Stoma

What is a stoma?

A stoma is a surgically created opening on the outside of your body that connects to an organ on the inside. The operation to create this opening and connection is called an ostomy. You might have a stoma in your abdomen if part of your intestine or urinary tract isn’t working properly and you need a different way for waste to come out. Less commonly, some people have a neck stoma to help them breathe.

Types of ostomies with stomas include:

• Colostomy: Connects your stoma to your colon
• Ileostomy: Connects your stoma to your small intestine
• Tracheostomy: Connects your stoma to your trachea
• Urostomy: Connects your stoma to part of your urinary tract (like your ureter)

Why would someone need a stoma?

Common reasons you might need an ostomy and stoma include:

• Bladder cancer
• Bowel cancer
• Inflammatory bowel disease (IBD)
• Laryngeal cancer
• Neurogenic bladder
• Neurogenic bowel
• Obstructions in your airways
• Surgery on your bowel or urinary tract

A stoma can be temporary or permanent. Sometimes, you only need one for a few months while your organ heals. After that, your surgeon can do an ostomy reversal and close your stoma. In other cases, you might need to have a stoma for life. Whether it’s temporary or permanent, learning to live with a stoma can be a big adjustment. But it can also be freeing, relieving you from a disabling disease.

How does a stoma work?

An abdominal stoma is a direct opening from the outer wall of your belly to the inside of your intestine or urinary tract. Your surgeon forms your stoma by creating an opening in the surface of your belly, then bringing a part of your intestine or ureter to the surface and stitching it there. Poop or pee will now come out of your stoma and collect into a pouch that you wear on your belly (ostomy bag or stoma bag).

A neck stoma is an opening into your throat to help you breathe. It also allows your provider to remove fluids and mucus from your respiratory system. This type of stoma has different supplies and care needs.

What does a stoma in your abdomen look like?

Your stoma is a roundish opening in your abdomen, about an inch to two inches wide. The exact location can vary, depending on the type. It’s pink or red in color and looks like moist tissue, similar to the inside of your mouth. When it’s new, it may appear swollen, but over time, it will shrink. Stomas can look a little different from person to person. Some lie flat against your skin, and some stick out a little.

What does it feel like to have a stoma in your abdomen?

Your stoma itself doesn’t have any nerve endings or feel any sensation. After your new ostomy heals, you shouldn’t feel it at all. But you might have feelings about having one. A stoma is a significant change in how your body works and looks. It’s normal to feel self-conscious or anxious about it at first. It might help to talk with a therapist or connect with a support network of other people living with ostomies.

What’s involved in stoma care?

When you have a new stoma, you’ll meet with a healthcare specialist called a stomal therapy nurse or wound ostomy continence nurse. They’ll teach you all about how to care for your stoma, including:

• How to get stoma supplies and how to use them
• How to choose the right type of stoma bag and the right fit
• How to clean and protect the skin around your stoma
• How what you eat or drink can affect your stoma output
• How to rebuild your abdominal muscles to prevent a hernia
• How to tell when your stoma needs medical attention

Your stoma nurse can also advise you on taking care of your mental health as you adjust to life with a stoma. They can connect you with support groups and other resources to improve your confidence.

What are some of the complications you can have with a stoma?

Possible complications with a stoma include:

• Leaks: Your ostomy bag can leak if it doesn’t fit snugly around your stoma. Your stoma nurse will explain how to get the right fit. The fit can also change with weight changes or pregnancy.
• Parastomal hernia: You can get a hernia next to your stoma if abdominal tissues bulge through the opening in your abdominal wall. If it interferes with your stoma, you can have it repaired.
• Skin irritation: Different things can irritate the skin around your stoma, including leaked bodily fluids, stoma bag adhesives and cleaning products. Your provider can help you troubleshoot.
• Stoma prolapse: Prolapse is when the lining of your intestine that forms your stoma starts to push further out of the opening, making your stoma stick out. Your provider can push it back in.

When should I contact my healthcare provider about my stoma?

Check in with your healthcare provider if:

• Your stoma bleeds more than a little when you clean it. (A little is normal.)
• You have pain, swelling or irritation around your stoma, or it turns black.
• There’s a hernia (a bulge) near your stoma that you can’t push back in.
• You have no output or little output from your stoma.
• You have high output from your stoma (more than advised by your healthcare provider).
• You’re having trouble with leaks or the fit of your bag.
• You’re pregnant or planning to become pregnant.

Living with a stoma

Living with a stoma takes a little extra planning when it comes to certain things. For example:

• Dating and sex: You might want to plan how to talk to your partner about your ostomy before becoming intimate. You can also buy specialty lingerie or covers to improve your confidence.
• Diet: Most people can eat as they did before with a stoma. But some people notice certain foods cause more gas or more frequent output. Adjusting your diet can help manage this.
• Dressing up: Stoma bags overall are very discreet and usually hide well under your clothes. For special occasions, you can get a smaller, more discreet bag or special concealing bodywear.
• Medications: When you have an intestinal stoma, medications in pill form won’t always work. They might pass through your stoma whole without being absorbed. Liquids can work better.
• Sports and swimming: You don’t have to avoid any sport with an ostomy bag. But you might want to invest in specialty bags, supports or caps to secure your bag and keep it watertight.
• Travel: If you’re going through airport security or customs, you might want to carry a doctor’s letter or certificate explaining what your ostomy bag is and that it shouldn’t be tampered with.