An ostomy pouch requires more than just a physical adjustment. You may have to adapt mentally and manage body image issues.

Ostomy surgery can be a health-preserving, lifesaving treatment for people experiencing issues like traumatic injury, colorectal cancer, ulcerative colitis, or Crohn’s disease.

An ostomy is a surgery that creates a stoma. A stoma is an opening in your abdomen that’s connected to your gastrointestinal (GI) tract. Stool exits your body through the stoma into a collection pouch.

Sometimes an ostomy is temporary and reversible to give parts of your GI tract a chance to heal after major surgical repair. An ostomy can also be a permanent solution to the necessary removal of damaged or diseased GI tract areas.

You can live a full, active life with an ostomy pouch. The underlying condition that necessitated an ostomy may affect your life span, but the presence of a stoma and collection pouch doesn’t usually change how long a person lives.

What can change, though, is the way you feel about yourself and your body.

Having an ostomy can be a big adjustment. In addition to managing your new device and the routine changes it brings, you may also find yourself wishing things were different.

If you’re finding it difficult to adjust to life with a stoma, you’re not alone. A 2019 review of 27 studies found that poor body image perception was a common psychosocial problem for people after ostomy surgery, along with:

  • mental health effects, such as:
    • poor self-respect
    • low self-esteem
    • denial
    • depression
    • anxiety
    • hopelessness
  • social effects, such as:
    • loneliness
    • reduced interest and participation in social activities
    • less contact with family and friends
    • avoidance of travel
  • relationship issues and sexual problems
  • work-related issues, such as a decrease in work activities and performance

Body image is more than just an opinion about your own appearance. Your journey through surgery recovery and into life with an ostomy pouch may generate feelings about how you function physically.

Pain, fatigue, and reduced mobility, along with bowel function changes and the need for stoma maintenance, can weigh on your state of mind. It’s natural for someone in your situation to experience resentment and negativity.

Some things can make a person more sensitive to body image disturbance from an ostomy.

A 2017 study identified some of these things as:

  • younger age
  • overweight
  • temporary stoma
  • male sex
  • thoughts of self-harm or depression soon after surgery
  • low perception of self-efficacy

Study authors recommend mental health therapy before and after surgery for people who meet these criteria.

Body image and mental health are important factors in the success of your postsurgical rehabilitation. There are ways you can help yourself through this experience.

You might be the only person you know who’s had ostomy surgery, but that doesn’t mean you have to face your situation alone.

Support like counseling or time spent with loved ones can help you manage challenges you may encounter, including unwanted feelings about your body image.

Share your story

Openness and honesty can be freeing and help alleviate the discomfort you might feel about wearing an ostomy pouch.

You don’t have to build a new identity around your stoma, but every time you practice advocacy by sharing your story, you create awareness and compassion for yourself and others in your situation.

Focus on the things you can control

There are many ways your health situation may have eroded your sense of control. For example, there’s the initial diagnosis or event that led you here, the nonnegotiable requirement to wear an ostomy pouch, or the fact that you can no longer control when stool leaves your body.

However, there are still many things in your life that you can control. Taking a moment each day to assess and acknowledge your areas of control may help you feel better.

Practice gratitude

Ostomies restore health and save lives. Your ostomy might be the cure for your ulcerative colitis, or the reason you can resume activities previously inhibited by your symptoms.

The human body is wonderfully adaptable. Your GI tract doesn’t necessarily require a rectum to function and can adjust to a stoma.

Your ostomy pouch represents survival rather than illness or injury.

Learn more about your condition

Myths and misconceptions surround most health conditions, and yours is no exception. Education can create empowerment, which may boost your mental health and body image.

For example, you may have heard that people with ostomies live with unwanted odor, when in fact ostomy pouches can retain odor.

As you heal your body image, it may help to avoid a few things:

  • ignoring or suppressing your feelings
  • thinking only about the downsides
  • comparing your body with others
  • neglecting support, like counseling or therapy
  • avoiding important ostomy-related conversations
  • accepting myths as facts without asking questions or doing research
  • neglecting self-care

Some of this can be challenging, like avoiding persistent negative thoughts or not comparing your body with others. A therapist can suggest coping strategies for you to try.

Support exists in several forms, including social, emotional, and practical.

Sources of support include:

  • healthcare professionals
  • family
  • friends
  • partners
  • support groups

Support groups can connect you with people who share your experience, which may help you feel less isolated. Knowing there are others living full lives with their ostomy pouches can boost your body image and improve your frame of mind.

The members of your healthcare team can suggest online or community resources. Sharing your feelings about your ostomy with the people close to you can also help.

If you’re interested in therapy, your doctor can provide a referral to a mental health professional.

You can also search for a therapist yourself using resources such as the American Psychological Association’s Psychologist Locator or the American Psychiatric Association’s Psychiatrist Locator.

Ostomy surgery can be lifesaving, but it can also bring some challenges. Transitioning from passing stool in the usual way to wearing an ostomy pouch on your abdomen can have an unwanted effect on your body image.

There are steps you can take to improve your postsurgical mental health, and support is available to help you manage the psychological effects of living with an ostomy pouch.