A stoma is an opening that a surgeon creates on a person’s abdomen to allow them to pass bodily waste. Stomas can be lifesaving for people with certain conditions.
A person has ostomy surgery to create a stoma. During an ostomy, surgeons connect part of a person’s intestines or bladder to their abdominal wall.
A person may need ostomy surgery if they have an injury or certain conditions, such as some cancers or types of inflammatory bowel disease (IBD).
This article discusses the functions and types of stomas and what a stoma looks like. It also discusses who might need a stoma, stoma bags, stoma care, and the surgery to create a stoma.
The function of a stoma is to allow bodily wastes to exit a person’s body through it. It forms an opening connected to part of a person’s intestine or bladder.
This allows their bodily wastes, such as stool or urine, to bypass their intestines or bladder. This may be necessary if part of the digestive system needs time to heal or if a surgeon needs to remove a part of it.
Different types of ostomy surgery create different types of stomas, depending on where in a person’s digestive system it attaches.
Colostomy
People with a colostomy have a stoma that connects to their large intestine, or colon. The stoma enables stool to evacuate into a collection device through the abdominal wall.
A colostomy may be permanent or temporary, depending on specific clinical circumstances or its location in a person’s colon.
Ileostomy
People with an ileostomy have a stoma connected to their small intestine, or ileum.
This stoma causes a person’s digestive contents to bypass their colon, rectum, and anus. It then collects in a bag or pouch outside of the body.
Ileostomies may be permanent or temporary.
Urostomy
A urostomy creates a stoma that connects to the tubes that carry urine to a person’s bladder. This redirects urine into a collection bag or pouch.
Urostomy may be temporary or permanent.
People may need a stoma if they have a condition or injury that affects their digestive system. They may need to rest part of their intestines to allow healing. In some cases, it may be necessary to remove part of the digestive system.
Colostomy
A person might need a colostomy to treat:
- bowel cancer
- anal cancer
- cervical cancer
- Crohn’s disease
- diverticulitis
- bowel incontinence
- Hirschsprung disease
Ileostomy
A person might need an ileostomy as a result of:
- inflammation, such as IBD
- infection, such as an abscess
- bowel obstruction
- ischemic bowel disease
- megacolon
- rectal incontinence due to a spinal cord injury
- Hirschsprung disease
- bowel cancer or other growths in the large bowel
Urostomy
A person might need a urostomy if their bladder does not work properly due to certain conditions, such as:
- neurogenic bladder
- chronic inflammation of the bladder
- bladder cancer
- birth defects
Stoma surgery involves an operation to place a stoma in a discreet, easy-to-reach location on a person’s lower abdomen.
A person typically receives a general anesthetic before the procedure.
Surgeons may perform open surgery or laparoscopic stoma surgery. Laparoscopic surgery is when surgeons use devices inserted through a small cut in the abdomen. Open surgery involves a larger cut in the abdomen.
A person’s doctor or surgeon will explain the type of procedure they recommend and what a person can expect before and after. This includes informing them about anything particular they need to do to prepare for stoma surgery, such as not having anything to eat or drink for a certain time beforehand.
A stoma bag is a device that fits over the stoma’s opening in a person’s abdomen using a skin seal, barrier, or flange.
Stoma bags are usually made of hypoallergenic, waterproof material to reduce skin irritation. Some stoma bags are disposable, while others are suitable for reusing.
People can care for their stoma at home, or sometimes with the help of a caregiver.
After an ostomy operation, a person receives instructions on how to care for their stoma. This includes how to clean and empty the collection bag or pouch and how often to change it.
Advice that a person may receive after the operation may include:
- using a well-fitting pouch to avoid leaks and skin irritation
- having a regular schedule to change the pouch
- avoiding waiting for leaks or other problems before changing the pouch
- cleaning the skin around their stoma with water and drying the skin completely before putting the pouch back on
- watching for any sensitivities or allergies to the pouch or attachment material, as some sensitivities and allergies may develop after weeks, months, or years
Learn about emptying and changing a urostomy pouch.
Some common possible complications of a stoma include:
- ostomy prolapse, where a part of the intestine pushes through the stoma
- ostomy stenosis, a narrowing of the opening of the stoma
- parastomal hernia, a bulging under the stoma
- skin rashes
- ostomy retraction, where a stoma goes back into a person’s body
- stoma obstructions
- ostomy ischemia or necrosis, where reduced blood flow to a stoma damages it
- dehydration
- electrolyte imbalance
- hemorrhage, or bleeding
- hematoma, or blood pooling beneath the skin
- fistula, or when a small hole develops in the skin alongside the stoma
A person’s doctor can discuss the possible complications and advise on ways to reduce these risks.
Here are some frequently asked questions about stomas.
Do you still go to the toilet with a stoma?
People with a stoma still produce bodily waste, such as stool and urine. People with a urostomy still defecate through the anus into the toilet.
Conversely, people with an ileostomy or colostomy still urinate through their urethra into the toilet. People with a stoma bag usually dispose of the contents using a toilet.
Is a stoma permanent?
Some stomas are permanent and others are not. It depends on the reason a person needs ostomy surgery. A person’s doctor can advise on whether they expect the stoma to be permanent or temporary.
What is a stoma vs. colostomy?
A colostomy is the operation that creates an opening from a person’s colon to their abdomen. The opening is called a stoma.
Stomas bypass a person’s bodily wastes from either their intestines or bladder to an external collection device. They allow part of a person’s internal organs to heal or be surgically removed if needed.
The type of stoma a person has depends on their medical condition. Types of stomas include urostomy, colostomy, and ileostomy.
A person can generally care for their stoma at home, either on their own or with the help of a caregiver. They can also contact their doctor for more advice or guidance on caring for the stoma.
Last medically reviewed on July 3, 2023
SOURCES
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https://www.ncbi.nlm.nih.gov/books/NBK565910/ - Ostomies. (n.d.).
https://www.cancer.org/cancer/managing-cancer/treatment-types/surgery/ostomies.html - Ostomy. (2021).
https://medlineplus.gov/ostomy.html - Ostomy surgery of the bowel. (n.d.).
https://www.niddk.nih.gov/health-information/digestive-diseases/ostomy-surgery-bowel - Overview: Colostomy. (2020).
https://www.nhs.uk/conditions/colostomy/ - Steinhagen E, et al. (2017). Intestinal stomas—postoperative stoma care and peristomal skin complications.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5498169/ - Why an ileostomy is done. (2023).
https://www.nhs.uk/conditions/ileostomy/why-its-done/