Concerns about gas and odor are normal.  Modern pouching systems are odor proof, as long as it remains properly sealed.  Immediately after surgery, it may seem that you have excessive gas almost all the time.  This is normal because of the swelling that occurs after surgery.  Once post surgical swelling is resolved, excessive gas usually is not a problem.
Gas can be reduced by eating regularly. Skipping meals should be avoided as this actually makes the small intestine more active and produce more gas and watery stool.  Some foods may cause increased gas such as: eggs, cabbage, onions, fish, baked beans, milk, cheese, and alcohol.

Most people with ostomies return to a regular diet soon after recovering from surgery.  A few precautions are important such as chewing well; eating a well balanced diet and drinking plenty of fluids especially water. If you experience problems with a certain food, wait a couple of weeks and try the food again.

Ileostomy patients may need to limit some high fiber foods and need to increase fluid intake to reduce the risk of dehydration.

Urostomy patients need to make sure to have an adequate fluid intake to keep the kidneys functioning well.

Whatever you wore before surgery, you can wear afterward with very few exceptions. Many pouching systems are made today that are unnoticeable even when wearing the most stylish, form fitting clothing for men and women.

Depending on your stoma location you might find belts uncomfortable or restrictive. Some people choose to wear higher or looser waistbands on trousers and skirts.

Cotton knit or stretch underpants or panty hose may give the support and security you need. Some men finds that jockey type shorts help support the pouch.

Women may want to choose a swimsuit that has a lining to provide a smoother profile. Stretch panties (with lycra) can be also be worn under a swimsuit to add support and smooth out any bulges or outlines. Men may prefer to wear a tank shirt and trunks if the stoma is above the belt line.

Once your strength returns, you can go back to work. Heavy lifting may be discouraged the first few weeks as the incisions heal. People with ostomies do all kinds of work including strenuous types such as fire fighters, truck drivers and construction workers. Ask your surgeon when and how much lifting you can do.

As your strength returns, you can go back to your regular activities. Most people can return to their previous line of work; however, communicate with your healthcare team about your daily routines, so they can assist you to returning to maximum health as early as possible.

An ostomy should not limit your participation in sports. Many physicians do not allow contact sports because of possible injury to the stoma from a severe blow or because the pouching system may slip, but these problems can be overcome with special ostomy supplies. Weight lifting may result in a hernia at the stoma. Check with your doctor about such sports. There are many people who are distance runners, skiers, swimmers, and participants in many other types of athletics.

The type of pouching system that was used in the hospital may need to be changed as the healing process takes place. Your stoma may shrink and may require a change in the size opening of your pouch. Your lifestyle may necessitate a change of the pouching system after a recuperative period. Make an appointment with your ostomy nurse to evaluate your management system.

Learning to care for your ostomy may seem hard at first, but with practice and your own adaptations, the entire process will become second nature, just like shaving or bathing. Everyone is anxious about how they will be able to manage the process, but with the help of the nursing staff or an ostomy nurse specialist, most people are feeling confident in just a few weeks.

For the first six weeks the stoma will be shrinking due to reduction in post-operative swelling.  This means that the opening in the skin barrier must be changed to accommodate the changing size of the stoma. Most ostomy care products include a measuring device in order to measure the stoma and cut the appliance skin barrier to the appropriate size leaving 1/8th inch of clearance around the stoma.

The pouch is emptied as needed, usually when it is 1/3rd full.  The skin barrier and pouch are changed on a routine basis.  Most ostomy patients can wear their appliance 4 to7 days without difficulty.

A conversation with someone who has already mastered the art of stoma care can boost you confidence.  Ask about getting a referral to a local ostomy support group.

You should tell those who need to know, such as healthcare providers, your spouse or significant others, and people who are involved in your recuperative care.

You need not feel you have to explain your surgery to everyone who asks. Those who are just curious need to know only that you had abdominal surgery, or that you had part or all of your colon or bladder removed.

If you are considering marriage, thorough discussions with your future spouse about life with an ostomy and its affect on sex, children, and family acceptance will help alleviate misconceptions and fear on the part of the spouse.

If you have children, answer their questions simply and truthfully. A simple explanation will be enough for them. You may want to confide in your employer or a good friend at work because keeping it a complete secret may cause practical difficulties.

Supplies may be ordered from a mail order company or from a medical supply or pharmacy in your town.

For medical assistance, seek help from your physician, surgeon, or ostomy nurse. Contact UOAA for more information and referrals to local support groups and to request an ostomy visitor. Contact the Wound, Ostomy and Continence Nurses national office, 1-800-224-9626 for information and local referrals for ostomy nurse specialists. Contact the American Cancer Society at 1-800-ACS-2345 for cancer information.

You should call the doctor or ostomy nurse when you have:

• severe cramps lasting more than two or three hours
• a deep cut in the stoma
• excessive bleeding from the stoma opening (or a moderate amount in the pouch at several emptyings)
• continuous bleeding at the junction between the stoma and skin
• severe skin irritation or deep ulcers
• unusual change in stoma size and appearance
• severe watery discharge lasting more than five or six hours
• continuous nausea and vomiting; or
• the ostomy does not have any output for four to six hours and is accompanied by cramping and nausea

Take your ostomy supplies with you since the hospital may not have your brand in supply. If you are in doubt about any procedure, ask to talk to your doctor.

