Living with a Stoma

A stoma may be temporary (to allow the bowel time to heal) or permanent

Sometimes, during surgery, it may be necessary for the surgeon to form a 'stoma' on the wall of your abdomen.  
 
The stoma may be temporary (to allow the bowel time to heal) or permanent.
 
'Stoma' comes from the Greek word for 'mouth' is an artificial opening on your abdomen to collect waste.
 
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.
 
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