A stoma is a round or oval opening made during surgery through the tummy (abdomen) wall. It lets the bowel connect onto the surface of the tummy. Poo (stools) will no longer pass out of the rectum and anus in the usual way. Instead it will pass out of the stoma, into a disposable bag that is worn over the stoma.
The stoma is made from an opening in part of the bowel. If the stoma is made from an opening in the colon, it is called a colostomy. If it is made from an opening in the small bowel (ileum), it is called an ileostomy. The stoma usually looks pink and moist. It has no nerve supply, so it does not hurt.
There are two ways to form a stoma:
- A loop stoma – the surgeon pulls a small loop of bowel through a cut in the tummy, makes an opening in the bowel and stitches this to the skin.
- An end stoma – the surgeon removes the section of bowel containing the cancer and stitches one end of the bowel onto the skin. They close the other end of the bowel leading to the rectum and leave it inside the tummy.
Stomas can be temporary or permanent. A surgeon may make a temporary stoma to allow the bowel to heal after surgery.
If you have a temporary stoma, you will usually have a second smaller operation a few months later to close the stoma and rejoin the bowel. This operation is called a stoma reversal.
If the cancer is very low in your rectum and close to the anus, you are more likely to need a permanent stoma.
Your surgeon will tell you whether you are likely to have a stoma after your operation, and whether it will be temporary or permanent.
If you need to have a stoma, you will be referred to a stoma nurse who specialises in stoma care.
Having a stoma is a big change to your body, whether it is temporary or permanent. It can take time to adjust to. You may find it helpful to talk to someone who is used to living with a stoma. Your stoma nurse may be able to arrange this for you.
A stoma may affect how you think and feel about your body (body image). If you have concerns about your body image there are different things that can help support you. Some people may find that having a stoma affects their sex life but there are ways of managing this.
If you want to talk about any concerns you have, you can also contact our cancer support specialists on 0808 808 00 00.
You will usually see a stoma care nurse on the first day after your operation. They will begin to teach you how to look after the stoma.
The stoma will be swollen at first, but will shrink to its final size within a few weeks. If you have a loop stoma there may be a rod underneath the loop to support it. A nurse will usually take the rod out after a few days.
Learning to look after a stoma takes time and patience, and no one expects you to be able to cope perfectly straight away. Like anything new, it will get easier with time and practice.
You will continue to have support from a stoma care nurse after you go home. You may want to have a family member or friend with you while you are taught how to care for your stoma. This means they will know how to help you at home, if needed.
The stoma care nurse will give you stoma supplies to go home with. After this, you will need to order them from your chemist or a specialist supply company. The supplies are free, but you need a prescription from your GP. If you are aged 16 to 60, make sure your doctor signs the form saying you’re entitled to free prescriptions.
Once you are at home, you can phone the stoma nurse if you have any problems. Or a district nurse can visit to make sure you are coping with your stoma.
If you have an ileostomy, you will wear a stoma bag that opens at the bottom so you can empty it. An ileostomy produces semi-liquid waste continuously, so you will need to empty the bag several times a day.
A colostomy may be active two or three times a day, but this will vary from person to person. It will also be affected by what you eat. It will usually settle into a pattern after a few weeks, so you can predict when it is likely to be active. You will usually need to change your stoma bag about one to three times a day.
Some people with a colostomy are taught how to flush out (irrigate) their colostomy once a day. This helps them to control when it is active. If you want to try this, your stoma care nurse can discuss it with you in more detail.
Before you change or empty your bag, make sure that you have plenty of bags and cleaning materials with you. It is a good idea to keep everything you need in one place, so that you don’t have to search for things at the last minute. Give yourself plenty of time, so you can work at your own pace without any interruptions.