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’.
It is now estimated that one in 335 people in the UK are currently living with a stoma. Individuals of all ages can have a stoma. Stoma surgery is undertaken to treat a range of illnesses including cancer, diverticulitis and Crohn’s disease or following a trauma to abdomen.
There are three types of stoma – colostomy, urostomy and ileostomy – all of which are diversions from the bowel or bladder, however, there are some differences between them.
In general, a stoma is pink and moist (similar to the inside of our mouths). Initially, a stoma will be swollen after the surgery, this will reduce after around 6-8 weeks. As there are no nerves in a stoma, there will be no sensation when touching it.
As stated by NHS UK a colostomy is an operation to divert 1 end of the colon (part of the bowel) through an opening in the abdomen. A colostomy may be needed if you cannot pass stools through your anus. This could be the result of an illness, injury, or problem with your digestive system.
A colostomy is often used after a section of the colon has been removed and the bowel cannot be joined back together. It is carried out while you’re asleep under general anaesthetic.
There are two types of colostomy – loop colostomy and end colostomy. Both result in an opening on the surface of the abdomen with the colon pulled through the opening and stitched to the skin to form an aperture called a stoma.
Proper stoma care is crucial for individuals with a colostomy to prevent infection and ensure a comfortable experience.
Adjusting to life with a colostomy can be challenging, however, most people get used to it in time. Colostomy equipment is discreet and secure, and you should be able to do most of the activities you enjoyed before. Your specialist stoma nurse will be able to give you further support and advice to help you adapt to life with a colostomy.
The urostomy care routine involves emptying the urine bag regularly and keeping the stoma area clean and dry. Macmillan Cancer Support explains that urostomy is an opening on your abdomen made during surgery. It lets urine drain out of the body from the kidneys if your bladder has been removed. It is sometimes called an ileal conduit urinary diversion because it is made using part of the bowel called Ileum. Before the operation, the surgeon or stoma nurse will talk to you about the best position for your stoma. After your operation, you will not pass urine in the same way as before. Instead, urine flows from your kidneys through the ureters and the piece of bowel and out of your body through the stoma. You wear a bag over the stoma to collect the urine.
A urostomy produces urine (pee) steadily through the day. Most people get into their own routine of when and how often the bag fills up and needs emptied.
To empty your urostomy bag, you will do the following:
At night, you can attach a larger bag to the tap at the bottom of your urostomy bag. Overnight urostomy drainage bags collect more urine so you do not need to empty them until the morning.
Put empty used urostomy bags in a sealed bag and dispose of them in your household rubbish.
Ileostomies are formed to either temporarily or permanently stop digestive waste passing through the full length of the small intestine or colon. This may be due to a variety of reasons, such as Crohn’s disease, ulcerative colitis or bowel cancer to mention a few.
You may need to stay in hospital for up to 2 weeks after an ileostomy operation. During this time you’ll be taught how to look after your stoma by a specialist stoma nurse. Recovering from the surgical procedure can be challenging. Many people experience short-term physical and psychological problems, ranging from skin irritation around the stoma to feelings of anxiety and self-consciousness. But with the right stoma care, many people adjust and often find their quality of life improves after surgery.
This is especially true if they have been living with a condition like Crohn’s disease for years.
While you’re recovering in hospital, a stoma nurse will teach you how to care for your stoma, including how to empty and change the bag. They’ll also teach you how to keep your stoma and the surrounding skin clean and free from irritation. The nurse will explain the different types of equipment available and how to get new supplies.
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.
· 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.
The role of the nurse specialist should not be underestimated. Once a decision is made that the patient will require a stoma, the individual will be introduced to the stoma nurse specialist, who can provide counselling. Not only that, the nurse is also able to provide as much information as required.
All our private care nurses provide 24 hour or, 12-hour care. Our priority is to ensure you or your loved feels safe and we know that finding the right nurse is part of that process. This is why each nurse or carer is selected based on your individual needs, and we aim to keep the same nurse throughout. This ensures familiarity with you and your family allowing for a seamless homecare service.
Esnart Namakando is a highly accomplished nurse with over 30 years of nursing experience. She dedicated 23 years to the Royal Hospital for Neuro-disability, where she rose to the role of Clinical Ward Manager, thriving in a fast-paced and challenging environment. Esnart has worked in various NHS and private hospitals in London as well as providing complex care to clients in their homes.
As the Deputy Nurse Manager at Cavendish Homecare, Esnart draws on her extensive expertise in neurological rehabilitation, stroke care, palliative & end-of-life care, Parkinson’s care and Dementia support. Esnart also specialises in delivering comprehensive training on subjects such as PEG feeding, stroke care, and falls prevention.