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This pamphlet aims to encourage and advise all ostomists to take up or return to an active sporting lifestyle after their operation.
When on the road to recovery, the prospect of having to pick up your life where you left off can be pretty daunting. The thought of taking up a new sport or striving for ambitious goals in a sport previously enjoyed, seems virtually impossible. But believe it or not, many ostomists have done just that most claiming they are much fitter and healthier now than they ever were before the operation.
What has been proven time and time again is that ostomists, as a result of the operation often have a renewed zest for life. The inclination and determination to achieve goals which would never have been considered if their lives had continued uninterrupted, results from this new found enthusiasm.
"Having to cope with the operation and the change in lifestyle that goes with it, brings out a strength in people which otherwise would lie dormant. As a result, no goal seems too difficult to achieve once you've set your mind to it. I strongly recommend everyone to take some kind of exercise, even if it is only walking a little each day. Once you give in and become inactive you lose so much out of life. Being active, especially in sport, can only add to the quality of life." Betty Sands, Colostomist and active swimmer.
The pages that follow look at three sporting areas; swimming, contact/team sports and 'super achievers', which we hope will be of interest to all ostomists, regardless of age, type of ostomy or level of fitness. Practical advice is given by fellow ostomists who have had first-hand experience of what is involved when returning to an active lifestyle and who wholly understand the fears and problems you are likely to face.
Before looking at specific examples of sports and their implications for ostomists, a clear understanding of what has actually happened, physiologically, as a result of the operation will be helpful.
The Physiological Implications
Strength of the Stoma
The stoma protruding from your abdomen may look vulnerable, however, it is in fact extremely hardy. The surgical wound will have fully healed just ten days after the operation and during the following two months, the scar tissue surrounding the stoma will have reached its maximum strength. To injure the stoma is in fact extremely difficult. An example of its resilience was demonstrated when an ostomist was accidentally kicked by a horse directly onto the stoma. Not surprisingly there was a good deal of bruising, but the stoma itself remained undamaged and continued to work normally.
The chances of getting a hernia
Special care taken to protect the stoma in everyday life is no more necessary than for anyone else to protect their abdomen. The risk of hernia as a result of lifting or strenuous exercise is only as likely as anyone getting a common groin hernia. Don't overdo things if you are unfit, but there is no need to take special care because you have an ostomy.
The Perineal Wound
In some cases, an ostomist may have a perineal wound (rectum wound) resulting from the removal of the anus and rectum. Although this area is likely to be tender for rather longer than the stoma, it will heal to become equally resilient.
A concern often highlighted by the medical profession is that of dehydration. Ostomists, particularly Ileostomists and Urostomists are more susceptible to becoming dehydrated so care should be taken to drink plenty of water. A sign of being well hydrated is the production of 2.5 pints (4 bladder's full) of urine each day. In hot climates and/or when exercising, less urine is produced making it more concentrated. It is important that you drink more to rehydrate the body. Equally when you suffer from diarrhoea, more water is being lost so more should be taken in. Pure water is the best drinking fluid available, however, special rehydrating solutions, such as Dioralyte or Rehidrat, can be useful for severe cases of diarrhoea.
Diet for Basic Fitness
Before looking at specific examples of sports and their implications for ostomists, a clear understanding of what has actually happened, physiologically, as a result of the operation will be helpful.
Once recovered from the operation your diet and state of nutrition should be quite normal. However, everybody has their own preferences and some foods may upset your system. You may find some foods cause wind, diarrhoea or even pain. Try anything, but cautiously at first and chew thoroughly to avoid possible digestive difficulties.
Fitness is a result of the correct balance between diet and exercise. How and what we eat is as much part of our individuality and lifestyle as our appearance and personality and having an ostomy should not restrict your individual preferences.
All foodstuffs contain energy in the form of calories and the number of calories we need in a day depends on our level of physical activity. However, everyone has a different metabolic rate so that some people will gain or lose weight when taking the same amount of dietary calories.
It is best therefore to keep an eye on your weight and learn to listen to your body. You will soon know its digestive control when it requires food, how long it takes to digest and what foods are going to upset your system. A good mixed diet contains fruit and vegetables, meat, fish, dairy produce and cereal foodstuffs and will ensure you remain healthy without the need for any vitamin supplements. A normal diet will provide all you require.
Now, armed with a fuller understanding of the medical implications of having an ostomy and the reassurance that sports and exercise are positively encouraged, there is nothing to hold you back.
However, before any strenuous exercise is taken up whether an ostomist or not it is wise to build up a level of fitness gradually.
A popular and good form of exercise, which can be enjoyed by everyone regardless of their ability, is swimming. Many people who have undergone a variety of operations are recommended to take up swimming as it is both an easy and gentle form of exercise.
An added benefit for ostomists is that it also helps to overcome a psychological hurdle. The fear of being conspicuous, both in the changing rooms and swimming pool, has frequently stopped ostomists from taking to the water. It can stop some people from going out at all.
