Stoma

What is a stoma? 

If you have surgery that involves the removal of a section of your bowel or bladder you may have a stoma. In the case of cancer this can be part of the treatment for bowel,  bladder or anal cancer.

In treating cancer with surgery, your surgeon may need to create an opening (stoma) in your abdomen which is used to remove bodily waste – faeces or urine – into a small bag. A stoma may be temporary or permanent.  

There are three types of stoma: 

• colostomy which is made from the colon in the large bowel 
• ileostomy which is made from the ileum in the small bowel 
• urostomy in your small bowel to divert urine from your bladder. 

Will the stoma be permanent? 

A stoma may be permanent or temporary.  

If the stoma is temporary, it will only be needed until the newly joined bowel has healed.  In the case of a temporary stoma you will have a second operation after 3-12 months to close the stoma and rejoin the bowel. This is known as a stoma reversal.  

Fewer than 10% of people with bowel cancer will have a permanent stoma.  

How does the stoma work? 

When the bowel moves, wind and waste matter (faeces) come out through the stoma. As you cannot control when this happens, a small, disposable bag (stoma bag) is worn outside the body to collect any waste. Stoma bags have adhesive on the back so that they will firmly stick to the skin. This provides a leak-proof and odour-proof system. Usually, you can’t see the bag under your clothing.  

You will see a stomal therapy nurse who will help you to choose a stoma bag that best suits your body shape and the stoma. The nurse will also explain how to attach it securely.  

There are different types of stoma bag based on the type of surgery you have had.

Colostomy bag

A colostomy bag is a plastic bag that collects faecal matter from the stoma created in the abdomen. A colostomy bag can be closed or drainable.

A closed bag needs to be discarded after each bowel movement. You should not flush it down the toilet.

A drainable bag will need to be emptied in the toilet when it is about one-third full. Depending on how much bowel has been removed, the colostomy bag will need to be  emptied 1-3 times a day.

Ileostomy bag

An ileostomy bag is a type of stoma bag that is placed over the stoma to collect waste (faeces) that usually passed thought the large intestine (colon) and out of the body through the rectum and anus. It is a drainable bag and may need to be emptied 4-6 times a day as the waste is watery.

Urostomy bag

A urostomy bag or pouch is a type of stoma bag that is used to collect urine. It fills continuously during and so needs to be emptied throughout the day using the tap on the bag. It will be connected to a larger drainage bag at night. 

Colostomy bag

A colostomy bag is a plastic bag that collects faecal matter from the stoma created in the abdomen. A colostomy bag can be closed or drainable.

A closed bag needs to be discarded after each bowel movement. You should not flush it down the toilet.

A drainable bag will need to be emptied in the toilet when it is about one-third full. Depending on how much bowel has been removed, the colostomy bag will need to be  emptied 1-3 times a day.

Ileosotomy bag

An ileostomy bag is a type of stoma bag that is placed over the stoma to collect waste (faeces) that usually passed thought the large intestine (colon) and out of the body through the rectum and anus. It is a drainable bag and may need to be emptied 4-6 times a day as the waste is watery.

Urostomy bag

A urostomy bag or pouch is a type of stoma bag that is used to collect urine. It fills continuously during and so needs to be emptied throughout the day using the tap on the bag. It will be connected to a larger drainage bag at night. 

Living with a stoma 

Even a temporary stoma means a big change in your life and it will take some time to adjust. While the stoma can affect travel plans, social life and sexual relationships, these things can be managed.  

You may worry about how the stoma might look but although the stoma bag may feel obvious to you, most people won’t notice anything different about you unless you tell them. The location of the stoma may make some clothes such as tight waistbands, less comfortable but generally you should be able to wear your normal clothes. You can also buy underwear designed for people with a stoma.

You may need to make some dietary changes as sometimes food can build up and cause blockages. However, over time, most people will be able to eat a normal healthy diet. If you do experience a blockage for more than two hours or start vomiting you should contact your nurse or hospital.

You should be able to continue with your usual activities unless your job or hobbies are particularly strenuous.

Where can I get reliable information and support?  

Your surgeon will probably refer you to a stomal therapy nurse if they think you will need a stoma. Stomal therapy nurses are registered nurses with special training in stoma care. For more information you can visit the Australian Association of Stoma Therapy Nurses or contact Cancer Council 13 11 20.