Hiking With an Ostomy: Conquering Koko Head One Step at a Time

On a hot summer day in June, I stood at the bottom of the Koko Head trail in Hawaii, staring up at what looked like an endless staircase to the sky. This notorious hike has 1,048 railway-tie “steps” leading straight up the side of a volcanic crater. There’s no shade. No bathrooms. Just the blazing Hawaiian sun, dusty tracks, and a relentless climb.

Honestly, I had no real intention of hiking the whole thing. My kids were only five and seven at the time, and I figured we’d just climb a few steps, snap some photos, and call it a day. But suddenly, my daughters were buzzing with excitement, determined to reach the top. What started as a casual glance at this towering staircase quickly turned into a full-blown family adventure.

I wasn’t about to let them go it alone. So up we went—together, side by side—me, my ostomy, and my two unstoppable little hikers.

The Reality of Hiking With an Ostomy

Living with an ostomy doesn’t mean giving up adventures. But it does mean planning and being prepared. On Koko Head, the intense heat and lack of restrooms added some unique challenges:

✅ Sweat and Heat: Sweat can break down adhesives, leading to leaks. Wearing moisture-wicking clothing and bringing extra supplies is crucial. On this particular hike, there aren’t really areas to get off the trail, so there’s not much privacy or space “in the woods” to empty your bag if needed—which makes planning ahead even more important.

✅ No Bathroom Access: Emptying your pouch before the hike helps avoid unexpected stops.

✅ Physical Strain: Climbing over a thousand steps is no joke. Abdominal support is essential to reduce strain on the stoma and lower the risk of a parastomal hernia.

✅ Stay Hydrated: Hydration is critical—especially for those without a colon, since the colon normally absorbs water. Bring much more water or electrolyte drinks than you’d think you’ll need to avoid dehydration, even on shorter hikes.

How an Ostomy Belt Made My Hike Possible

One of the biggest game-changers for me was wearing an ostomy support belt. On this hike, my belt kept everything snug and secure, even with constant movement, bending, and sweating.

Research backs up the benefits I felt firsthand:

A study by Pittman et al. (2022) found that wearing an ostomy support belt significantly improves comfort, confidence, and quality of life while reducing fear of leaks or pouch dislodgement (NIH National Library of Medicine, PMC8768503). The University of Miami’s 2023 study showed that belts reduce the risk of hernias and improve physical activity participation among ostomates, highlighting their importance for active lifestyles (Surgeries, 5(1), Article 11).

Personally, I noticed:

Better Security: My pouch stayed firmly in place, even climbing steep steps. Reduced Movement: Less bouncing or shifting of my pouch made the hike more comfortable. Core Support: The gentle compression provided abdominal support, helping me feel safer during exertion.

Tips for Hiking With an Ostomy

If you’re considering a challenging hike like Koko Head—or any outdoor adventure—here are a few practical tips:

✅ Wear an Ostomy Belt or Band: It’s worth the investment for both support and confidence.

✅ Pack Extra Supplies: Bring spare pouches, barrier rings, adhesive wipes, and disposal bags.

✅ Dress for Success: Choose breathable, sweat-wicking clothes that won’t rub against your appliance.

✅ Empty Your Pouch Before You Go: Start with as little output as possible.

✅ Stay Hydrated: Especially crucial for those without a colon. Bring extra fluids to stay ahead of dehydration.

✅ Know Your Limits: Listen to your body and take breaks as needed.

Keep Climbing

I’m proud to say I reached the top of Koko Head with my daughters, sweaty but victorious. The view from the summit was incredible, but the real victory was proving to myself—and showing my kids—that an ostomy doesn’t define my limits.

If you love hiking, don’t let your ostomy hold you back. With preparation, the right gear, and the confidence that comes from good support, the trail is yours to conquer.

References:

Pittman, J., Colwell, J., Gray, M., et al. (2022). “The Impact of an Ostomy Support Belt on Quality of Life and Comfort.” NIH National Library of Medicine. PMC8768503 University of Miami. (2023). “Impact of Ostomy Support Belts on Physical Activity and Hernia Prevention.” Surgeries, 5(1), Article 11.