Stoma Care

A stoma is an opening of the abdomen to direct the flow of either faeces or urine into an artificial pouch. The most common operations that lead to the formation of a stoma are a colostomy or an ileostomy.

  1. Temporary or permanent solution following bowel surgery
  2. Resembles a small circular piece of plastic that sits outside the body
  3. Often used in inflammatory bowel disease

If you have a stoma and need to speak to a doctor for any reason,, you can book an appointment to use our online video consultation service. Our UK doctors can issue advice about how to manage your stoma, and provide guidance on what to do if you are experiencing any problems with it.

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What is a stoma?

A stoma is an opening in the abdomen, created during an operation, that allows urine or faeces to be collected in a pouch that sits outside of the body. It can be permanent or temporary.

Why would someone need a stoma?

There are a variety of reasons as to why someone may need a stoma. Most commonly it is due to the development of bowel cancer, or an inflammatory bowel disease such as ulcerative colitis or Crohn’s disease, which has not responded to treatment. The two surgical operations that lead to a stoma are a colostomy and an ileostomy. 

A colostomy is where a part of the colon has to be removed, and the loose end is attached to the surface of the abdomen. An ileostomy is the same procedure, but with the ileum brought to the surface instead of the colon. Both of these operations can result in a ‘loop’ (a looped section of the bowel) or ‘end’ (an end section) stoma.

What complications can a stoma cause?

The most common problem that can arise from a stoma is leaking, as it can be uncomfortable and cause problems with the skin. Naturally, the more liquid the constitution of the faeces is, the more likely it is that leaks will occur. 

There are measures you can take to avoid this happening that you should discuss with your stoma nurse. They include using some adhesive tape or tightening a belt around the ‘flange’ of the bag. You can also change your diet or medication in an attempt to thicken the waste being produced.

Retraction and prolapse are other issues that can stem from the opening of the stoma, either retracting inside the abdomen or sticking out too much. Either can increase the chances of leaking and make the skin sore. It’s possible that a retraction or prolapse will require minor surgery to correct the problem. 

Other complications include a stenosis, when the bowel connected to the stoma becomes too narrow, and general skin issues. Due to the nature of a stoma, fungal skin infections are possible because of how irritated the skin can become. It’s vital to clean the skin when changing the bag with non-perfumed cleansing products. It may also help to use a skin wafer (a circular patch) to act as a protective layer for the skin.

Can I get advice about a stoma online?

If you have recently had a stoma, or have developed any issues surrounding it that you would like to discuss, our private online video consultation service could help. Our doctors can offer advice and support for any problems that you might have with your stoma, and let you know whether you will need to see your stoma nurse. Book a slot at a time that suits you.

Page last reviewed:  15/06/2020

What do stomas do?

A stoma allows waste from your body to be passed out of the intestine. It involves a section of your bowel being fitted through a hole in your stomach, where a bag on the outside of the body can collect the waste.

There are two different types of stoma: a colostomy and an ileostomy. An ileostomy brings an end of the small bowel to the surface of the abdomen, whereas a colostomy is formed by bringing a section of the colon to the surface of the abdomen. These two types can either be ‘end’ or ‘loop’ stomas. An end stoma is where one end of the colon or ileum is sewn to the surface of the abdomen, whereas a loop stoma is when a looped section of the bowel is brought to the surface of the abdomen, and the open edges are sewn to the skin.

How are stomas managed?

After the operation, a stoma care nurse is assigned to the patient. They advise the person on which bag would be more suitable, depending on lifestyle. There are drainable bags, closed bags, disposable bags and urostomy bags, which come in one or two-piece systems. A two-piece system allows a ‘flange’ to be stuck to your skin, which reduces soreness and the hassle of detaching the entire bag.

A nurse usually helps formulate a routine with the patient so that bowel movements are regular and easily manageable. They can suggest ways to make the stoma more comfortable, such as wearing high-waisted clothing, offer any emotional support and provide contact details for local support groups.

Most people can return to eating normally immediately after a stoma has been put in place. It can often be useful to eat high-fibre foods to reduce the possibility of constipation.

Regular check-ups

It’s important to regularly check in with your stoma care nurse in order to assess how you are coping with it. Many issues can arise with the stoma and the surrounding skin. Therefore, reporting any problems that you have encountered can allow a nurse to make suggestions, such as changing the type of bag or adjusting your diet.

Signs that something is wrong and how to get help

If you notice any liquid seeping outside of the bag, this is an indication of leeking, and can be avoided by using seals and adhesive tapes to seal the bag. If you notice that your faeces appears thinner than usual, this could be a sign of stenosis, where the connecting bowel has thinned. This usually occurs some time after the operation. 

Colostomy UK has a helpline and there are local NHS stoma support services available.

If you are experiencing any issues, our online doctor is also available to provide help.

Page last reviewed:  15/06/2020
Questions and Answers

What is a stoma?

A stoma is an opening that sits on the surface of the skin, to direct faeces and urine from your bowel or urinary tract to a pouch outside of the body. It is usually created via a colostomy or an ileostomy, where a section of the colon or ileum is cut and an end or loop is redirected out of the abdomen.

What should I do with the stoma day to day?

Most people can carry on with life as normal once the stoma has formed. However, it is important to be shown how to clean the surrounding area of skin and change the bag by a stoma care nurse. There are a number of bags you can choose from, depending on your specific needs. 

It can help to get a special belt to reduce the strain on your abdomen, and also wear clothing to cover the bag if you are not happy with the appearance of it.

Where can I get help if I need it?

If you need assistance, input or advice on your stoma, there are helplines on the websites of Colostomy UK, the Ileostomy and Internal pouch Association (IA Support) and Crohn’s and Colitis UK. There are also information leaflets and pages on their stoma sections.

Can I speak to a doctor about stoma problems?

Our doctors are on hand to help should you require any advice on maintaining your stoma. To book an online video consultation, click below. Pick a time that’s convenient for you, and a clinician will be able to provide any guidance you require through our secure video facility.  

Page last reviewed:  15/06/2020

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