A stoma is where a section of bowel is brought out through an opening on your stomach area (abdomen). Your bowel movements (poo) are collected in a pouch or bag attached to the skin around your stoma.
Types of stoma
There are two types of stoma - a colostomy is formed from the large bowel and an ileostomy is formed from the small bowel.
A colostomy is a stoma formed by bringing part of your colon (large bowel) out on to the surface of your abdomen. The waste from a colostomy is usually more formed than from an ileostomy, as it has had some of the water removed on its way around the bowel. The waste passes out of the colostomy and is collected in an external pouch (known as a colostomy bag).
An ileostomy is a stoma formed by bringing the end or a loop of the small bowel (ileum) out on to the surface of your abdomen. The waste passes out of the ileostomy and is collected in an external pouch (known as an ileostomy bag). Ileostomies are often formed during rectal cancer surgery to allow the area to rest and heal after surgery. The waste produced is usually liquid rather than solid.
Your surgeon or specialist nurse will explain why you need a stoma, what type of stoma you might have and how long you might need it for. If your stoma surgery is in an emergency, you may not be able to meet your stoma nurse before you go in for your operation. If your surgery is planned, you will meet your stoma care nurse before your surgery. They will show you how to look after your stoma and answer any questions you may have. It’s not always possible to know 100% if you will need a stoma before your operation, as the decision can sometimes only be made during the surgery. You can contact your stoma care nurse for support at any time before or after your surgery.
When you go home from hospital, your stoma care nurse will give you some stoma supplies. Once you are at home, you will need to get further supplies from a chemist or from a stoma supply company. If you live in England you’ll need a prescription from your GP and, if you are under the age of 60, you will need to sign a form to get free prescriptions. All prescriptions are free if you live in Scotland, Wales or Northern Ireland.
Your stoma may either be permanent (if there’s no longer enough bowel left to make a continuous pathway from the healthy bowel to the anus) or temporary. If you have a temporary stoma, you will usually have another operation to reverse it. Your healthcare team will tell you when this is likely to happen. Some people have their stomas reversed after a few months, while others have their stomas for several years before they have a reversal. It can take a while for your bowel function to return to normal after your stoma is reversed.
Managing your stoma
Some people struggle to get used to their stoma and find it difficult to manage day-to-day life. Others find it affects the way they see themselves. Your stoma care nurse is there to support you and answer your questions.
Eating and drinking with an ileostomy
When we eat, the colon absorbs water and salts from our food. If you have an ileostomy, either temporarily or permanently, food will no longer reach the colon. This means you will need to make some changes to your diet.
After surgery, the output from the ileostomy is likely to be liquid. Over six to eight weeks, your body will adapt and the output may become slightly thicker, like toothpaste. Eating regularly can help with this. If you still have a watery output, speak to your stoma care nurse, GP or consultant. They can give you medicines that can help.
Some foods may cause blockages, increased output, wind or odour.
Eating and drinking with a colostomy
If you have an ‘end colostomy’ then the output from your stoma is more likely to be formed and less frequent. If your colostomy is further up the large bowel, the output may be less formed (toothpaste consistency) and may work more frequently.
On the whole, once the food reaches the large bowel most of the digestive processes have been completed. This means that you do not need to follow a special diet unless you have been advised by your GP or dietitian. Following your operation and in the early days, certain foods or drinks may upset you, this is very individual. If you think a particular food or drink has upset you, leave it for a few weeks then try it again. Keeping a food diary can be helpful to identify these foods.
Some foods may cause wind, constipation or loose and runny stools (diarrhoea).
Colostomy UK provides support, reassurance and practical information to anyone who has, or is about to have, a colostomy.
IA (Ileostomy and Internal Pouch Support Group) is a support group run by and for people with ileostomies and internal pouches.
Reviewed December 2019