The courage to take up this challenge will be rewarded by newly gained confidence, not only to enjoy various social sports but also other activities, such as clothes shopping and sun bathing.
"As a swimming instructor I never doubted that I would take up swimming again after my colostomy operation. In the past seventeen years, I can honestly say I have never had an embarrassing moment at the pool because of my colostomy." Betty Sands.
People tend to be very self-conscious, especially of the way we look, but how often do we notice other people around us? Ostomists make the mistake of believing everyone will immediately turn to their stoma and stare in truth most will not even notice the colour of your costume, let alone what may lie beneath it.
"A few years ago, when I was at the beach, I even wore a bikini and the fact that I have a colostomy went entirely unnoticed." Betty Sands.
Another concern often felt about swimming is that your ostomy bag may drift away or come loose while in the pool, creating a highly embarrassing situation. If you consider what has to take place before this is likely to happen then these concerns should be calmed. However, if not convinced, then try sitting, submerged in bath water at home and see that the chance of a leak or loosening of the seal is most unlikely.
"What people tend to forget is that while in the water the seal around the stoma becomes even more secure due tot the adhesive seals on an appliance. The adhesive properties increase with moisture, making the appliance fasten more firmly. If you have ever tried to remove an ostomy bag after a bath you will know exactly what I mean." Betty Sands.
Once these initial fears are overcome, ostomists should feel happy to take up swimming. The sport is not only one of the best forms of exercise for every part of the body, but it can also be taken up gradually gently at first so as to build up fitness at a steady pace. It also is a highly sociable pastime which is frequently enjoyed as a family outing. There is no reason why an ostomist cannot join in the fun!
Tips and Advice
  • Before going to a public swimming pool, try on your swimming costume at home and give yourself a thorough inspection in the mirror. Also, get in to the bath to see what you look like when the costume is wet and clinging to your body. Once you have seen what others will see when you go swimming, you are sure to be wholly confident even on your first public swim.
  • All modern appliances are totally water tight and will even strengthen their grip in water. Try removing your appliance while at home in the bath and you will see how securely fitted it is.
  • Diving is often thought to pull on the stoma and the bag on impact with the water. However, the appliance is extremely secure especially if worn with drawstring trunks, tightly fitted around the waist. The chance of the bag showing or coming off, even when wearing a two-piece bag, is highly unlikely.
  • Will an ostomy bag dry as quickly as the rest of the body or will it leave a wet patch?

  • "In my experience, I have been able to move between sauna, Jacuzzi and swimming pool over a four hour period without any problems. My swimming trunks and ostomy pouch dried perfectly well and I did not need to change my pouch in between sessions." Chris Penney, former National Secretary to the Ileostomy Association and marathon runner.
  • If you are embarrassed getting changed in front of other people, try wearing a long shirt which will cover most of the body while getting changed. Even just draping a towel over your shoulder will keep your stoma from view. If you are still concerned, get changed at home and wear a track suit over your costume on the way home. Don't le the possibility of problems arising when changing prevent you from an enjoyable afternoon's swim with the family.
  • There are a number of special suppliers of swimwear who make swimming costumes to suit particular needs (e.g. high-waisted swimming trunks). The back of this pamphlet lists contact names and addresses.
For those who are more active and are members of contact and team sports, having an ostomy should not lead to any problems. However, contact sports can be dangerous and having extra concerns about whether the stoma may be damaged or the ostomy bag ripped off or punctured, does not help the sportsman's peace of mind.
Firstly, as already pointed out, the stoma is firmly fixed ten days after the operation and has reached its maximum strength months later. To do any real damage is extremely difficult. In addition, it should be remembered that, although unlikely, should the stoma become damaged it is repairable and is usually less complicated and painful to set right than a broken collar bone or twisted knee.
The second area of concern relates to the appliance. People, engaging in contact sports in particular, find the appliance can get in the way of a rugby tackle, kung fu kick or wrestling grip, for example. To avoid the appliance being damaged a number of precautions can be taken.
Many ostomists use firmly-fitted waistbands or girdles to keep the appliance securely in place, tucked out of reach and harm's way. However, everyone's needs are specific to themselves and the best solutions are through trial and error. We suggest trying out sportswear items, such as running tights or Lycra shorts.
Anyone who enjoys the trill of a team or contact sport is unlikely to let minor concerns prevent them from returning to the sport. Once it is made clear that there are no medical reasons why an ostomist should not play contact sports, then any other obstacles that may get in the way can easily be overcome. It should also be remembered, however, that competitive sports require both skill and fitness. So it is essential, before returning to or taking up a strenuous sport after the operation, that fitness is built up gradually.
