What is it like to have a colostomy, and through it, consciously and manually to manage the – normally automatic – process of excretion? Author William Fiennes had a colostomy for two years in his early twenties, a by-product of Crohn’s disease. He has now described his experience in colourful and olfactory detail the process of caring for his stoma. (It has been published in a book of essays, and in the Guardian, but it was originally a talk for Radio 3’s The Essay.)

Fiennes tells of his fascination with variations in the live organ that is his bowel, a pipe emerging on his outside ‘like the Pompidou centre’ in Paris. Unlike the Pompidou Centre the tubes and its mouth had their own moods, altering shape and texture with William’s states – or perhaps his moods altered to match the state of his guts. Fiennes explains in amazement the lack of pain sensation in the bowel, even when he has a prolapse, watching folds of bowel escaping from the stoma, and then watching them being replaced inside him by a paramedic.

This is a wonderful short exploration of a basic reality of our existence – we have our own internal sewage plant. For some people it has to become visible and a part of everyday life. These are parts of the body we are not meant to see, and yet there are now many people who manage a colostomy either temporarily or permanently as a way to function in spite of malfunction. (Some people with spinal cord injury even volunteer for a colostomy to avoid the alternative methods of bowel management.)

While fascinated with the visible processes of his internal organs, William was also disgusted. He hated the intermittent accidents. He describes the way the colostomy affected his erotic self, and his difficulties in being close to others. But in his essay he talks of how managing his colostomy became a new normal for him, and years after his stoma was closed, he can even talk of missing the sweet smell of the chyme.

For those who are new to living with a colostomy, or who have to make up their minds about whether to have one, this essay is a rare short introduction from someone who has experienced it. I imagine that it would also be very useful for their family members.


Radio 3 essay, https://www.bbc.co.uk/programmes/b075p9zv 14 mins

Fiennes William (2018) Bowel, in: Beneath the Skin: Great Writers on the Body,  London, Profile Books/ Wellcome Collection

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