When the large bowel or colon is brought through the abdominal wall and empties into a bag, this is called a colostomy. A colostomy may be temporary or permanent, depending on the condition it was made for and the circumstances under which it was made.
Patients with a colostomy can usually eat and drink normally. The colostomy works periodically during the day, and usually produces a solid or formed stool. Depending on the type of appliance used to manage the colostomy, sometimes the bag is then emptied and if another type of appliance, the bag is then removed and discarded and a new bag applied. Modern appliances effectively absorb odour and vent gas. Leakage beneath the appliances are relatively uncommon when the appropriate appliances are used.Patients with colostomies can work, exercise, swim and have normal relationships.
Problems with stoma prolapse, parastomal hernias, retraction, stenosis or bleeding can occur and may require corrective surgery.
Stomas can also be made with small intestine. Most commonly this is part of the small intestine known as the ileum, thus the stoma is an ileostomy. They are managed in a similar way to colostomies in that the fluid that drains from them is caught in a bag attached to the skin.
Ileostomies can be fashioned in different ways depending on their use and whether they are temporary or permanent. Permanent ileostomies are most commonly ‘end’ ileostomies and thus only have one ‘hole’ or ‘lumen’ at the skin opening. Temporary ileostomies are often ‘loop’ ileostomies and have two lumens at the skin.
Because the effluent from ileostomies is liquid and is digestive, they can sometimes be a little more tricky to manage than colostomies, where the effluent is usually formed. Ileostomies are also more likely to produce dietary modifications, allowing the fluid volume coming from the stoma to be kept to a reasonable volume.
Independent of which type of stoma is formed, whilst still in hospital, you will meet one of the highly trained, skilled nurses who specialise in looking after stomas – stomatherapists. The stomatherapist will teach you how to look after your stoma and select and organise the appropriate appliances for you. They will often also visit you at home shortly after you leave hospital, to make sure you are coping away from the hospital environment. They will also facilitate your joining of the Stoma Society, so that you will always have supplies to manage your stoma.