I had ulcerative colitis and noticed I had issues when there was blood in my stool. I buried my head in the sand about it until it was too late, my bowel was so inflamed that it perforated, poisoning me from the inside. I needed emergency surgery and 8 weeks in hospital for that one.
I the had the aforementioned j-pouch or ileal-anal pouch, but sadly this wasn't a success for me so after a little more than a year I elected to have the pouch excised and a permanent ileostomy.
Yeah, the surgery hurts! It's a 10" midline incision through your abdominal wall. Makes moving hard but you have to get moving a little bit because it wakes your bowels up, else the stoma doesn't start working and you get massively bloated and vomit a lot. I'm on my 6th major bowel surgery now so I'm used to it! (this should be the last since there's now literally nothing left inside me which can get colitis!).
You push through it though and after a few days it gets much easier. My pain was adequately managed with fentanyl at first, then just codeine.
Day to day, a stoma has no pain or even feeling at all. The only time it might get a bit sore is if I'm not 100% accurate with bag placement and leave a skin gap, it can get nappy rash type symptoms. You can get barrier wipes which provide a protective film to help with this though.
It's totally permanent for me, in January I also had my rectum and anus removed and it all sewn up, so stoma for ever now. But unlike when I had colitis I can eat, drink, take any drug I want, with no negative effects. With colitis I was stuck with about three bland foods, now I eat anything - it just helps a lot to chew well.
Really though, my life is great. I'm back working full time in London, where I make 3D art for computer games. Hardly anyone even knows I have a stoma. Bake out running a couple of times a week 5kms in 27mins12, training for my first 10km. Did a 45km bike ride loaded up with camping gear and camped by the river for two nights before cycling home again at the weekend. Training to see what adjustments I might need to survive festival season. None really, as it turns out!
https://www.dropbox.com/s/mgprqfwgz3hnoev/2015-06-27 21.14.25.jpg?dl=0