Sometimes, during surgery, it may be necessary for the surgeon to form an artificial opening on the the wall of your abdomen called a 'stoma' to collect waste.  
 
The stoma may be temporary (to allow the bowel time to heal) or permanent.
 
'Stoma' comes from the Greek word for 'mouth' or 'oral cavity'.
 
There are different types of stoma and, if you need one, the type you have depends on the location of your tumour and the type of surgery you need.
 

Ileostomy 
 
An 'ileostomy' is a stoma formed by bringing the end or loop of small bowel (the ileum) out on to the surface of your abdomen.
 
If possible, you may be able to agree on a site for your stoma with your Stomal Therapy Nurse before your operation.  This is usually made on the right-hand side of your body, but may in some circumstances be on the left-hand side.
 
The stoma will be moist and pinkish red in colour and will protrude slightly from your abdomen.
 
It may be quite swollen to begin with but will reduce in size over time – usually after 6-8 weeks.
 
Despite being red, there is no sensation in the stoma and it's not painful.
 
The intestinal waste passes out of the ileostomy and is collected in an external pouching system (generally known as an ileostomy bag).  
 
Ileostomies can be formed during surgery to allow the colon to rest and heal following your surgery.  Usually, following a period of 8–10 weeks, the ileostomy is reversed and you go back to using your bowels in the usual way.
 
About Ilesostomy 770new
   

Colostomy
 
A 'colostomy' is a stoma formed by bringing part of your colon (large bowel) out on to the surface of your abdomen.
 
If possible, you may be able to agree on a site for your stoma with your Stomal Therapy Nurse before your operation.  The opening is usually made on the left-hand side of your body, but may in some circumstances be on the right-hand side.
 
The stoma will be moist and pinkish red in colour and will protrude slightly from your abdomen.
 
It may be quite swollen to begin with but will reduce in size over time – usually after 6-8 weeks.
 
Despite being red, there is no sensation in the stoma and it's not painful.
 
The intestinal waste, (which is 'formed' having passed through the colon where water is absorbed) passes out of the colostomy and is collected in an external pouching system (generally known as a colostomy bag).
 
A temporary colostomy can be formed to 're-route' the faeces away from the section of the colon which has been operated on.
 
A second operation is later carried out to reverse the stoma and allow the patient to resume normal bowel function.
 
Permanent colostomies also need to be formed for some patients if the surgeon is unable to join the ends of the bowel that are left or if your anus needs to removed due to the location of the tumour.
 
About Colostomy 770new
 

Before surgery
 
Your surgeon will tell you before surgery, during the consent process, if you might need a stoma to be formed.
 
It's not always possible to know 100% either way as the decision is often made during the surgery once they can see the tumour and what needs to be surgically removed.
 
You may meet with the Stomal Therapy Nurse before the surgery who is a specialist in caring for patients who require a stoma.
 
They will discuss with you where the stoma will be on your abdomen and answer any questions or concerns you have.

Managing your stoma after surgery
 
You will meet with the Stomal Therapy Nurse again after the operation.  They understand it can be very daunting at first and that learning to manage your stoma will take time and practice.
 
No-one expects you to be an expert overnight.
 
For the first few days, the Stomal Therapy Nurse and the nurses on the ward will help you with your stoma.
 
As soon as you are well enough, the Stomal Therapy Nurse will show you how to clean your stoma, and how to change the bag.
 
The Stomal Therapy Nurse will give you hints and tips on how to independently manage your stoma, including how to be thoroughly prepared before you start changing the bag so you know you have everything you need to hand in the bathroom.  If appropriate, they may also talk to you about irrigation as a method of managing your stoma (colostomies only) instead of wearing a bag.
 
They will also talk to you about the different types of appliances (bags) that are available and which one might be best for you.
 
It might be useful to have a relative or friend with you at this time in case you need help or support when you get home.
Managing your stoma at home 
 
Once you are able to manage your stoma independently, and the medical team are happy with you, you will be able to go home, with a plentiful supply of stoma bags.
 
Once you get home, you will be able to order new supplies from your pharmacy, dispensing doctor or a home delivery company.  
 
You should also ensure you have the contact details of the Stomal Therapy Nurse in case you have any concerns or queries.

Low fibre stoma sample menu
 
This is a sample menu guide please ensure you read our Bowel Cancer Risk: Diet and Lifestyle to follow the other helpful nutrition and lifestyle advice.

Breakfast 
  • Cup of cornflakes with milk of choice, topped with sliced banana (NOTE very ripe banana makes motions loose, green banana binds the bowel motion use them as medicine), could also enjoy tinned or a tub of peach, pear or apricot in natural juice or apple sauce
  • Slice or two of white sourdough or ordinary white bread and spread of your choice with two poached eggs with ¼ cup of fresh wilted baby spinach
  • Two egg omelette with a sprinkle of cheese and 1/4 avocado with toasted white bread and spread of choice
  • Rice porridge made on water with 1/2 a tub of stewed apple and a dollop of full fat plain Greek yoghurt
  • Two slices of white bread with spread of choice and two teaspoons of smooth peanut butter or Philly cheese and a fresh peeled apple
 
Lunch 
  • White bread wrap with sliced chicken, Dijon mustard, sliced peeled cucumber and a slice of cheese with chopped rockmelon
  • Crusty white sourdough bread with vegetable soup made from zucchini, pumpkin, carrot, green bean, sweet potato with 2 teaspoons of tomato paste, chicken stock – very well blended before consuming eat with a tin of tuna or salmon
  • Basmati rice with butter chicken, with a ½ cup side of very well cooked green beans
  • Stir fried vegetables , 1/4 cup green beans, 1/4 cup carrot, 1/4 cup zucchini, garlic powder, salt and pepper to season, with a 1/4 BBQ chicken, skin off, two rice cakes with spread of choice
 
Dinner
  • Poached white fish sprinkled with ginger powder and teaspoon of fresh chives, salt and pepper to flavour, skinned baked pumpkin and potato with tinned asparagus (fresh is good but must be very slim stalks as the thick stalks are very fibrous and may cause problems with stoma)
  • Lamb or beef minute steak (150 grams) with mashed potato no skin, ½ cup of steamed carrots, ¼ cup fresh baby spinach leaves
  • Stir fry chicken strips with 1/2 cup of snow peas ensure they are de veined, and bamboo shoots add a dash of soy sauce, serve with basmati rice
  • Eggplant moussaka, skin eggplant and layer spaghetti Bolognese meat with sauce, with lasagne sheets serve, bake and serve with salad of lettuce leaves
  • Soup made of pureed vegetables (pumpkin, sweet potato, potato, carrot, green beans, baby spinach with a chicken/beef stock cube) with poached fresh white fish and slice of white sourdough bread with spread of choice
 
Snacks - choose one of the following
  • Plain white rice crackers with cream or hard cheese
  • Peeled apple with tablespoon of smooth peanut butter
  • Fruit salad, with banana, melon and mandarin with a dollop of plain yoghurt
  • Rice crackers with crème cheese and chives
  • Smoothie with milk of choice, teaspoon of chocolate powder and whey powder, fresh banana and a tablespoon of non-fruit yoghurt well blended
  • Four squares of dark chocolate
  • Plain or vanilla yoghurt with peaches in their own juice

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