Mental Preparation Before Stoma Surgery

Stoma surgery is not only a surgical event. It is also a change in the relationship with your own body, and it begins before you enter the operating theatre. Preparing for that part is not a luxury — it affects how quickly and how smoothly you adapt afterwards.

Whatever you are feeling right now is expected

Fear, anger, sadness, shame, even relief — often all of them within the same day. Many patients describe a kind of grief for the body they had before. That is not a sign of weakness or a lack of courage; it is a normal reaction to a real loss.

The same is true for the people close to you. Your partner or your children may respond with silence, over-protectiveness or awkwardness. Usually it is not rejection — it is their own fear, which they do not know how to put into words.

Three fears that come up almost every time

Will it show?

Modern pouches are flat, quiet and filtered. Under clothing they are not visible. The fear is reasonable, but practice disproves it almost every time.

Will it smell?

The pouch is sealed. Odour is present only at the moment of emptying, and there are deodorants and charcoal filters for exactly that.

Will my partner still want me?

It is the question asked least often and worried about most. Sexual life with a stoma continues. It takes time, conversation and a few practical adjustments — not resignation.

What you can do before the operation

• Ask for preoperative stoma site marking by a stoma care nurse. It is done standing, sitting and bending forward, so that the stoma does not end up in a skin fold, on the waistband or on a scar. It is the most underrated step of the whole process and it directly affects how many leaks you will have afterwards.
• Write your questions down on paper. In the consulting room they get forgotten.
• Ask to see and handle the supplies before the operation. The unknown is more frightening than the known.
• Talk to someone who lives with a stoma. Ten minutes with a patient is worth an hour of briefing.
• Organise the practical side — who will bring you home, what supplies will be there, how the first prescription will be arranged.

What does not help

Endless forum searches at three in the morning, photographs of complications taken out of context, and trying not to bother anyone. Isolation is the one factor that consistently makes things worse.

When professional psychological support is needed

Ask for help — and it is not an overreaction — if you notice:

• Persistent insomnia or complete loss of appetite
• A constant sense of hopelessness that does not ease with the days
• Complete avoidance of any social contact
• Thoughts that it is not worth carrying on

If you have such thoughts, speak to your doctor or to someone you trust straight away, or contact your local mental health crisis service.

The most useful thing patients have said

That the difficulty does not disappear — but it stops being the centre of the day. In the first months the stoma occupies you constantly. Later it becomes a ten-minute routine, like brushing your teeth.

Read also

• The First 30 Days with a Stoma: What Is Normal and What Is Not
• When you listen for the first time the word stoma
• Sexual life & relationships after stoma
• All the answers to the 10 most frequently asked questions of people with a stoma

If you want to talk through what you will practically need after the operation, or to see the supplies up close before you decide, get in touch with us.

Sources

The recommendations on preoperative stoma site marking, pre-surgical education and the observations on quality of life are based on the following published sources:

1. Davis BR, Valente MA, Goldberg JE, Lightner AL, Feingold DL, Paquette IM. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Ostomy Surgery. Dis Colon Rectum. 2022;65(10):1173-1190.
2. Person B, Ifargan R, Lachter J, Duek SD, Kluger Y, Assalia A. The Impact of Preoperative Stoma Site Marking on the Incidence of Complications, Quality of Life, and Patient's Independence. Dis Colon Rectum. 2012;55(7):783-787.
3. Vonk-Klaassen SM, de Vocht HM, den Ouden MEM, Eddes EH, Schuurmans MJ. Ostomy-related problems and their impact on quality of life of colorectal cancer ostomates: a systematic review. Qual Life Res. 2016;25(1):125-133.
4. Colwell JC, Bain KA, Hansen AS, Droste W, Vendelbo G, James-Reid S. International Consensus Results: Development of Practice Guidelines for Assessment of Peristomal Body and Stoma Profiles, Patient Engagement, and Patient Follow-up. J Wound Ostomy Continence Nurs. 2019;46(6):497-504.

Content last updated: August 2026.

This information is educational and does not replace medical or psychological assessment. For any clinical decision, consult your treating physician or your stoma care nurse.