What is a stoma?
In treating bowel or bladder cancer with surgery, your surgeon may need to create a 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 you have had bowel surgery and the stoma is temporary, it will only be needed until the newly joined bowel has healed. Often in this situation a loop of the bowel is brought out, opened and stitched to the skin. 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.
With a urostomy, a watertight bag is placed over the stoma to collect urine. This bag fills continuously and will need to be emptied throughout the day through the tap on the bag.
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.
Stoma bags can be closed (discarded after each bowel movement) or drainable (emptied). The stoma bag may be closed or drainable with a colostomy whereas with an ileostomy or urostomy, it will be drainable. A closed bag needs to be put in the rubbish after use, not flushed down the toilet.
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 should be able to continue with your usual activities unless your job or hobbies are particularly strenuous.
- 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 buy underwear designed for people with a stoma.
- You may need to make some dietary changes as some foods can cause blockages.
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.
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