It is surgery in the abdomen that allows waste to leave your body, rather than through your digestive system.
It is used when part of your intestines or bladder needs to be healed or removed.
To create a stoma, the doctor will remove part of your small or large intestine on the surface of your skin and sew it into an opening in the abdomen.
The end of the intestine empties waste into an ostomy device , which is a pouch attached to the stoma.
Stomata are generally round, red, and moist, and are about 1 to 2 inches wide.
Many people use the terms “ostomy” and “stoma” interchangeably, but they have slightly different meanings:
- An ostomy refers to the actual opening in your abdomen.
- A stoma refers to the end of the intestine that is sewn into the ostomy.
Ostomies can be permanent or temporary, depending on the condition.
If you have an organ that is permanently damaged, you may need a permanent stoma.
However, if it is part of a treatment and the intestine only needs to heal for a while, it may be a temporary ostomy.
Types of stomata
There are several types of stoma, depending on the procedure used to create them:
A stoma is created with part of the colon, also known as the large intestine, to bypass the rectum.
In some cases, the lower part of the colon may be removed, leading to a permanent stoma.
A colostomy can also be temporary if the colon just needs to heal.
A colostomy may be needed if you have colon or rectal cancer, a colon injury, or an obstruction in the colon.
Stoma for a urostomy
The doctor will make a bag, connecting the ureters to a bag so that urine can drain out of the body bypassing the bladder.
You may need a urostomy if your bladder is diseased or damaged.
Stoma for an ileostomy
A stoma is created using the small intestine so waste can bypass the colon and rectum.
This is the most common type of temporary stoma, but it can also become permanent.
An ileostomy may be needed if you have Crohn’s disease , ulcerative colitis, or bowel cancer.
Regardless of the type of stoma you have, your doctor will likely use one of two methods to create it:
The cut end of your intestine is pulled through the ostomy and sewn to the opening.
A loop of intestine is pulled through the opening. The loop is then cut and both ends are attached to the ostomy.
One stoma opening is for mucus, while the other is for stool.
Before ostomy surgery to create a stoma, you will be placed under general anesthesia.
The doctor will begin to remove any diseased or damaged parts of your intestines before creating the stoma.
After surgery, the patient will be given instructions on how to care for the stoma and ostomy appliance.
After you leave the hospital, you will need to rest for a few days and avoid strenuous activities for a few weeks.
Your doctor may also recommend a low-fiber diet for the first few months while your body adjusts to the procedure.
During the first few weeks after surgery, you may notice a lot of gas being produced, which is normal.
The stoma may also shrink during the first few months, which is also normal and part of the healing process.
Most people can return to work about six to eight weeks after surgery.
The ostomy appliance includes a bag into which the stoma drains.
Depending on the type of bag you have, it should be changed every three to seven days.
When the pouch is changed, the skin around the stoma should be cleaned with warm water and allowed to dry completely.
You do not need to use soap, but if you do use it you must make sure that it is very mild and odorless.
While the bag is being removed, look for signs of irritation, blood, or changes in the size and color of the stoma.
While some changes are normal as the stoma heals, it is best to be safe and consult with your doctor.
In addition to changing the bag every few days, it should also be emptied several times a day.
You should try to empty it when it has about a third content to avoid leakage.
As the patient recovers, different foods can be reintroduced into the diet.
These changes should be made slowly so that you can see if you have difficulty digesting certain foods.
It should be noted that you may have problems digesting some of the foods that you used to eat.
The consistency and amount of debris in the bag can also be checked for signs of dehydration or some other problem.
Making sure you fully understand how to care for a stoma before you leave the hospital is very important.
The doctor must provide a complete set of instructions for caring for a stoma at home.
Temporary or permanent stoma
Depending on the underlying condition, the stoma can be permanent or temporary.
Some ostomy patients have a temporary stoma made with the intention that it can later be reversed.
This is often the case when the intestines or bladder are not permanently damaged and only need a break or if the intestine is diseased or damaged further down the digestive system, the stoma could be reversible.
Other patients have a permanent stoma formed from scratch, but improved surgical techniques mean that operations to form permanent stomas are decreasing.
If the stoma is temporary, surgery to reverse it is usually done three months to a year after the original surgery, this gives the organs time to heal.
To reverse a stoma, enough intestine needs to remain to reattach the ends to each other.
During reversal surgery, after the ends of the intestine are attached, the ostomy opening will be closed.
It may take some time for the intestine to function normally again.
Although stomas are a relatively common and safe surgery, there are some possible complications. These include:
This is a common problem caused by the adhesive on the ostomy appliance. Try using a different appliance or changing the adhesive you use.
The discharge of a lot of waste through your stoma can lead to dehydration.
In most cases, you can rehydrate by drinking more fluids, but severe cases may require hospitalization.
Avoiding foods high in sugar, salt, and fat can lower your risk of dehydration.
If the stoma device does not fit properly, it may leak, if this happens, you will probably need a new device that fits better.
If food is not chewed or digested properly, it can cause a blockage in the intestines.
Symptoms of a blockage include cramps, stomach pain, and a sudden decrease in waste.
Call your doctor if you notice any symptoms of a blockage.
While it may go away on its own, some blockages require additional treatment.
The stoma may move inward, usually due to weight gain, scar tissue, or improper placement.
Retraction makes it difficult to install the appliance and can also cause irritation and leakage.
Appliance accessory products can help, but in severe cases a new stoma may be needed.
This is a common complication that occurs when your intestine begins to push out through the opening. These are very common and often go away on their own.
However, in some cases you may need surgery to repair it.
Necrosis refers to tissue death, which occurs when blood flow to the stoma is reduced or cut off.
When this happens, it is usually done within the first few days after surgery.
Most of the complications associated with stomata are minor, but some, especially necrosis and dehydration, can turn into medical emergencies.
Call a doctor immediately if:
- Vomiting occurs and no waste is observed in the bag.
- The skin around the stoma is turning blue, purple, or very dark red.
- If the patient is dizzy, groggy and always thirsty.
Living with a stoma
Having a stoma can be a big life change, however, you should be able to resume almost all your normal activities once the patient recovers from the procedure.
Only the stoma should be properly cared for, including draining and changing the pouch as often as needed and monitoring for any changes that are observed.