A stoma is an opening on the abdomen that can be connected to either your digestive or urinary system to allow waste (urine or faeces) to be diverted out of your body. It looks like a small, pinkish, circular piece of flesh that is sewn to your body. It may lie fairly flat to your body or protrude out. Over the top of your stoma you will wear a pouch, which can either be closed or have an opening at the bottom. Your stoma has no nerve endings so you should feel no pain from it.
According to research carried out by the NHS, there are 176,824 people in the UK living with a stoma, with the most common conditions resulting in stoma surgery being colorectal cancer, bladder cancer, ulcerative colitis, Crohn’s disease and accidental injury.
Why Would Someone Need A Stoma?
There are many reasons why you may need a stoma. Common reasons include bowel cancer, bladder cancer, inflammatory bowel disease (Crohn’s Disease or Ulcerative Colitis), diverticulitis or an obstruction to the bladder or bowel. A stoma can be temporary or permanent depending on the cause.
There are three main types of ostomy – colostomy, urostomy and ileostomy.
A colostomy is when a part of your large bowel or colon is pulled through from an incision made on your abdomen to form a stoma. There are two types of colostomy that can be formed.
Where one end of the colon is pulled through and sewn to your abdomen. This can be permanent or temporary. The other part of the diseased bowel is usually either removed or allowed to heal before being joined back up together
This is when a looped portion of your colon is pulled through to your abdomen. An incision is made in the loop and then sewn to your stomach with a rod to keep it above surface level. A loop colostomy is usually a temporary measure performed in emergency operation and will be reversed a few weeks/months down the line.
Learn more on the NHS website
An ileostomy is when part of your small bowel (the ileum) is pulled through an incision made on your abdomen to form a stoma. There are two types of ileostomy that can be formed.
Where one end of the ileum is pulled through and sewn to your abdomen. This can be permanent or temporary. The other part of the diseased bowel is usually either removed or allowed to heal before being joined back up together
This is when a looped portion of your ileum is pulled through to your abdomen. An incision is made in the loop and then sewn to your stomach with a rod to keep it above surface level. A loop ileostomy is usually a temporary measure performed in emergency operation and will be reversed a few weeks/months down the line.
Learn more from the NHS
A urostomy is formed when your bladder is removed due to disease such as bladder cancer.
A small piece of your bowel will be pulled through an incision made through your abdomen and sewn to your stomach to form a stoma. The ureters will then be detached from the bladder and attached to the piece of bowel to form the urostomy.
At the Bladder & Bowel Community, we offer a range of help and support to those who have a stoma including help and advice from qualified nurses and a Home Delivery Service to ensure you have everything you need.
For more information about what a stoma is and how we can help explore our stoma care section where you will find information about what to expect before and after surgery, products available, problems you may encounter with a stoma, and where you can go to talk to people in a similar situation.
When You Need Surgery to Get a Stoma
You might need this kind of operation because of:
- A bowel blockage or tear
- Crohn’s disease or ulcerative colitis
- Birth defects
- Injury to the colon
- Pouches in the colon, called diverticulitis
Sometimes doctors do a colostomy to give a damaged section of bowel time to heal. In this case, the stoma is temporary. You’ll have it for a few weeks or months.
Once the damage has healed, your surgeon can reverse the procedure and reattach the ends of the intestine. But if you had to have a large piece of the bowel removed, you may need the stoma for good.
What Happens in a Colostomy
Your surgeon will remove the damaged or diseased part of your colon. They’ll pull out the healthy part of the colon and attach it to a small opening in your abdomen — the stoma. Then you’ll get a plastic pouch over the stoma to collect wastes.
You’ll stay in the hospital for a few days to a week after your surgery. Before you leave there, a doctor or nurse will teach you how to change the bag and keep the skin around your stoma clean.
How to Care for Your Stoma
You’ll change it a few times a day. Try to do that when the pouch is only a third full to prevent leaks, which can irritate your skin.
To remove the pouch, carefully push down on your skin to separate it from the sticky part of the pouch. Empty its contents into the toilet before you throw it away, or wash it out to use again.
Gently clean the skin around your stoma with a wet washcloth or paper towel. Pat the area dry. Then put the pouch back on.
Skin irritation is one of the most common problems that can happen with a stoma. Wash and dry your skin well to help avoid redness and soreness.
The stoma will be dark red at first. The color should get lighter over time, although it will stay pink or red.
It will also get smaller in size. You may need to change the opening of your pouch so it’s the right size for the stoma. If the opening is too big, stool can leak out.
Also ask your doctor about skin barriers and sealants you can put around the opening of the pouch to keep stool from leaking.
The stoma may bleed a little bit when you clean it. Call your doctor if the bleeding doesn’t stop, or if you notice blood inside your pouch.
If you have a lot of gas, the bag can over-expand. You can take medicine to reduce gas. Or use a bag with a vent that releases it. Also, limit foods that make you gassy, like broccoli, cabbage, beans, and cauliflower.
Sometimes after a colostomy, stool can become very watery. To stay hydrated, drink lots of fluids. Include sports drinks, which also replace some of the sodium, potassium, and other electrolytes you’ve lost.
It’s rare, but sometimes a piece of the bowel can push out through the stoma. Doctors call this a prolapse. You may need surgery to fix it.
When to Call Your Doctor
Pick up the phone if you notice any of these problems: