Running with an Ostomy

This post does not apply to many runners, however I did want to share my experiences here to encourage ostomates to return to or start running. I found that running helps me tremendously with mental and emotional issues which includes dealing with an ostomy. There is no real concern in regards to the ability to run with an ostomy whether it is recreational or even competitively…

In March of 2022 I was diagnosed with colon-rectal cancer during a standard screening. The good news was the cancer had not spread to any other organs or lymph nodes, however the bad news was, as the cancerous cells were found very close to my sphincter, that I needed a permanent colostomy. Basically my rectum and a piece of my sigmoid colon had to be surgically removed leaving me with a stoma and the need to have a bag attached to my stomach for the rest of my life.

I had the colostomy surgery in June of 2022. Having run for decades one my questions to the surgeon was whether I will be able to run again. He ensured me that exercise and specifically running should be possible without reservations.

My first run with a colostomy bag

Around 3 months after my surgery I laced up my running shoes and headed out to the local trails which I have run literally thousands of times. I was excited and in good spirits, but my mood quickly soured. It was much hotter on the trail than expected, my bladder was acting up (still some weirdness from the surgery) leading to the feeling I had to constantly go to the bathroom and finally, the straw that broke the camel’s back was that I tripped and fell flat on my face including my stoma hitting some rocks/roots. I was miserable and walked back home in discouragement only to find out that my bag contained a fair amount of blood from the impact. Generally, a stoma is somewhat sensitive to impact and trauma and may bleed very quickly, but usually the bleeding also stops fairly promptly. I was inexperienced at the time and a little scared. Overall I found the experience a disconcerting and I was definitely not prepared for this outcome.

Higher volume running

It was not until late summer of 2023 when I made a second attempt to get back to running in earnest. I started slow, but built up to 150 – 200km a month and now, at the time of writing, I am up to around 300km a month and back to training for marathons. Most of the time I actually forget that I am running with a colostomy bag – until I don’t. The very few times I do have issues is when:

• The bag fills during a run and gets heavier creating friction between the skin and the bag adhesive. It usually starts as itching and develops to slightly burning sensation and can be a little painful or at least discomforting. It really is kind of a road rash that leads to bleeding of the skin close to the stoma under the adhesive with the blood ending up in the bag. Fortunately this happened only very rarely to me. Out of a few hundred runs this has only occurred only 4-5 times to me. I have only experienced this on very long runs (2+ hours) or when doing intensive workouts (e.g. track intervals). The good news is that the skin and stoma heal very quickly and I am ready for a run the very next day.
• The bag leaks – essentially the adhesive breaks down and the waste finds a way out from under the bag. Every ostomate dreads leaks! For some they may occur more frequently, but I have only experienced a leak once (having a colostomy instead of an ileostomy helps) while being on a long run. Now this can potentially be an issue when running out in the boonies and not having supplies on hand…

Bag support

I have experimented with the following 5 different ways of placing and supporting bags during running:

My first intuition was to run with a stealthbelt, but to be honest I just hated it. Some ostomates like the extra support and sense of security, but I just feel too constrained in my movements and do not like the feeling of an extra belt on me. Then again, I am a very minimalistic type of runner. I never run with a phone, ear pods, running vest, hydration belt / backpack and I typically underdress. Any additional weight or garment just bothers me. Long runs are just with a water bottle in my hand, perhaps a few gels in my shorts pockets and some strategies on how to refill the bottle on the go.

So, I end up always running with the same way as I carry my bag daily. Now, as I do have a slight hernia as most ostomates do, the bag and the bump are visible to others on the roads and trails. I tend to shirts that a size larger than I need them to be and typically they are also baggy. However when I am out I typically look like this:

I do notice some people staring at me and wondering what kind of fancy carrying pack I have under my shirt, but nobody has every asked 😉

Tips and tricks for ostomates

• Be especially careful positioning a new bag / wafer and make sure the bag edge is not touching the stoma. This should be done anyways, but I found when I am not running I can be a little sloppy every once in a while with not adverse effects. However the constant, if subtle, movement of the bag can create friction and bleeding when running.
• Shave the area around the stoma as much as possible. The skin should be as smooth as a baby’s bottom. The better that bag sticks to your abdomen the less likely you will encounter any issues.
• Empty the bag completely – I mean completely. Or put on a fresh bag. Any weight in the bag will exacerbate the amount of skin friction.
• If you prefer, use a supporting belt for security and ease of mind. I personally run with a loose bag, but I can see why many runners would want to use a belt or secure the bag othewise.

If you have made it this far, you are likely an ostomate. I can only encourage the reader to pursue any sports whether running or something else. I found alone the feeling not to be limited by a plastic bag very liberating. Start easy, use some common sense and precautions and just enjoy the feeling of being physically active and normal again…