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Stoma comes from a Greek word meaning ‘opening’. For us, it is a surgically made opening from the Gastrointestinal or Urinary tracts which allows us to expel our waste out of the body into an ostomy bag. The three main types are; Ileostomy, coming from the ileum, the end of the small intestine, colostomy, coming from the colon or large bowel, and urostomy from the urinary tract.
A stoma may be required as a result of surgeries for certain conditions, Crohn’s Disease, Ulcerative Colitis, Cancer, Diverticulitis, Continence issues, injuries
There will be a pre operative assessment that will assess your needs and will give an opportunity to ask questions about your particular surgery.
When you wake from surgery, you may have a drip, or multiple, in your arm, a dressing covering your wound possibly a drain from your abdomen, a catheter in your bladder, and a clear bag over your new stoma. There may be pain, this will be treated and you will be monitored and looked after by nurses and doctors on the ward. All these drains and lines will be removed during the days following surgery when appropriate until all you have left is your stoma. The stoma is not a drain or a tube, it is a little piece of your own bowel protruding from your abdomen.
Recovery from surgery can vary, depending on how ill a person may be going in to surgery and the extent of the surgery. The hospital stay post surgery can be 5-10 days.
Your stoma will be a pink/red colour, it is mucous membrane, the same lining as inside your mouth it will be warm and moist. It will be swollen after surgery, this will reduce over the following 6-8weeks. The stoma may not work for a couple of days after surgery but it will start passing wind and faecal matter through the stoma into the ostomy bag, this may be watery to start with and it will thicken up as you begin to eat more in the days after surgery. A urine stoma will work straight away producing urine only.
If you have an epidural as part of your surgery, it may take a few hours to a few days for the numbness to ease in your legs. You will be under supervision with your medical team regarding this.
Please note the stool in your stoma can change colour depending on the food you consume , this is normal however if you have any concerns plese contact your stoma nurse.
The stoma care nurses at the hospital will assess your stoma and help you choose an appropriate bag to wear. They will advise you on how much and what consistency the output from your stoma may be. An ileostomy generally produces a looser output and the bag will need to be emptied approximately 4-7 times a day, a colostomy output would be more firm and dry and may only output 1-3 times a day. The stoma nurses will teach you how to care for your stoma and set you up with equipment and give you a list of ostomy items to be prescribed that you will get from your pharmacy. You will have specialist ostomy equipment, for example remover spray, maybe a seal and an appropriate ostomy bag.
You will need to be able to remove the bag from your abdomen, clean around the area, inspect the stoma and surrounding skin and ensure it is healthy and dry and be able to place your new bag over your stoma correctly ensuring it is comfortable, allows no leakage of output and it seals and fits your abdomen well. Leakage of the output onto the skin is the main issue that people with a stoma face. The output itself is our waste and is corrosive to skin, when the skin becomes irritated and sore, the bag will struggle to adhere properly. It is so important to find the bag that fits your body profile and stoma all day every day. It is normal to have a little bleeding from the stoma surface, cleansing will be gentle, there are no nerve endings in the stoma so it will have no sensation. You will build confidence in caring for your stoma, every time you change your bag is valuable practice, be sure to go to see your stoma nurse if any problems arise.
The frequency of bag changes can vary between people.
An Ileostomy bag will need to be emptied regularly due to the looser output it produces. This bag can then be changed every 1-3days. This can depend on the person wearing it. We need to ensure that the bag is fitting us as well as it can, that there is no leakage onto the skin causing moisture associated damage to the skin and degrading of the bag.
A Colostomy bag can be either changed or emptied, sometimes the output is difficult to move through the bag and a person can choose to change rather than empty. With this a person can wear a closed bag and change the bag 1-3 times a day.
A 2 piece is an option for both Ileostomy and Colostomy where a baseplate can stay adhered to the skin and a bag be attached and released from this.
You will be given specific dietary advice while in hospital after your surgery.
There have been changes to your digestive tract as you have had surgery and a stoma formed. Therefore you will notice some changes in how food affects you.
If you have had an ileostomy, you are now no longer using your large intestine, therefore digestion time is shorter, you may not tolerate foods high in fibre and you may need to lean towards foods that slow your gut down. Some people may need to take extra care with their hydration and focus on not losing too much fluid through the stoma, you may need guidance on diet, fluids and medication. We do need to avoid any blockage of our ileostomy as this can result in a hospital admission, Foods that may block are insoluble fibres, like nuts seeds, skins raw vegetables. Find what foods suit you, some foods may cause extra wind or come through the stoma quickly.
