A stoma is an opening on the abdomen, connected to either your digestive or urinary system to allow faeces or urine to be diverted out of your body into a bag. The word ‘stoma’ originates from Greek, meaning ‘mouth’ or ‘opening’. The terms ‘stoma’ and ‘ostomy’ are often used interchangeably, and people with a stoma are sometimes called ‘ostomates’.
A stoma looks like a small, oval-shaped piece of pink flesh, but everyone’s is different in size and shape. It can lie flat on your body or protrude out. It does not have nerve endings so it does not hurt or have any sensations when touched.
This article is your ultimate guide to stomas. Click on the links below to skip directly to a section of the guide:
- Why would someone have a stoma?
- Types of stoma
- What is a colostomy?
- What is an ileostomy?
- What is a urostomy?
- How long do you have a stoma bag for?
- What is a loop stoma?
- Stoma reversal
- What is an end stoma?
- What is a stoma bag?
- Is having a stoma a big operation?
- Can you live a normal life with a stoma?
- Stoma resources
Why would someone have a stoma?
Stoma surgery is used in the treatment of a range of different diseases and conditions, including but not limited to:
- Cancer, such as bowel or bladder cancer
- Inflammatory bowel disease (Crohn’s Disease or Ulcerative Colitis)
- Diverticulitis
- Bowel or bladder obstruction
- Abdominal trauma
Find out the full list: Why would you need a stoma bag?
People of all ages can have a stoma, and it is estimated that 1 in 335 people in the UK are living with one.
The purpose of an ostomy is to allow people to safely pass waste who may have otherwise struggled to in the ‘normal’ way (through the anus for faeces or through the urethra for urine).
Types of stoma
There are three types of stoma operations – colostomy, ileostomy and urostomy. Let’s explore the differences between them:
What is a colostomy?
A colostomy is an opening from the large intestine (colon). The surgery involves bringing a part of the large intestine from inside the patient’s body through to the outside of the abdomen, before securing it down with stitches. This is usually on the left side of the abdomen below the waist, but positioning will depend on the section of the colon that is diverted.
The output from a colostomy tends to resemble a traditional stool (poo) – solid and formed. However, this depends on what section of the large intestine your colostomy is and what you have eaten and drank. It varies from person to person, but a colostomy often functions between 1 and 3 times a day, after which the bag will need changing.
There are two types of colostomies; loop and end. We explore these in more detail later. Someone may have an end colostomy after having a Hartmann’s Procedure.
Read more: Understanding your colostomy
What is an ileostomy?
An ileostomy is an opening from a part of the small intestine called the ileum. During surgery, a part of the small intestine will be brought through the abdomen to the outside and stitched down. This will usually be on the right on the abdomen, as opposed to a colostomy which is on the left.
An ileostomy is more active than a colostomy and the output is looser. The stoma bag for an ileostomy allows for drainage into the toilet; about 3-6 times a day.
Like a colostomy, you can have either a loop or end ileostomy.
Read more: Understanding your ileostomy
What is a urostomy?
A urostomy is an opening for urine, usually formed when the bladder is removed. This could be due to a disease such as bladder cancer.
A piece of small intestine is pulled through the abdomen and sewed down. Ureters are detached from the bladder and attached to the piece of the bowel to form a passageway for urine to pass through and exit the body via the stoma. This is permanent surgery.
A urostomy is normally on the right-hand side of the abdomen. The bag for a urostomy has a tap on the bottom to allow urine to be drained into the toilet regularly.
Read more: Urostomy Association guides
How long do you have a stoma bag for?
Many people’s first question on this topic is ‘Is an ostomy for life’? The answer is that an ostomy can be temporary or permanent. Urostomies are not reversible, but some colostomies and ileostomies are. How long you have a stoma bag for will depend on the type of surgery you had and the problem that caused the need for surgery. Find out more: Is a stoma permanent?
