Self Image

by Alan Mortiboys

If you have recently gone through the trauma of having an ileostomy, it would be natural to be concerned about the effect it may have on your present and future relationships with other people. You may well try to hide the fact that you have an ileostomy but be worried that everyone will find out because you think you look different. It is quite common for new ileostomists to feel this way.

Broadly speaking, there are two ways you can deal with this – firstly, you can look at the practical matter of appliances and other services available and, secondly, you can do something about how you view yourself.

There is available a wide range of ostomy equipment and other associated products, such as deodorants and swimwear, backed up with advice from manufacturers representatives. Full details can be obtained from your stoma care nurse or from the quarterly IA Journal.

Anyone, through their local IA member organisation, can make contact with other ileostomists and find out what others do. You will soon realise that there are no constraints on where you go, who you meet, how you travel, what pursuits you take up, how you look, what you wear, what you eat – in fact there is really no need for your appearance or behaviour to change at all.

Apart from gathering all of this valuable information and finding equipment that suits you, you may also need to deal with the not so straightforward matter of how you feel about it all. In considering how you see yourself, first of all don’t pretend that your ileostomy and bag aren’t there.

They are – it’s a fact. However, it is important to get this into perspective – it’s a small part of your life and who you are. Secondly, think of all of the people you see – at work, friends, in shops and so on. Do you know someone who has an ileostomy or, for that matter, a colostomy or urostomy? Do you?

Well, the chances are that you do know someone who wears a bag, yet you don’t know they wear a bag, because how would you? You are not inspecting everyone to see if they are an ileostomist, any more than others will be looking at you.


Consider this – possibly the biggest factor that affects how others see you is the way you see yourself. A lot of the population who don’t have ileostomies lack self-confidence and are too ready to stress their perceived faults and failures rather than their many good points.

When you have an ileostomy, it can be taken as an invitation for these characteristics to be exaggerated. You might think the ileostomy is the most important thing about you and you can see it as meaning you are less, rather than different. If you find it difficult to see yourself as good as everyone else or to think of yourself in a positive way, this is not surprising, but it is possible to do something about it.

There are a number of books available which focus on self-image and help you think well of yourself. Also, a number of excellent counsellors and counselling services exist, not necessarily specialising in dealing with ileostomists or altered body image. These provide an opportunity to talk over the non-mechanical aspects of living with an ileostomy and help you become more confident and think better of yourself.

A list of the different counselling services in your area can be obtained from the British Association for Counselling (telephone 0870 443 5252).

Remember, however, that it is likely to take some time to become adjusted to you new self. Having your body visibly altered by surgery is a significant transition in life. It is well known that at times of significant transition, for instance bereavement, redundancy, leaving the parental home, there are certain stages people go through. It is normal, and perhaps necessary, to experience emotions like shock, denial (making light of it) and depression, before becoming positive about the change and accepting your new circumstances.

Ileostomists entering a new relationship often ask, how will I tell him/her? When? What will he/she think? Most ileostomists in this situation have found that their worries are unfounded and that the person who truly cares for you accepts all of you as you are. Equally, the person whose view of you changes on discovering that you have an ileostomy may not be the person with whom you should consider embarking on a long-term relationship.

Physical difficulties

Occasionally, physical difficulties with having sex can result from having an ileostomy. Sometimes it may not be possible to continue in the same way as before your operation. Your specialist nurse will be happy to discuss this with you and your partner.

As time goes by, you may find yourself telling more and more people about your ileostomy and, curiously, once you have accepted it yourself, you may find any problems you do have are helping others with their embarrassment as they are not sure what to make of it.

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