Stoma care at home after surgery

What is a stoma?

According to Colostomy UK the terms ‘stoma’ and ‘ostomy’ are often used interchangeably. A stoma is an opening on the surface of the abdomen which has been surgically created to divert the flow of faeces or urine. People who have had stoma surgery are sometimes known as ‘ostomates’.

Who is likely to need a stoma?

Individuals of all ages can have a stoma. Stoma surgery is undertaken to treat a range of illnesses including cancer, diverticulitis or following a trauma to abdomen. For individuals living with a stoma, stoma care at home can be a vital part of maintaining independence and well-being. Beyond the practicalities, homecare also offers crucial emotional support and guidance, helping individuals adjust to life with a stoma and empowering them to lead fulfilling lives within the comfort and familiarity of their own home.

What are the 3 types of stoma?

There are three main types of stoma—colostomy, ileostomy, and urostomy. Each diverts waste from either the bowel or bladder, but they differ in how they function and the type of output they produce.

A stoma typically appears pink and moist, much like the inside of the mouth. It is normal for the stoma to be swollen immediately after surgery which is usually settles within 6 to 8 weeks. As a stoma has no nerve endings, touching it causes no pain or sensation.

Colostomy care

According to the NHS, a colostomy is a surgical procedure in which one end of the colon (large bowel) is brought through an opening in the abdomen. This allows stool to leave the body through a stoma rather than the anus.

A colostomy may be necessary when passing stools in the usual way is not possible, often due to illness, injury, or problems affecting the digestive system. It is commonly performed after part of the colon has been removed and the bowel cannot be re-joined. The operation is carried out under a general anaesthetic.

There are two main types of colostomy:

Loop colostomy: where a loop of the bowel is brought to the surface, often used temporarily.

End colostomy: where the end of the colon is brought through the abdomen, usually permanent.

Both involve the colon being secured to the skin to form the stoma.

Good stoma care is essential to prevent infection, protect the skin, and ensure comfort. While adjusting to life with a colostomy can take time, most people adapt well. Modern stoma equipment is discreet, secure, and allows individuals to continue most of their usual activities. Specialist stoma nurses provide ongoing advice, reassurance, and practical support to help people adjust with confidence.

Ileostomy care

An ileostomy is created to divert digestive waste away from the full length of the small intestine or colon. This may be temporary or permanent, and is often required due to conditions such as Crohn’s disease, ulcerative colitis, or bowel cancer.

Following surgery, you may need to remain in hospital for up to two weeks. During this time, a specialist stoma nurse will show you how to look after your stoma, including how to empty and change your bag, keep the stoma and surrounding skin clean, and prevent irritation. They will also explain the different types of equipment available and how to order new supplies.

Recovery can be both physically and emotionally challenging. Some people experience short-term issues such as skin irritation, anxiety, or self-consciousness. However, with the right support and stoma care, most people adjust well, and many report that their quality of life improves, particularly those who had been living with long-term conditions like Crohn’s disease before surgery.

Urostomy care

A urostomy is a surgically created opening on the abdomen that allows urine to drain directly from the kidneys when the bladder has been removed or is no longer working. It is sometimes called an ileal conduit urinary diversion because a small section of the ileum (part of the small bowel) is used to create the passage. Before surgery, the surgeon or stoma nurse will discuss the best position for your stoma. After the operation, urine will no longer pass in the usual way; instead, it will flow continuously from the kidneys, through the ureters and the segment of bowel, and out through the stoma into a collection bag.

Caring for a urostomy involves regularly emptying the bag and keeping the stoma area clean and dry. A urostomy produces urine steadily throughout the day, and most people quickly establish a routine for when and how often the bag needs to be emptied.

To empty your urostomy bag:

• Get into a comfortable position, such as standing, kneeling, or sitting on the toilet.
• Open the tap or valve at the bottom of the bag and allow the urine to drain into the toilet.
• Wipe the tap with toilet paper and close it securely.

At night, you can connect a larger overnight drainage bag to your urostomy pouch. This holds more urine, allowing you to sleep without needing to get up to empty it.

Disposal: Used urostomy bags should be placed in a sealed bag and thrown away with household rubbish.

Changing a stoma bag

Before you leave hospital your stoma care nurse will show you how to change your bag. S/he will also teach you how to use a stoma guide to check that the hole in the adhesive flange or base-plate is the correct size. If necessary, you will also be shown how to cut the right size and shape using a template. It is important to receive guidance from a specialised stoma nurse to learn how to change the stoma bag correctly.

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Guide to the changing routine:

• Check you have everything you need: water, soft wipes, a new bag, any accessories you use and a plastic disposal bag.
• Remove the old bag, working slowly and gently from the top to the bottom of the flange. Medical adhesive remover (available on prescription) can be used to avoid damaging the skin. It is wiped or sprayed beneath the flange as it is peeled away from the skin.
• Wash the stoma and surrounding skin with warm water using dry wipes (provided free by suppliers) or kitchen roll. Don’t use harsh solvents, soaps or disinfectants. Remember the stoma bleeds easily if it is rubbed too hard, but bleeding should stop quickly. If blood comes from inside the stoma, contact your stoma care nurse.
• Dry the area around the stoma thoroughly using dry wipes or soft kitchen roll. If you are prone to sore skin, barrier wipes, sprays and lotions are available.
• When your skin is completely dry, fit the new bag (or base plate). Make sure it is secure all the way round. When fitting a one-piece bag, it helps to bend the top half of the flange away from your body, so that you can see to fit the bottom half around the stoma. Then, with the flat of your hand, press the remainder of the flange in position. The warmth of your hand will ensure that it adheres snugly.
• If using a two-piece appliance, then attach the bag to the base plate.

How can Cavendish Homecare help?

At Cavendish Homecare we are experts in providing stoma homecare for clients who want to remain in their own homes. When it comes to your health and wellbeing, choosing the right homecare package is of utmost importance and navigating this process can be overwhelming. With Cavendish Homecare by your side, you’ll have the support you need to remain safely at home while enjoying elevated health and wellbeing.

If you would like to enquire about our homecare services, contact us on, 02030085210 or email us at info@cavendishhomecare.com.

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