What is a stoma and
How to live with?
A stoma, often a life saving condition
A stoma is a surgical opening on the abdomen through the skin surface for the purpose of removal of body waste (feces or urine). It is not a disease, but often a life saving condition that relieves you from troubles of diseases, obstruction and pain.
You‘ve just learned that you will need a stoma? Be assured, it is probably the best solution for your very own medical condition.
Different types of stomas
Permanent or temporary ostomy
There are different types of ostomies depending on the surgery you have undergone, either on the digestive tract (colostomy or ileostomy) or on the urinary tract (urostomy). While a urostomy is always permanent, a colostomy or ileostomy can be both permanent or temporary. A temporary colostomy or ileostomy might be needed when a part of your colon may need time to heal after having been damaged by a trauma or underlying disease. In this case, the continuity of the bowel is not interrupted as the stoma is a continuity of the digestive tract. A temporary stoma will be removed after three to six months. In other cases the ileostomy or colostomy will be permanent.
What is a colostomy or an ileostomy?
Definition of colostomy and ileostomy
A colostomy is a surgically created opening on the surface of the abdomen to divert the feces through a hole in the colon and through the abdomen. An ileostomy is constructed from the small intestine, the ileum to bypass the rectum or colon.
Regarding colostomies we distinguish between a right (or ascending) colostomy, a transverse colostomy or a left colostomy including the descending or Sigmoid colostomy. Depending on the stoma position the stool consistency vary from liquid or semi-liquid stool to formed stool (left colostomy).
Why the creation of a intestinal stoma sometimes is necessary?
The main role of a stoma is to eliminate waste from the bowel when a number of situations make it necessary to bypass the rectum, part of the colon or the whole colon. We invite you to watch the video to understand the normal functioning of the intestinal track and possible disfunction leading to a stoma creation.
What is a urostomy?
The kidneys of the urinary tract ensure blood filtration and produce the urine which is then conducted through the ureters to the bladder. The bladder serves as urine reservoir whose emptying is controlled by the sphincter. Only if the muscles and nerves in the bladder wall are working correctly a full voluntary emptying is possible.
A urostomy is a surgically created opening made to drain urine from the kidneys, after a part of the urinary tract has been damaged (bladder cancer, trauma…). There are two main types of urostomies:
Ileal conduit (left): A so called «ileal conduit» created of part of the small intestine is joined to both ureters, serving as condut tho the stoma created in the abdomen. This ileal conduit has no sensation.
Ureterostomy (right): With this technique, the surgeon brings one or both ureters through a stoma to the surface of the abdomen. The ureterostomy stoma retains sensation.
Reasons why a stoma may be necessary?
Reasons why a stoma may be necessary
Main reasons for a colostomy are:
- Inflammatory bowel disease
- Familial polyposis
- Congenital defects
- Vascular accident
Main reasons for an ileostomy are:
- Ulcerative colitis
- Crohn‘s disease
- Familial Polyposis Coli
- Congenital defects
Main reasons for a urostomy are:
- Bladder cancer
- Spinal cord injuries
- Congenital defects such as spina bifida
- Chronic inflammation of bladder
Using a stoma bag
After your stoma surgery you will need to use a stoma bag. A stoma or ostomy bag is a removable plastic bag, which is sticked on the skin around the stoma to cover it and so collect or your fecal matter from the digestive tract or the urine if you have undergone a urostomy surgery. One important thing to know is that there are different types of stoma bags available depending on your stoma and your preferences. After surgery you will be advised by your nurse or doctor which type of bag better fits to your stoma.
Questions and answers
You've learned that you will get a stoma and with this a lot of questions arise. We will try to answer some of those you may already have before undergoing the stoma surgery.
How to talk to my kids and relatives about my stoma?
Children need a climate of trust, you have to speak to them and explain the situation in a simple way. They must not have the feeling that something is being hidden from them. Sometimes, what they are imagining is often far worse than the reality. Saying that you have a stoma does not mean one have to show it! Regarding relatives, it is up to you to judge whether you find it necessary to talk about it.
Can I have intimity and sex with my partner?
Of course! Just remember to change or empty your bag before going to bed. Initially, you might be worried but gradually you will gain confidence in yourself and bedtime will no longer be synonymous with fear and apprehension but will be a moment of intimacy.
However, if the presence of the bag is a problem for you or your partner, discuss this with your E.T. nurse who can suggest various options, one of which may help you.
Contraception, pregnancy and childbirth- Will the situation be same as before my surgery?
As colostomate or ileostomate you may need to change the type of contraception you were using prior to the surgery as in the case of oral contraceptives for example, you may no longer be able to absorb the full dosage of medication (see also "What should I know taking medicine?"). You should ask your E.T. nurse about contraception following surgery.
Regarding contraception being a urostomate, you will most likely be able to keep the same as before. For more information do not hesitate to ask your doctor for advice.
However, having a stoma doesn't prevent a woman from falling pregnant or giving birth. Many women have had successful, uncomplicated pregnancies after their surgery. Indeed, in many cases they have had several children following stoma formation.
Finally, it is usually advisable to wait for about a year after your operation to have a baby, this gives you time to heal after the surgery and allows you to recover psychologically from the operation. If you have any concerns, ask your E.T. nurse.
Can I wear all kinds of clothes having a stoma?
Yes! However right after the surgery you may at first feel more comfortable in loose fitting clothes as your abdomen will be swollen and you will still be feeling a bit sore. This will gradually settle during the first couple of months, after that you will then be able to start wearing the type of clothes you want as the stoma bag will be perfectly hidden under your clothes. You might feel a little self-conscious about the bag the first few times you go out, but no worries this is perfectly normal! With time and as you go back to your usual lifestyle this feeling will gradually disappear.
Don’t be afraid to discuss any clothes preferences or any clothes related questions with your E.T. nurse before the operation (see pre-operative consultation).
After surgery, when can I start driving/traveling again?
You will start driving again when you feel enough comfortable. This can take up to 8 weeks. To be safer, you should start with a short distance or ask another insured driver to come with you.
Having a stoma shouldn't prevent you from travelling, but you will need a bit of preparation to make sure that everything goes smoothly. At the beginning, start by going away for a weekend or going back to a familiar place where you will be able to relax.
Is going back to work possible after surgery?
There is no reason why your stoma should prevent you from working (unless your doctor or E.T nurse says otherwise for a specific reason). A lot of people are able to resume their previous employment within three months depending on their surgery and type of work and subject to the condition that the job is compatible with your stoma (physical efforts needed, place of work…).
You can also ask your employer if you can start by working part time, e.g. only in the morning, or only in the afternoon or on certain days of the week. When the time arrives, talk with your employer to find out what works best for you both.