What is a stoma?

If have part of your bowel or bladder removed for medical reasons, your surgeon may need to form a stoma. This is an opening in your abdomen (tummy area) to the outside of your body. The stoma is used to remove body waste — faeces (poo) or urine (wee) into a small collection bag that is placed outside your body.

Stomas can be created anywhere along the digestive system. Common types of stoma include:

• colostomy — from your colon or large intestine
• ileostomy — from your small bowel or ileum
• urostomy (also known as an ileal conduit) — if your bladder is removed, your surgeon can form a new ‘pouch’ out of small bowel tissue to hold urine. Your urostomy will allow urine to pass from this pouch into a stoma bag outside your body.

Your stoma will look moist and pinkish-red and will protrude slightly from a round hole in your abdomen. Your stoma may be swollen to begin with, but will usually reduce in size over time. You shouldn't feel anything in the stoma, and it shouldn’t be painful. Over time, bodily waste and gas will pass out through the stoma instead of your anus or urethra.

A stoma can be permanent or temporary.

What is the difference between a permanent and a temporary stoma?

Many stomas are temporary and can be reversed with surgery, usually after 3 to 12 months. In some cases, you will need a stoma permanently, for example, if the ends of your bowel can’t be reconnected after surgery, or if your anus needs to be removed due to a tumour.

Why might I need a stoma?

Stomas are needed by people of all ages, from newborns to older people and for a variety of reasons, including:

• trauma to the abdomen (such as caused by a car accident or another major injury)
• surgery to remove bowel cancer or other cancers in your pelvic area
• diseases such as Crohn’s disease or ulcerative colitis
• congenital (birth) abnormalities
• rare genetic disorders
• neurological (nervous system) disorders that make emptying your bowel or bladder difficult
• changes to the bowel’s blood supply in premature babies and older people
• following radiotherapy in your pelvic area

How do I manage daily life with a stoma?

Living with a stoma can seem daunting at first, but you’re not alone. Over 42,000 Australians live with a stoma. With help and support, many maintain a normal quality of life.

While it’s not easy at first, with the right help and support, most people manage their stoma as part of their daily hygiene routine. It may take time and practice, but stomal therapy nurses and specialists can help with the adjustment process.

Using your stoma equipment

Learning to live with your stoma may take time. Following your surgery, a stomal therapy nurse will show you how to clean your stoma and change your bag. They can offer advice, tips and tricks and answer any questions you may have.

There are several different types of stoma bags, depending on the type of stoma you have. These include ileostomy, colostomy and urostomy bags. Your nurse will help you to work out which one is most suitable for you.

Diet

Immediately after surgery, you may need to eat less and more often, but you should gradually build up what you are eating and how much. This helps you to regain more predictable bowel movements and allow you to learn how often and when you will need to change your bag.

Try to maintain a well-balanced diet. Chew your food properly and don’t eat large amounts of food at one time. You may want to avoid certain foods that are difficult to digest and may cause blockages, such as nuts, fruit and vegetable skins and corn.

Most people can return to their normal diet. If you have any concerns, speak with your doctor or stomal therapy nurse and they can refer you to a dietitian.

Odour and wind

Some foods may produce more wind (flatulence or 'gas') than others. If this bothers you, consider cutting down on those foods.

Foods that may cause wind include:

• peas and beans
• cabbage
• broccoli
• onion
• cauliflower
• soft drinks and beer

Foods that may reduce odour include:

• yoghurt and probiotic drinks
• cranberry juice
• stewed or grated apple (without skin)
• buttermilk

Swallowing air can also cause wind. Try avoiding chewing gum or chewing with your mouth open. Smoking and snoring can also make you swallow more air.

Sport and exercise

Having a stoma shouldn’t stop you from enjoying most sports or physical activities. You should avoid any extreme contact sports.

There are special supports, bags and caps you can use to cover your stoma when swimming and playing sport.

Travel

After surgery, you may have an increased risk of deep vein thrombosis (DVT). Talk to your surgeon before any air travel.

Remember to pack enough stoma-related supplies for your time away. Be prepared for extra bag changes while traveling or on your holiday.

It may be helpful to carry a doctor’s letter explaining your condition or a travel certificate signed by your stomal therapy nurse or doctor.

Sex and body image

Who you tell and how much you say about your stoma is entirely your choice.

Once your body has had time to heal from surgery, it’s okay to have sex with a stoma. Sexual intercourse won’t harm your stoma. You may find it helpful to plan ahead, for example, emptying your stoma bag beforehand to lower the chances of any unwanted 'accidents'.

It’s important to talk to your partner about how you feel regarding sex and intimacy. If you’re nervous about how your partner may react to your stoma, remember that there’s more to how they feel about you than your physical appearance.

Resources and support

There is a range of support services to help Australians live well with a stoma.

• A stomal therapy nurse can help answer any questions regarding your stoma. You can find a nurse by visiting the Australian Association of Stomal Therapy Nurses. You can also find support groups.
• Call 1800 555 494 or visit Bowel Cancer Australia to speak with a bowel-care nurse from Bowel Cancer Australia.
• Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.
• Read the experiences of other people living with a stoma on stoma-product supplier DANSAC's website.
• Visit the Australian Council of Stoma Association for advocacy support and information on living with a stoma.
• Visit Western Australian Ostomy Association Incorporated for support.