What is a stoma, and what does it do?

A stoma is a surgically created opening on the abdomen that allows bodily waste to be diverted out of the body. This opening connects either the bowel or the urinary system to the outside of the body through the abdominal wall. Stomas can be temporary or permanent and are required for a range of medical reasons.

What is a stoma?

A stoma is a visible, round opening on the abdomen that collects waste into a bag. Depending on the condition being treated, it may be part of the digestive system (colostomy or ileostomy) or urinary system (urostomy). It is not painful and does not involve any part of the spine or nervous system.

Why do people need a stoma?

There are several reasons a person might need a stoma. It is usually carried out when normal There are several reasons a person might need a stoma. It is usually carried out when normal elimination through the rectum or bladder is not possible or safe.

The most common reasons include:

Bowel cancer: Surgery to remove a tumour may involve creating a stoma if a section of the colon or rectum is removed or if the new rectal anastomosis (join) made, needs a period of rest/healing.
Inflammatory bowel disease (IBD): Conditions such as Crohn’s disease or Ulcerative Colitis (UC) may damage the bowel so severely that a stoma is needed. Diverting the faeces and resting part of the bowel may improve patient’s symptoms.
Diverticulitis: Severe cases can lead to complications like perforation or abscess that may require a temporary or permanent stoma.
Trauma or injury: Physical injury to the bowel or bladder may necessitate a stoma.
Bowel obstruction: When a blockage can’t be resolved, a stoma may be formed to relieve pressure.
Congenital conditions: Some babies are born with conditions affecting the bowel or urinary tract, requiring a stoma early in life.

What operations are used to create a stoma?

The type of operation depends on the condition and the part of the body affected. Common procedures include:

Colostomy: The large intestine (colon) is brought through the abdominal wall. This is often performed after rectal cancer surgery or complications of diverticular disease.
Ileostomy: The end of the small intestine (ileum) is diverted through the abdominal wall either as an end ileostomy or a loop ileostomy. The indications may be for IBD surgery or post rectal cancer surgery.
Urostomy: Urine is diverted away from the bladder, often using a section of the bowel to form a conduit for urine to leave the body.

These surgeries may be performed using open surgery or keyhole (laparoscopic) techniques, depending on the patient's condition and the surgeon's approach.

Can a stoma be reversed?

In many cases, stomas are temporary and can be reversed once healing has taken place or the underlying condition has been resolved. However, not all stomas are reversible.

A stoma is more likely to be reversed if:

The remaining bowel is healthy and intact
The patient is in good general health
The underlying reason for the stoma has been resolved

Stoma reversal is a separate surgical procedure and may require several months of healing before it can take place. The decision to reverse a stoma will be made based on clinical assessment and patient preference.

What support is available after surgery?

People living with a stoma are usually supported by a specialist stoma care nurse. These healthcare professionals provide advice on:

Stoma management and hygiene
Diet and lifestyle adjustments
Troubleshooting problems such as leaks or skin irritation
Psychological and emotional support

Modern stoma care has improved greatly, and many people are able to lead full and active lives with a stoma.