Colostomy: Complete Guide 2026 — From Diagnosis to Full Life

Colostomy: What you need to know before, during and after

You have been told that you will need a colostomy and you feel lost, scared, with thousands of questions in your mind? It is completely normal. In this complete guide 2026 you will find all the answers — from scientific documentation to practical everyday life — based on current international guidelines (ASCRS, ACPGBI, WCET) and our experience as exclusive B Braun Avitum representatives in Greece .

📑 Table of Contents

1. What is a colostomy
2. The 3 types of colostomy
3. When is a colostomy done
4. The surgical procedure
5. Preparation before surgery
6. The first days after discharge
7. Choosing a bag — Decision Tree Flexima
8. Common problems & solutions
9. Diet with a colostomy
10. Daily life — work, travel, relationships
11. EOPYY coverage
12. Why B Braun Flexima

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1. What is a colostomy

A colostomy is a surgical procedure where a part of the large intestine is removed through the abdominal wall and creates a opening (stoma) — from which feces are collected in a special bag ^[1] .

It is one of the 3 major categories of digestive system stomas :

• Colostomy — from the large intestine (colon)
• Ileostomy — from the small intestine (ileum)
• Ureterostomy — from the urinary system (different category)

According to the According to data from the Hellenic Anti-Cancer Society, in Greece ~3,500-4,000 new colostomies are performed annually — the vast majority due to colon cancer, the 2nd most common cancer in the country.

Colostomy can be:

• Permanent — when the affected part of the bowel has been removed or the anus no longer functions
• Temporary — when the bowel needs to rest to heal (reversed in 3–12 months)

Good news: Modern colostomy care does not interfere with normal life . Over 85% of patients return to work, travel, exercise, and sex life ^[2] .

2. The 3 types of colostomy

Depending on the site of the colon used, we distinguish:

Type	Characteristics	Stool consistency
Ascending	Right side of the abdomen. Rarer.	Liquid/watery
Transverse	Upper-mid abdomen. Often temporary.	Semi-formed
Descending/Sigmoid	Left lower abdomen. Most common type.	Shaped (regular)

Why does the type matter? The type determines:

• How liquid the stool will be — so what kind of bag you need (closed for shaped, open/drainable for liquid)
• How often the bag will be filled
• The dietary adjustments

➡️ Read more about the 3 types of colostomy

3. When is a colostomy performed — Indications

According to the guidelines of the ASCRS (American Society of Colon and Rectal Surgeons) ^[3] , the main indications are:

• Colon or rectal cancer (~70% of cases)
• Inflammatory bowel disease (IBD) — Crohn's disease, ulcerative colitis
• Diverticulitis with complications (perforation, bleeding, stricture)
• Bowel injuries (traffic, puncture wounds)
• Congenital anomalies (Hirschsprung, pediatric)
• Severe fecal incontinence resistant to other treatments
• Radiation enteritis after pelvic radiotherapy

➡️ Complete analysis of all indications

4. The surgical procedure

Modern colostomy is mainly performed laparoscopically (through 4-5 small incisions) — with clear advantages over the open technique ^[4] :

• ✅ Less postoperative pain
• ✅ Faster recovery (hospitalization 4-7 days instead of 7-12)
• ✅ Lower risk of infection
• ✅ Better cosmetic result
• ✅ Fewer hernias (parastomal + abdominal) in the long term

The total duration of the surgery is 2-5 hours depending on the underlying Hospitalization 4-9 days with modern ERAS protocols.

