What is a stoma (ostomy)?
A stoma is a surgically created opening between an internal organ and the body surface. Stomas are sometimes required during colorectal surgery, especially during an emergency operation or for surgery with a rectal cancer.
Stomas can be permanent or temporary. They can be “loop” (loop of bowel) or “end” (end of the bowel).
The most common type of stomas made include:
- This is a made from the ileum, the last part of the small intestine.
- It is often required following surgery where there is a low join after removing the rectum for cancer (low anterior resection). This is often described as a “loop ileostomy” as a loop of ileum is brought out through the skin. This is usually “reversed” after a few months after checking to make sure that the join has healed. It may also be used to divert the stool away from an area of blockage or inflammation.
- Sometimes, after removing all of the colon, rectum and anus, a permanent end ileostomy is created.
- This may be a temporary or permament stoma.
- It may be a “loop” or an “end” stoma.
- It is most often made during an emergency operation to treat a perforation of the left colon. This can often be reversed.
How will I control my bowel movement?
After a stoma is created, the stool will empty through the stoma and be collected by a specially designed pouch or bag. A stomal nurse will help you with learning how to manage this including support groups and where to access supplies.
Will my diet be limited?
Generally your diet will be the same as before. You may need to alter your fibre intake and take medications to control the volume and frequency of your bowel movements. Over time, most patients can have a normal diet without requiring any medications.
Will other people know I have a stoma?
Not unless you tell them. A stoma is easily hidden by your clothes.
Will it interfere with my physical activity or sex life?
Once you have recovered from surgery, you can resume normal activities. There are professional athletes competing with a stoma. Most patients with stomas will resume their normal sexual activity. There can be a change in body image that can be overcome with a strong relationship, communication and support groups.
What are the complications of a stoma?
While you are getting used to managing your stoma, occasional “accidents” can occur. Once you have adjusted to having a stoma, most problems are minor such as skin irritation that can be managed with simple measures such as pastes and powders. Other problems include hernias and prolapse. These may need to be fixed by a surgeon.
What is a colorectal surgeon?
A colorectal surgeon is an expert in the surgical and non-surgical treatment of colon and rectal conditions. In Australia, a colorectal surgeon has completed general surgical training to be a specialist general surgeon (FRACS). A minimum of 2 years of clinical post-fellowship training is then undertaken in high volume accredited institutions through the Colorectal Surgical Society of Australia and New Zealand (CSSANZ). There is also a research requirement and a written examination on colon and rectal conditions. An equivalent domestic or international experience may qualify a surgeon for CSSANZ accreditation.