Beyond the three different types of ostomy that we discussed above, there are two different stoma surgery techniques; loop and end. Loop stomas are more likely to be reversed than end stomas. Let’s explore this in more detail:
What is a loop stoma?
A loop stoma is where a loop of intestine is pulled out through the abdomen. The loop is then opened up, meaning it has two openings that are close together. One is connected to the functioning part of the bowel where waste leaves the body into a stoma bag, and the other opening is connected to the inactive part of the bowel, leading to the anus.
This can allow a damaged or diseased section of the bowel to heal by stopping poo from passing through it. A loop ostomy can then be reversed by re-joining the bowel.
Stoma reversal
If you have a temporary stoma, you will have a second, smaller operation called a stoma reversal usually a few months later – but the length of time changes from person to person, depending on their health. Some people decide not to undergo reversal at all, even if it is an option for them, because their quality of life has improved or they do not want another surgery.
After stoma reversal, you pass faeces through your anus again and don’t need to use a stoma bag anymore.
What is an end stoma?
Alternatively, an end stoma is where the bowel is severed and only one end of the colon is pulled out through the abdomen. A lower section of the colon may be removed and any inactive parts that remain are known as the rectal stump.
An end stoma isn’t as easy to reverse as a loop stoma, so is likely to be formed with the intention of it being permanent. This could be because there isn’t enough bowel left to connect the healthy bowel back to or because the rectum and anus have been removed and sewed up, such as due to a tumour. This procedure is known colloquially as ‘Barbie Butt’ surgery.
What is a stoma bag?
A stoma bag is a small pouch worn over a stoma to collect waste material. Ostomates cannot control when their stoma is active, so they wear their pouch all the time. As we mentioned above, how often it is changed depends on the type of surgery you have had and the type of bag used.
Colostomy bags are generally changed 1-3 times per day, with the whole bag disposed of in the bin. Although ileostomies and urostomies are generally more active than colostomies, ileostomy and urostomy bags can require less frequent changes because they can be drained in the toilet without having to dispose of the bag.
Stoma bags come in different sizes and colours, and you can choose which works best for your needs . You can also get accessories to help you manage your stoma bag such as seals and medical adhesive removers. Your stoma nurse will help you with this and you can order free samples to try.
They are waterproof meaning you can wear them in the shower, but this is personal preference. Some have a filter to reduce the chance of odour; this needs to be protected from water to keep it functioning properly.
Read our ultimate guide to stoma bags
Is having a stoma a big operation?
Stoma surgery is carried out under general anaesthetic, using either open or keyhole surgery. Recovery from keyhole surgery is quicker, so it is generally the preferred option.
After surgery, you will need to recover in hospital for a few days – usually 3 to 10. Nurses will monitor your stoma to ensure it is working properly, and a dedicated stoma nurse will show you how to care for it (including applying and removing a stoma bag, taking care of stoma skin and what products will best suit you).
Can you live a normal life with a stoma?
Yes, you can live a normal life with a stoma. Ostomies enable people who struggled with illness prior to surgery to get back to doing things they loved, including physical activity and getting out and about.
Your stoma nurse will advise you on how soon you can resume your normal day-to-day activities once you are home – usually about 8 weeks. It can be challenging to adjust to life with a stoma but there is lots of support available to help you go back to living your life to the full.
Find out more: Living with a stoma
Stoma resources
If you are due to have stoma surgery, or have recently had it, speak to your doctor, surgeon or stoma nurse about any concerns or questions you may have. They are there to provide you with all the information you need and support you with any issues. The NHS website also has lots of comprehensive information that you can access at any time – read their colostomy and ileostomy pages.
Also, many charities exist to support ostomates, with dedicated resources, advice lines and community groups where you can get advice from experts and connect with other ostomates. For example:
Ileostomy and Internal Pouch Association
If you are a medical professional and are interested in finding out more about how StoCare products can help your patients or requesting a repeat sample order, please email info@rhodespharma.co.uk.
This information is for guidance and does not replace advice given by your healthcare professional.
