Q I am due to have a colostomy next week. I hope to be back running in a few months. Will I have any problems with hydration, and what other effects will it have on my running?
A A colostomy is a surgical operation that forms an artificial exit for the colon on the lower abdominal wall, then a pipe allows the evacuated bowel contents to be collected in a container. For the operation to become necessary, and a portion of the lower bowel to be removed, the patient generally suffers from a severe and possibly uncontrolled inflammatory bowel disease, such as ulcerative colitis, or even a malignant cancerous growth.
The underlying surgery may be prolonged and extensive, so it is quite possible that you’ll need several weeks of recuperation after the operation. The bowel exit, or stoma, will need time to heal and settle, and you will have counselling from a specialist stoma nurse in the practicalities of dealing with what is usually a very liquid bowel content. You may have to avoid high-fibre foods, and dehydration can be a risk even before exercise is contemplated.
Early sessions should be short and slow exercise, which is a good thing as you learn to run with your bag. It is sensible to start with the bag empty, and wearing briefs that hold it semi-firmly against the lower abdomen. It should not be visible, but for added security many runners prefer to wear dark kit in case of spillage.
Owing to the more rapid transit time for food through the bowel, you need to watch for dehydration as you build up mileage, especially in warmer weather. Electrolyte disturbance and salt depletion are also high on the risk list, but taking electrolyte drinks at every opportunity should minimise this.
—Dr Patrick Milroy, RW Medical Adviser