By Erika Kana, RN

Any ostomy surgery, whether temporary or permanent, requires recovery. Fatigue, decreased physical capacity, and reduced energy are common after surgery. It can be frustrating to feel like you’re “doing nothing” yet still feel exhausted. Needing rest doesn’t mean you’re recovering poorly. Having both good days and bad days is normal, and progress isn’t always linear. Give yourself permission to rest while your body heals.  

Recovery can be dependent on the type and extent of surgery, your health before surgery, and whether you experience complications. Always follow your individual surgical instructions, which take priority over the general advice in this article.  

The Healing Basics 

1. Rest and sleep:  

1. Your body needs adequate rest and sleep during recovery. You may find that you need more rest than usual in the weeks following surgery. 

2. Nutrition and hydration:  

1. First, follow your healthcare team’s instructions post surgery on when to start eating and what foods are appropriate during your initial recovery. 

2. As you return to your usual diet, eating enough protein and calories can help support healing and maintain muscle mass.  

3. Maintaining adequate hydration is particularly important for people with an ostomy. Individuals with ileostomies can be at a greater risk of fluid and electrolyte losses. Here is an article with Dr. Maitreyi Raman about hydration with an ostomy.  

3. Pain and symptom management: 

1. Pain can limit your ability to move and return to your usual activities.  

2. If pain is preventing you from becoming more active, or you feel that you need to “push through” significant pain, contact your healthcare team.  

Managing Energy After Surgery  

Your healthcare team will likely provide guidance on when and how to resume your normal activities. Here are some general tips that may help: 

1. Don’t immediately try to accomplish everything you want to do at once as soon as you’re given the green light.  

1. Divide tasks into smaller steps and take breaks in between. Don’t wait until you’re completely exhausted to rest.  

2. Alternate activity with rest and gradually increase what you do as your energy improves.  

Any Movement is Part of Recovery 

Movement doesn’t always mean exercise. Early activity might look like: 

• Sitting upright 

• Standing 

• Walking to the bathroom 

• Short walks around the house 

• Showering, cooking, and other activities of daily living 

• Gentle mobility exercises recommended by your healthcare team 

Why Move? 

Gradual movement after surgery can help: 

• Rebuild strength and endurance 

• Reduce deconditioning 

• Improve circulation 

• Support bowel function and healing 

• Improve confidence and restore independence 

• Make everyday activities easier  

Rest is necessary for healing, but prolonged inactivity can contribute to loss of strength and conditioning. Start slowly and gradually build your activity as you are able.  

How to Start 

While following your healthcare team’s guidance, use this general progression: 

Step 1: Move more often 

• Start with short, easy bits of movement throughout the day. 

Step 2: Increase duration 

• Gradually make walks and activities slightly longer. 

Step 3: Increase frequency 

• Add another walk or activity session when you’re ready. 

Step 4: Increase intensity 

• Only once the activity feels comfortable, gradually increase the effort. 

Step 5: Adapt  

• Modify activities around your energy, symptoms, and stage of recovery.  

How to Know if You’re Doing Too Much 

You may need to scale back if you experience: 

• Significant increase in fatigue after the activity. 

• Pain that persists or worsens. 

• Feeling significantly worse that day or the following day.  

• Dizziness or new/worsening shortness of breath. 

• Difficulty keeping up with normal daily activities afterwards.  

If you’re unsure whether a symptom is a part of normal recovery, contact your healthcare team.  

Progressing to Exercise 

Start with low-impact activities like: 

• Walking 

• Stationary cycling 

• Swimming (once your incision is healed and you’re cleared by your healthcare team). If you are interested in learning about swimming with an ostomy, check out this article.  

• To protect your abdominal wall:  

• Follow your healthcare team’s recommendations about when to resume lifting and intense exercise.  

• Once cleared to lift, start with daily activities like carrying groceries. When returning to the gym, start with lower weights.  

• Use good body mechanics and avoid suddenly returning to heavy lifting or high-intensity exercise. 

Protecting Your Abdominal Wall  

An ostomy creates an opening in the abdominal wall, which can contribute to the risk of developing a parastomal hernia. Gradually increasing physical activity and allowing time for healing is important. To learn more, check out this article. 

Contact sports require additional consideration because of the possibility of trauma to the stoma or abdominal wall. However, having an ostomy doesn’t automatically mean giving up the activities you enjoy. Speak with your healthcare team about modifications or what protective equipment may be appropriate. You can also read more about returning to sports after an ostomy. 

When to Stop and Seek Medical Advice 

Stop exercising and contact your healthcare team if you notice things such as: 

• Increasing or severe abdominal pain 

• New swelling or a noticeable bulge around the stoma 

• Significant changes in stoma appearance or function 

• Persistent or unexpected bleeding 

• Problems with your wound or incision 

• Repeated dizziness or fainting 

• New or worsening shortness of breath or chest pain 

• Concerning changes in ostomy output or signs of dehydration.  

• Symptoms that are worsening rather than gradually improving 

Seek urgent medical attention for severe symptoms such as chest pain, severe shortness of breath, fainting, severe abdominal pain, or significant change in stoma colour or function.  

You may need to modify the duration, intensity, equipment, or frequency at first, but having an ostomy does not mean you have to give up an active lifestyle. Start where you are, progress at your own pace, and remember that every step forward is part of your recovery. Your recovery may look different than it did before surgery, but an ostomy does not have to limit what your body is capable of. 

Disclaimer: The information shared by Ostomy Canada Society is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Every person’s ostomy experience is unique. Please consult your health care provider with any questions about your condition, care, or treatment plan.