Ask to have the following information listed on your chart:
1) type of ostomy or continent diversion,
2) whether or not your rectum is intact,
3) describe in detail your management routine and list the ostomy products used. For urinary stomas,
4) do not take a urine specimen from the urostomy pouch, use a catheter inserted into the stoma.

There will be times after surgery when you may feel low, discouraged or even depressed.  You may feel alone and isolated, even unable to enjoy life again.  These are common feelings.  Serious illness, medication, hospitalization, and the surgery itself, all cause feelings if insecurity, dependence, concern, and discouragement.

Feeling discouraged is real and normal.  You might cry, be hostile or angry, or react in ways that are unusual for you.  Talking to a trusted relative, friend, nurse, clergyman, or another person with an ostomy may be helpful for you.  You may be able to work through your feelings and discover new hope and encouragement.  Talk to your physician if feeling of discouragement persist and affect your ability to return to the level of emotional health you desire.

You may bathe with or without your pouching system in place.  Exposure to air, water or soap will not harm the stoma.   Water cannot enter the body through the stoma.

When swimming, you may want to choose a swim suit with some support or a lining for a smoother profile. Some people add tape to the edges of the pouch for greater security.

There may be some modifications in your diet according to the type of ostomy surgery. People with colostomy and ileostomy surgery should return to their normal diet after a period of adjustment. Introduce foods back into your diet a little at a time and monitor the effect of each food on the ostomy function. Chew your food well and drink plenty of fluids. Some less digestible or high roughage foods are more likely to create potential for blockage problems (i.e., corn, coconut, mushrooms, nuts, raw fruits and vegetables).

There are no eating restrictions as a result of urostomy surgery. Urostomates should drink plenty of liquids each day following the healthcare team's recommendations.

You may bathe with or without your pouching system in place. If you wish to take a shower or bath with your pouch off, you can do so. Normal exposure to air or contact with soap and water will not harm the stoma, and water does not enter the opening. Choose a time for bathing when the bowel is less active. You can also leave your pouch on while bathing.

Sexual relationships and intimacy are important and fulfilling aspects of your life that should continue after ostomy surgery. Your attitude is a key factor in re-establishing sexual expression and intimacy. A period of adjustment after surgery is to be expected. Sexual function in women is usually not impaired, while sexual potency of men may sometimes be affected, usually only temporarily. Discuss any problems with your physician and/or ostomy nurse.

Your ability to conceive does not change and pregnancy and delivery should be normal after ostomy surgery. However, if you are thinking about becoming pregnant, you should first check with your doctor about any other health problems.

Absorption may vary with individuals and types of medication. Certain drug problems may arise depending on the type of ostomy you have and the medications you are taking. Make sure all your healthcare providers know the type of ostomy you have and the location of the stoma. This information will help your pharmacist and other healthcare providers monitor your situation (i.e., time-released and enteric coated medications may pass through the system of ileostomates too quickly to be effective).

All methods of travel are open to you. Many people with ostomies travel extensively, from camping trips to cruises to plane excursions around the world. Take along enough supplies to last the entire trip plus some extra, double what you think you may need. Checked luggage sometimes gets lost, carry an extra pouching system and other supplies on the plane with you. When traveling by car, keep your supplies in the coolest part, and avoid the trunk or back window ledge. Seat belts will not harm the stoma when adjusted comfortably.

When traveling abroad, take adequate amount of supplies, referral lists for physicians and medical centers, and some medication to control any diarrhea and stop the fluid and electrolyte loss. When going through customs or luggage inspection, a note from your doctor stating that you need to carry ostomy supplies and medications by hand may be helpful.

The adhesiveness and durability of pouching systems vary. Anywhere from three to seven day is to be expected. Itching or burning are signs that the wafer should be changed. Changing too frequently or wearing one too long may be damaging to the skin.

It is natural to wonder how you will explain your surgery and how others will accept you.

You can tell them as much as you want them to know. A brief explanation would be that you had abdominal surgery or that you had part or your entire colon removed.  If you have children, answer their questions simply and truthfully.  A simple explanation will be enough for them.  Talking about your surgery in a natural way will dispel any misconceptions that they have.

Check the pouch occasionally to see if it needs emptying before it gets too full and causes a leakage problem. Always empty prior to going out of the house and away from a convenient toilet. Most people find the easiest way to empty the pouch is to sit on the toilet with the pouch between the legs. Hold the bottom of the pouch up and remove the clamp. Slowly unroll the tail of the pouch into the toilet. Clean the outside and inside of the pouch tail with toilet paper. Replace the clamp.

Medicare Part B covers ostomy equipment. Medicare only allows a predetermined maximum quantity each month.

Medicaid is the federal/state insurance of last resort for low income persons. Check with the state Medicaid office for specifics.

Individual Health Insurance: most plans typically will pay you 80% of the “reasonable and customary” costs after the deductible is met.

You need no special clothing because ostomy pouches are fairly flat and inconspicuous.  Pressure from undergarments with elastic will not hurt the stoma or prevent it from working properly.

There are no barriers to travel both here and abroad.  Just make sure to take plenty of you ostomy supplies with you.  If flying, take your supplies onboard as checked luggage is sometimes misplaced.  A note from you doctor stating that you need to carry ostomy supplies, medication or other supplies on the plane can speed you way through inspection lines.

An ostomy should not limit your involvement in sports.  Many people with ostomies are distance runners, skiers, swimmers, etc. and participate in most athletic activities.  Check with your physician about strenuous physical activity such as weight lifting.