What is a stoma?

A stoma is an opening that is made through the tummy (abdominal) wall. It connects the bowel to the surface of the tummy. The stoma is round or oval-shaped, and it looks pink and moist. It has no nerve supply, so it does not hurt.

Having a stoma means poo (stools) will not pass out of the rectum and anus in the usual way. Instead, it will pass out of the stoma, into a disposable bag that is worn over the stoma.

If the stoma is made from an opening in the colon, it is called a colostomy. If it is made from an opening in the small bowel (ileum), it is called an ileostomy.

Stomas may be temporary or permanent. A surgeon may make a temporary stoma to allow the bowel to heal after surgery. If you have a temporary stoma, you will usually have a second smaller operation a few months later to close the stoma and re-join the bowel. This operation is called a stoma reversal (see below).

Only a small number of people with colon cancer need a permanent stoma. If you have rectal cancer, you need a permanent stoma if the cancer is very low in your rectum and close to the anus.

Your surgeon will tell you whether you are likely to have a stoma after your operation, and whether it will be temporary or permanent. If you need to have a stoma, you will be referred to a stoma nurse who specialises in stoma care. They can talk to you about what to expect.

You will usually see a stoma care nurse on the first day after your operation. For the first few days, they will show you how to look after the stoma and change the bags. The stoma will be swollen at first, and it can take several weeks before it settles down. The stoma care nurse will help you cope with any problems. You may want to have a family member or friend with you when you are shown how to care for your stoma. This means they will know how to help you at home, if needed.

Learning to look after a stoma takes time and patience. No one expects you to be able to cope straight away. It will get easier with time and practice. The stoma care nurse will continue to support you after you go home.

If you have an ileostomy, you will wear a stoma bag that opens at the bottom, so you can empty it. An ileostomy produces semi-liquid waste continuously, so you will need to empty the bag several times a day. If the bag needs emptying very often, your doctor can prescribe you anti-diarrhoea medicines to help.

A colostomy may be active 2 or 3 times a day, but this will vary from person to person. It will also be affected by what you eat. It will usually settle into a pattern after a few weeks, so you can predict when it is likely to be active. You will usually need to change your stoma bag 1 to 3 times a day.

Some people with a colostomy are taught how to flush out (irrigate) their colostomy once a day. This helps them to control when it is active. If you want to try this, talk to your stoma care nurse.

Before you change or empty your bag, make sure that you have plenty of bags and cleaning materials with you. It is a good idea to keep everything you need in one place, so that you do not have to search for things at the last minute. Give yourself plenty of time, so you can work at your own pace without any interruptions.

There are different types of ileostomy and colostomy bags and supplies. Your stoma care nurse will give you supplies to take home with you. When you have used these, you will need to order supplies from your pharmacy or a specialist supply company. Your stoma care nurse will help you choose what is suitable for you.

The Ileostomy and Internal Pouch Support Association and Colostomy UK have details of companies that provide stoma supplies.

You will need a prescription from your GP to get stoma supplies. In England, prescriptions are free for people with cancer. However, if you are aged between 16 and 60, you will need to make sure your doctor signs an FP92A form saying that you are entitled to free prescriptions. Prescriptions are free for people living in Scotland, Wales and Northern Ireland.

If you have a temporary stoma, you can usually have an operation to reverse the stoma when your treatment finishes. This is when the piece of bowel from your stoma is re-joined with either your colon or small bowel, and the stoma opening is closed. This means you will pass poo (stools) from your bottom again.

How the stoma reversal is done depends on the type of stoma you have. When you have a stoma reversal the operation is different for each person. It can be from a few months after the stoma was made, to 1 or 2 years later. Your surgeon and stoma nurse can tell you more about having a stoma reversal and when it might be best to have it done.

After a stoma reversal, it may take some time for your bowel function to get back to normal. We have information about coping with bowel changes. You can also learn more about stoma reversal from Colostomy UK.