➡️ Step-by-step procedure: from preparation to discharge

5. Preparation before surgery (2-4 weeks before)

According to ERAS protocols and the guidelines of ACPGBI (Association of Coloproctology of Great Britain and Ireland) ^[5] :

1. Pre-operative staged check (CT scan, MRI, cardiological assessment)
2. Smoking cessation — ideally 4 weeks before
3. Stoma siting (stoma marking) by a specialized stoma nurse — before surgery
4. Psychological preparation — discussion with spouse/family
5. Selection of B Braun Flexima materials (free consultation from Traumacare) — we have all the consumables ready when you return home
6. Bowel prep (bowel cleansing) 1-2 days before

6. The first days after discharge

The first 2 weeks are psychologically most demanding. What to expect:

• The stoma is swollen and will gradually shrink over the first 6-8 weeks
• Bag change every 2-4 days (more often initially)
• The first bowel movements may be watery — this will normalize
• Gradual resumption of normal diet (not all at once)
• Re-evaluate stoma size at 4-6 weeks (possible change of bag type)

➡️ Complete 6-month recovery guide

7. Bag Selection — Decision Tree B Braun Flexima

The right bag is the most important tool for your quality of life. The B Braun Flexima range offers a complete range for every patient profile ^[6] :

Patient Profile	Flexima Recommendation
Active, young patient (discreet)	Flexima Active mini (1-piece, low profile)
Elderly, sensitive skin	Flexima Key (2-piece, gentle hydrocolloid)
Flat or retracted stoma (leakage)	Flexima Active O' Convex
Economical 5-day wear, fixed shape	Flexima 3S (2-piece guided)
Liquid stools / high output	Flexima Flat Drainable (empties without changing)
Skin folds / uneven surface	Flexima + Ally Paste (alcohol-free)
Parastomal hernia/sports	Flexima + Ally Belt (support)
Unusual stoma size	Flexima + Ally Rings (custom sizing)

All Flexima Colo pouches come with standard :

• ✅ Activated carbon filter — controls odor and gases
• ✅ Premium hydrocolloid skin barrier — German made
• ✅ Discreet beige midi cover — invisible under clothes
• ✅ Soft fabric backing — breathable, anti-perspirant

➡️ Complete bag selection guide with decision tree

​​8. Common problems & B Braun solutions

8.1 Bag leakage (Stoma Leakage)

The #1 problem of colostomy patients. According to studies by the Wound Ostomy and Continence Nurses (WOCN) Society ^[7] , rates > 30% report at least one leak/month.

Flexima Solution:

• Flexima Active O' Convex — convexity presses around stoma
• Ally Paste — fills folds, alcohol-free
• Ally Rings — custom sizing for irregular stomas
• Ally Belt — extra support

➡️ Read: 7 causes of leakage & solutions

8.2 Irritation & perioral dermatitis skin

~50% of patients experience skin problems at some point ^[8] : contact dermatitis, fungal infections, folliculitis.

Flexima Solution:

• Flexima Key — gentle hydrocolloid for sensitive skin
• Ally Paste — alcohol-free protection (no irritation)
• Correct technique: only lukewarm water + mild soap (no antiseptics)

➡️ Read: skin irritation — recognition & treatment

8.3 Parastomal hernia

Most common late complication — seen in ~38% of patients at 5 years and >50% long term ^[9] .

Flexima Solution:

• Ally Belt — daily support, reduces aggravation
• Flexima Convex — adapts to uneven surfaces

➡️ Read: parastomal hernia — prevention with Ally Belt

8.4 Odor & flatulence

The #1 psychosocial issue. The activated carbon filter incorporated into all Fleximas controls odor and gas.

➡️ Read: 8 practical solutions for odor

9. Colostomy diet

The diet is free — but some foods need attention ^[10] :

Category	Examples
✅ Safe	Lean meat, fish, eggs, yogurt, cheese, rice, potatoes, pasta, white bread, bananas
⚠️ Caution — gas	Beans, cabbage, cauliflower, broccoli, onion, garlic, beer, carbonated drinks
⚠️ Caution — odor	Asparagus, fish, eggs, garlic, spinach, coffee
⚠️ Caution — blockage	Carrots, celery, corn, whole nuts, mushrooms, fruit with peel
💧 Hydration	1.5-2 liters of water/day — more at high output

➡️ Complete nutritional guide with 30 foods

10. Daily life — work, travel, relationships

• Work: Return to office 6-8 weeks, heavy work 12+ weeks
• Exercise: Walking from week 1, cardio from month 2, weights after 3 months (always with Ally Belt)
• Swimming: From the 4th week — Flexima are waterproof
• Travel: Double Flexima stock, travel certificate from a doctor
• Sex life: Returns to 75%+ of patients after the first 3 months ^[2]