Tips and Advice
  • Try wearing a reasonably but not too tight fitting girdle / waistband, to keep the pouch is place. Suggestions have been made to wear body stockings, girdles or Lycra high-waisted and tight-fitting shorts. Everybody's needs and preferences are individual to themselves so it is up to you to try these options to see what suits you best. If all else fails, use your ingenuity and design your own means of keeping your pouch secure.
  • If a lot of running is involved, rubbing or chafing around the stoma may occur. This is inevitable when a single movement is repeated. Little red marks like mouth ulcers might appear on the stoma, but these are nothing to worry about as they will disappear in time and heal very quickly. Provided the appliance size fits properly and it is not too long, the pouch itself should not touch or rub against the skin. Material covers are available for comfort and can soak up perspiration during the game, but they are by no means essential.
  • A warning to watch out for dehydration has already been noted. It is important, therefore, that before and after the game you drink plenty of water to ensure you remain adequately hydrated.
  • No special diet can be recommended just eat whatever suits your own metabolic rate. Empty your pouch at the beginning of the game and if you have a colostomy and you wish to minimize the 'flow' from the stoma, stick to a low fibre diet.
The last group of sports men and women still to be considered are the 'super achievers'. Ostomists often heel more determined to become fitter and healthier than they were before the operation. This can lead to a tremendous determination to reach ambitious goals which a non-ostomist is less likely to strive for.
Chris Penney, former National Secretary to the Ileostomy Association and an Ileostomist for many years, became a marathon runner because he wanted to set an example to others that these kinds of achievements can be made.
"I would never have believed I would ever become a marathon runner 26 miles and 385 yards is a long way but I have completed four marathons and am still keen to keep on going."
Chris Penney is particularly unusual in his determination to become a 'super achiever' because before the operation he only had an average interest in sport. However, many ostomy patients who were 'super achievers' before their illness are terrified that they may not be able to continue with their sport once they have an ostomy.
"When I first learned I had to undergo a urostomy operation my first reaction was - will I still be able to ride? If the answer had been no, I'm not sure I would have gone ahead with it. I live for sport and within 3 months of my operation I was back on my horse 'Cocky Socks." Julie Pedder, endurance horse rider who participates in 3 day event races of non-stop horseback riding.
In any endurance sport the body needs to be in peak condition. Whether you have an ostomy or not alters very little. The only real concern is that of dehydration for which regular drinking stops is all that is required.
Tips and Advice
  • Remember - you have undergone an operation which means that initially you will be less fit than you were before. Take it easy to start with and gradually build up your strength and fitness before setting yourself ambitious goals.
  • Dehydration is a major concern for 'super achievers' whether they are ostomists or not. Drink plenty of water at every opportunity and you won't have problems.
Having an ostomy is a major operation which should not be underestimated. The first few weeks or even months following the operation may be difficult as you adjust gradually to being an ostomist. However, once fully recovered and settled at home, returning to the lifestyle enjoyed before the operation should be no problem.
As long as you have no complications an your doctor has no objection, you can enjoy any kind of sporting activity. Even violent contact sports such as rugby, karate or kung fu are enjoyed by fellow ostomists and sports such as bowls and aerobics, which involve a lot of bending, have been taken up.
If you would like to talk to someone about a particular sport, contact your Ostomy Association. They may be able to put you in touch with an ostomist who currently enjoys your sport and who can give you some practical advice.
Hollister Limited
Rectory Court
42 Broad Street
RG40 1AB
Telephone: 0118 9895000
Advisory Service: (FREEPHONE) 0800 521377
Website: www.hollister.co.ukLeaving Hollister.com
Hollister Limited
Belgard Road
Dublin 24
Telephone: 00 353 14041680
Advisory Service: (FREEPHONE) 1800 503400
Website: www.hollister.co.ukLeaving Hollister.com
British Colostomy Association
15 Station Road
Telephone: (FREEPHONE) 0800 3284257
Website: www.bcass.org.ukLeaving Hollister.com
The Ileostomy Association of Great Britain and Ireland
Peverill House
1-5 Mill Road
BT39 9DR
Telephone: (FREEPHONE) 0800 0184724
Website: www.ileostomypouch.demon.co.ukLeaving Hollister.com
Urostomy Association
Beaumont Park
Telephone: 01245 224294
Website: www.uagbi.orgLeaving Hollister.com
NASPCS - Association for Support of Parents of Children with Stomas
51 Anderson Drive
Valley View Park
KA17 0DE
Telephone: 01560 322024
National Association for Colitis and Crohn's Disease
4 Beaumont House
Sutton Road
St Albans
Telephone: 0845 1302233
Website: www.nacc.org.ukLeaving Hollister.com
Chums Limited
Caddick Road
Knowsley Industrial Park South
L34 4AB
Telephone: 0151 548 8088
Respond Plus Limited
7 Gauntley Court
Ward Street
Telephone: (FREEPHONE) 0800 220300
Website: www.respondplus.co.ukLeaving Hollister.com
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