical activities are possible. Even strenuous exercise and swimming.

All stoma bags are suitable for exercise and swimming. But some people may want something smaller when doing sport and hobbies, so they might use a stoma cap. This is a small round bag that just covers your stoma.

Talk to your stoma nurse about how to best manage your stoma whilst doing sports and hobbies.

If the stoma bag smells

It is normal to smell your stoma bag when emptying or changing it. But if it smells otherwise, it could be due to the bag not fitting properly. Speak to your stoma nurse if you notice your bag smells when you are wearing it. They can check how well the bag fits you and may suggest you try a different type.

Types of colostomy bags

Stomas are of different shapes and sizes. So not all types of stoma bag may fit you. If the bag doesn't fit properly, you are likely to have problems with smell and leakage. Your stoma nurse can get different types of bags for you to try. You might have to try a few bags before you find the one that suits you best. 

All bags have charcoal filters built into them. Charcoal is good for absorbing smells, and the filter lets gas escape from the bag. This means the bag doesn't get too full of air and feels uncomfortable. If the bag fits properly, you should only be aware of the smell when changing or emptying the bag.

These photos show the front and back of one type of colostomy bag;

Anti odour products

There are products that can help to mask the smell of a colostomy but they can be difficult to find. Your stoma nurse will be able to give you tips on how to mask the smell when you are changing your stoma bag.

If your bag smells while you are wearing it, anti odour products should be the last resort. They should mainly be for people who have difficulties finding the perfect fit colostomy bag. You can ask your stoma nurse or Colostomy UK to suggest products for you.