➡️ Read: exercise, travel & swimming with a colostomy

11. EOPYY Coverage

According to the Official Gazette B' 5395/09-10-2025 ^[11] , EOPYY covers:

• 270€/month colostomy materials
• 0% participation patient
• Bags, base plates, accessories (paste, rings, belts)

Procedure:

1. Electronic opinion e-EOPYY from a surgeon/gastroenterologist
2. Contact with Traumacare (name + AMKA)
3. We take care of all the paperwork
4. Express delivery next-day

12. Why B Braun Flexima & Traumacare

Traumacare is the exclusive representative of B Braun Avitum in Greece — and this means specific benefits for you:

✅ German manufacturing	B Braun Avitum — 180+ years of reliability in the medical sector
✅ Full range	Active mini/midi/maxi, Key, 3S, Convex, Flat Drainable + Ally Paste/Rings/Belt
✅ Activated carbon filter	Standard across the Flexima Colo range — no extra addition
✅ Premium hydrocolloid	3-5 days bonding, gentle on sensitive skin
✅ Express delivery	Next-day delivery throughout Greece
✅ Free consultation	Pre-op + follow-up + product changes
✅ EOPYY Management	Full e-EOPYY processing — zero bureaucracy
✅ Convatec Distribution	Complementary range when needed

Start today — Free Flexima Sample

Related articles — Cluster navigation

• #1C — What is a colostomy (3 types)
• #2C — When is a colostomy performed (indications)
• #3C — Colostomy procedure step-by-step
• #4C — Comparison: colostomy vs ileostomy vs ureterostomy
• #5C — Colostomy bag: which one to choose?
• #6C — Bag leakage: 7 causes & solutions
• #7C — Skin irritation: recognition & treatment
• #8C — Parastomal hernia with colostomy
• #9C — Odor & flatulence: 8 practical solutions
• #10C — Colostomy Diet: 30 Foods
• #11C — Life After Colostomy: 6 Month Guide
• #12C — Exercise, Travel & Swimming

📚 Bibliography / Scientific sources

1. ASCRS Clinical Practice Guidelines for the Surgical Care of Patients with Colostomy . American Society of Colon and Rectal Surgeons. fascrs.org
2. Vonk-Klaassen SM et al. Ostomy-related problems and their impact on quality of life of colorectal cancer ostomates: a systematic review . Quality of Life Research , 2016. pubmed.ncbi.nlm.nih.gov
3. ASCRS Practice Parameters for the Management of Colon Cancer . American Society of Colon and Rectal Surgeons, 2024. fascrs.org
4. Buunen M et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomized clinical trial . Lancet Oncology , 2009. pubmed.ncbi.nlm.nih.gov
5. ACPGBI Position Statement on Pre-operative Stoma Siting and Education . Association of Coloproctology of Great Britain and Ireland. acpgbi.org.uk
6. B Braun Flexima Colostomy product specifications . B Braun Avitum. catalogs.bbraun.com
7. WOCN Society Clinical Practice Guideline for Management of the Adult Patient with a Fecal or Urinary Ostomy . Wound, Ostomy and Continence Nurses Society. wocn.org
8. Salvadalena G et al. Peristomal Skin Conditions: A Systematic Review . Journal of Wound Ostomy & Continence Nursing , 2020. pubmed.ncbi.nlm.nih.gov
9. Antoniou SA et al. European Hernia Society guidelines on prevention and treatment of parastomal hernias . Hernia , 2018. pubmed.ncbi.nlm.nih.gov
10. UOAA Diet & Nutrition Guide for People with Ostomies . United Ostomy Associations of America. ostomy.org
11. ΦΕΚ Β' 5395/09-10-2025 — Specification of ostomy materials with EOPYY coverage . National Printing House. eopyy.gov.gr
12. WCET International Ostomy Guidelines . World Council of Enterostomal Therapists. wcetn.org