We should get in to good eating habits, choose and prepare good food, set out time to eat, do not rush your food, chew your food well, be well hydrated, don’t drink large volumes and eat at the same time.
For a person with a colostomy, we need to make sure we keep our output good and soft, avoid any constipation. Again figure out foods that may cause extra wind for you, maybe eggs, beans, certain vegetables or fruit.
A person with a urine stoma would not have any dietary restrictions but may be prone to some constipation especially in the weeks after surgery.
When you have recovered from your surgery, you should be able to get back to doing all that you were doing prior to your surgery and hopefully more. The reason for stoma surgery in the person with IBD is to enhance your health, therefore enable you to do more.
With some considerations and adjustments you should get back to school, college, work, sport, all that you did before.
Advice on all these issues and more can be found here.
Follow all the advice that your stoma nurse gave you, identify the cause of a leak or the bag lifting. Our stomas and bodies can change over time and our bag will need to be adjusted in size or changed. Contact your stoma nurse, make an appointment or take some advice over the phone until you see them.
There is no doubt that stoma surgery changes your physical being. Hopefully, this change will have been a positive and your health is better. You need to have confidence in the way your bowel is working and in the bag that you are wearing. Know your supplies and do not run short. If you are struggling with worry, plan where you will be and for how long, what you will eat and what you will wear, know your toilets. have some practice runs. Having someone you can trust and confide in throughout your journey is a great help. Someone you can talk to. They may not have the answers to the issues you may be having but they will encourage to you to make that phone call to your stoma nurse or support group if you are having problems. They will go out for dinner with you and your friends and not have a drink so that they can drive you home if you get uncomfortable. Go to places you are comfortable in and you know the parking, the toilets etc. Each time you succeed you will gain confidence, and you will venture further.
Crohn’s and Colitis Ireland will be beginning a stoma Support Group in 2025, please visit our events page to find the next meeting. Alternatively, you can visit Ostomy Ireland for their upcoming meetings around the country.
Stoma supplies are available from your pharmacy on prescription. All ostomy items advised by any stoma nurse in Ireland will be covered on the Primary Care Reimbursement scheme (PCRS) Anyone with a PPSN is entitled to this scheme. Your pharmacist will sign you up if you are not already using it. This scheme caps the amount you pay in a month to 80 Euros per month*. If you have a medical card, these items will be covered by the medical card.
When you first order your supplies from the pharmacist, they will not have them on the shelf, they will need to order them in from their suppliers and may take a few days. Subsequently, order your supplies a week in advance of you needing them. 6-8 weeks after surgery when all the swelling has gone down you can order your bags to come pre cut. Your stoma nurse will arrange this for you.
Please be aware, if you get samples from another country, these items may not be available in Ireland. *at time of publishing, February 2025
So many people travel with a stoma. Yes, it is safe, Similar to everyone else, we need to take care that we don’t get dehydrated, sunburned, constipated, tired. Eating unusual foods can cause tummy upset or diarrhoea.
Bring what you would normally use and more to allow for extra changes. Different countries have different ostomy bags available and use different codes. If going for an extended time, arrange this with your pharmacist to give you supplies to cover you for the time you are away.
When travelling, give yourself plenty of time, maybe pack some food instead of relying on airport food.
Yes you can! You need to recover from your surgery and take the advice of your surgeon but after that you should get back to what you were doing before and more. We do need to heed hernia prevention advice but staying fit is a key to preventing hernias and ongoing good health
Swimming is great, again have confidence in your bag, maybe use some elastic tape or flange extenders to secure the bag a bit more.
If you have an ileostomy and your stoma stops working as normal and you feel there is a blockage, this could be an emergency, call your stoma nurse or GP. Stop eating and drink plenty of fluids, If the stoma does not start working/if there is pain and/or vomiting, proceed to your emergency room.
If your stoma is a colostomy, it may only produce output once a day, it is important to keep your output soft and moving, If it is dry and constipated it is difficult to pass and you may find your colostomy doesn’t work for a day or 2, drink plenty of water, eat well, if you have been advised to take a laxative, take it. If you have pain, vomiting or your stoma does not start working, seek medical attention.
If your stoma changes, if a bulge or a hernia develops, ensure the stoma keeps working, contact your stoma nurse for a review.
If your stoma becomes enlarged or falls forward out of your abdomen, contact your stoma nurse and/or your GP, you may need to proceed to the emergency room or make an arrangement to be seen in hospital.
Initially, your stoma care will be under the HSE and your hospital team.
If your stoma surgery was more than a year ago or if you are no longer in contact with your HSE stoma nurse, do not hesitate to contact the Coloplast Nursing Service on 01 9190190 or email nurseteam@coloplast.com