Bowel cancer


Having a stoma

 

A stoma is a surgically created opening in the abdomen that allows bowel movements (faeces, stools or poo) to leave the body. The end of the bowel is brought out through the opening and stitched onto the skin. Some people need a stoma after bowel surgery, which may be temporary or permanent.

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Types of stoma

The two types of stoma are a colostomy (made from the colon in the large bowel) and an ileostomy (made from the ileum in the small bowel).

Description of a colostomy with images and text

Description of a ileostomy with images and text

Stoma bag placement on body

 


A temporary stoma is only needed until the newly joined bowel has healed. In this situation, a loop stoma is often used, whereby a loop of the bowel is brought out, and then cut and stitched to the skin, creating two openings. You will have another operation, usually after 3 to 12 months, to close the stoma and rejoin the bowel. This is called a stoma reversal.

About 1 in 10 people with rectal cancer need a permanent stoma. Like the inside of the mouth, a stoma is soft, moist, and red or pink in colour. It may be level with the surrounding skin or slightly raised. The stoma itself doesn’t have any feeling, but the skin around it does. Stomas vary in size and can change shape during the weeks after surgery.

How the stoma works

When the bowel moves, wind and waste matter (faeces, stools or poo) come out through the stoma. You cannot control when this happens, so a small disposable bag is worn on the outside of the body to collect the waste. This is called a stoma bag or an appliance.

Stoma bags have adhesive on the back, so they stick firmly to the skin and provide a leak-proof, odour-proof system. A filter lets out any wind (but not the odour), which should stop the wind inflating the bag. The bag usually can’t be seen under clothing.

Some people don’t like to wear stoma bags. If you have a colostomy in your descending colon, you may be able to learn how to give yourself a type of enema (colostomy irrigation) to remove the waste every day or two. Talk to your doctor and stomal therapy nurse about this option.

Using a stoma

Attaching the bag

A stomal therapy nurse will help you choose an appliance that suits your body shape and the stoma, and will explain how to attach it securely.

Emptying the bag

Stoma bags can be drainable (able to be emptied) or closed (thrown out after each bowel movement). With a colostomy, the bag may be drainable or closed, depending on the consistency of your waste matter. With an ileostomy, you wear a drainable bag.

A drainable bag has to be emptied in the toilet when it is about one-third full. A closed bag should be put in a rubbish bin, not flushed down the toilet. A colostomy bag may need to be emptied 1 to 3 times a day depending on how much large bowel was removed, while an ileostomy bag may need to be emptied 4 to 6 times a day because the waste is more watery.

How often you need to empty a stoma bag is also affected by what you eat and drink.

Living with a stoma

Having a stoma, even temporarily, is a big change in a person’s life and takes some getting used to. However, thousands of Australians have a stoma and most lead a relatively normal life.

The stoma may sometimes affect your travel plans, social life and sexual relationships, but these issues can be managed, especially with some planning. Unless your job or hobbies are particularly strenuous, you should still be able to participate in your usual activities.

How a stoma might look

How a stoma might affect your sex life

How a stoma might affect what you can eat

Stoma prolapse

Ways to manage stoma blockages

If you have a stoma, you may need to change what you eat in the first few weeks to help the stoma settle. The amount of stoma output will vary depending on how much and when you eat.

Here are some tips to manage stoma blockages:

  • Eat regular meals.
  • Avoid eating a large amount of food at one time.
  • Try to maintain a balanced diet so your body is well nourished.
  • Aim to drink 8–10 glasses of fluid a day so you stay well hydrated.
  • Cut food into small, bite-sized pieces, and chew slowly and thoroughly.
  • If you have trouble eating a certain food, talk to a dietitian about alternatives.
  • You may find cooked food easier to digest.
  • Limit foods that are more likely to cause blockages. These include high-fibre foods, raw vegetables, fruit and vegetable skins, nuts, seeds, kernels (e.g. corn, popcorn) and sausage skins.
  • Have small amounts of a new food. If it doesn’t irritate the stoma, try more next time.
  • Massage your belly and the area around the stoma. Lie on your back and pull your knees up to your chest and roll from side to side. 

Support

See a stomal therapy nurse

Join a stoma association

Register for the Stoma Appliance Scheme

 

Understanding Bowel Cancer

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