In some colorectal surgeries, the surgeon creates a stoma.
This is when one one end of your colon is brought through an opening made in your abdomen. The procedure is called a colostomy (if it’s made from your colon) or an ileostomy (if it’s made from your small bowel). The opening – called a stoma – enables faeces to be removed from your body and collected in a bag.
A stoma looks a bit like the inside of your mouth. It’s soft, moist, and red or pink in colour. Some stomas are level with your surrounding skin while others are slightly raised. It can change in size or shape during the weeks following your surgery. Your stoma won’t have any feeling, but the skin around it will.
Stomas are usually temporary – giving your colon time to heal after surgery – but sometimes they’re permanent. Fewer than 10% of people who have bowel surgery for cancer need a permanent stoma.
If you have a temporary stoma, you’ll need another surgery around 3 to 12 months to close the stoma and re-join your bowel. This is called a stoma reversal.
How a stoma works
When you have a bowel movement, wind and faeces come out through the stoma. You can’t control this but a small disposable or drainable bag attached to the outside of your body will collect the faeces. This is called a stoma bag or an appliance.
A stoma bag has adhesive on the back so that it sticks firmly to your skin providing a leak-proof, odour-proof system. Any wind (but not the odour), escapes through a filter to stop the bag from inflating. The bag usually can’t be seen under your clothing.
Having a stoma may affect your travel plans, social life and sexual relationships, but these issues can be managed. Except for particularly strenuous activities, you should be able to work and do all the things you enjoy. You may have to make some changes to your diet in the short-term.
Your stomal therapy nurse
Living with a stoma can take some getting used to. If there’s a chance you’ll need one, your surgeon will refer you to a stomal therapy nurse before your surgery. They’ll talk to you about the best location for your stoma and how to choose the right type of bag.
They’ll also advise how to attach the bag and empty it, what to do if you have any problems and where to get supplies of bags and accessories.
If you have a stoma, it’s a good idea to join a stoma (or ostomy) association. They often provide free bags plus support and assistance for members. The Australian Council of Stoma Associations represents stoma associations across Australia.
The Australian Government’s Stoma Appliance Scheme provides free stoma supplies. To be eligible, you must have a Medicare card and belong to a stoma association. Visit health.gov.au and type ‘Stoma Appliance Scheme’ into the search box for more details.