Stoma Surgery

If you or someone you care about is waiting for or has just had ostomy surgery, this guide will help you understand the different types of stoma surgeries and what to expect before, during and after the operation.

What is stoma surgery?

Stoma surgery is an opening in the abdomen that brings the intestine to the surface. A stoma bag is then placed over the opening to collect waste (urine or faeces) leaving the body. Stoma surgery improves the quality of life for those who have difficulty with their bowels or bladder; in many cases, it is a life-saving operation.

Why would someone need a stoma?

Most people have stoma surgery due to an illness, condition or previous surgery that’s affected the digestive or urinary system function. The most common include:

• Crohn’s disease
• Ulcerative colitis
• Bowel cancer
• Bladder cancer
• Diverticulitis
• Trauma
• Birth defects

Types of stoma surgery

There are several types of stoma surgery, each tailored to the patient’s needs.

Ileostomy surgery

An ileostomy is an opening in the small intestine directing waste out through the abdomen. This may bypass a section of the bowel, if needed. When it’s only needed for a short period, usually to let a damaged area heal, stoma reversal surgery can restore normal function later on.

For ongoing conditions like severe inflammatory bowel disease (IBD) or where the large bowel has been removed, a permanent ileostomy may be needed.

Colostomy surgery

A colostomy is an opening into the colon that directs waste through the abdomen. In some cases, this is intended to be temporary, allowing the bowel time to recover after injury or illness; once healing is complete, the stoma can be reversed. If the colon is extensively damaged or removed, however, a permanent colostomy is usually required.

Transverse colostomy surgery

A transverse colostomy channels waste out before it travels down the descending colon. This approach is commonly used when part of the lower colon is blocked or has been significantly affected by conditions like colorectal cancer or diverticulitis. Diverting waste at the transverse section can help prevent further strain on the damaged area while ensuring that waste is still expelled from the body.

Preparing for stoma surgery

It’s important to be physically and emotionally prepared to handle the procedure to make it easier to manage afterwards. Make sure you have a support network ready to assist you, whether family members, friends, or even a local or virtual support group, to rely on when needed.

This will make a big difference and provide the help and encouragement you need throughout your stoma surgery journey.

Pre-surgery preparation

You’ll likely have plenty of questions beforehand. Remember, it’s normal to feel uncertain or anxious about how your life will change in the weeks and months post-surgery.

Before your operation, you’ll meet the surgeon and stoma nurse, who will answer your questions. The surgeon will go through the procedure with you and explain the most suitable type of stoma for you and whether the stoma will be temporary or permanent. The stoma nurse will explain how to care for your stoma and any lifestyle concerns you may have.

Diet Pre-stoma surgery

Before having stoma surgery, you must eat a balanced and nutritious diet. This will improve your overall health and help you recover quicker. Try to eat more fruit, vegetables and protein-rich foods. You should also limit your intake of processed foods and sugary drinks. Making small changes to your diet can help prepare your body for surgery and shorten your recovery time.

Before the surgery, you must discuss dietary restrictions or allergies with your healthcare team to ensure a safe and successful procedure.

Emotional & psychological preparation

Stoma surgery often raises emotional and psychological concerns. Patients can feel anxious about adapting to life with a stoma. Specialist stoma nurses often provide support sessions, addressing fears and offering realistic insights into what life is like post-surgery.

Support groups can connect patients with others who have undergone stoma surgery. Sharing experiences helps reduce isolation and build confidence before and after the procedure.

Family members often participate in these sessions to understand their role in helping their loved ones adjust. Counselling services are also usually available for those feeling overwhelmed or distressed. Emotional stability is as critical as physical readiness in facilitating a smoother recovery process.

The Stoma Surgery Procedure

Stoma surgery is performed under general anaesthesia. This means you’ll be put to sleep before the surgery and won’t feel anything. Recovery from stoma surgery can take some time, but with proper care and management, patients can soon lead comfortable and fulfilling lives.

Keyhole vs open surgery

Keyhole (also called laparoscopic surgery) and open surgery are two commonly used techniques for stoma surgery.

Laparoscopic surgery involves making small incisions and performing the surgery using specialised instruments and a camera.

Patients who have open surgery have a larger incision to give direct access to the affected area. Patients booked in for planned stoma surgery will usually have keyhole surgery. However, in urgent cases, the surgeon may perform open surgery.

A big advantage of keyhole surgery is that there is a lower risk of infection and you’ll recover faster. Your surgeon and stoma nurse will explain the type of surgery you’ll be having and why.

Ask questions if anything is unclear or if you’d like clarification.

Creating the stoma

The location of the stoma depends on the patient’s medical needs and the type of stoma. It’s usually created in the abdominal wall, on either the left or right side. Depending on the type of stoma, it can be placed at different levels. The stoma nurse may meet you before surgery to place some marks on your abdomen to guide the surgeon as to the best place for the stoma to be positioned.

Creating a stoma involves an incision in the abdominal wall, bringing a section of the intestine to the surface and attaching it to the skin. The waste will then be able to pass through this part of the intestine. The surgeon will choose the location of the stoma for the best outcome for the patient.

Finally, the surgeon will make sure the connection is secure and properly aligned with the digestive tract.

How long does a stoma operation take?

The operation time can vary, depending on its complexity and whether it is an ileostomy, colostomy or urostomy. Other factors determining the time the surgery takes include whether it is an emergency or planned surgery. Your surgeon will be able to discuss this with you.

Is stoma surgery a major operation?

Stoma surgery is considered a major operation. It involves making significant changes to the body and can significantly impact a person’s daily life. It requires careful preparation, a skilled surgeon and an extended recovery period.

How painful is stoma surgery?

As an opening is made in the abdomen, the affected area will experience some discomfort and soreness. The recovery process can also be uncomfortable l as the body adjusts to the new stoma and incision site.

Correct pain management and support from your medical team can reduce the pain you experience after surgery. Discuss any concerns or fears about the pain with your surgeon and stoma nurse to ensure a smooth and comfortable recovery.

How long are you in hospital after a stoma operation?

The average hospital stay is 5-7 days after stoma surgery, but it can be longer for more complex cases. This time allows for proper healing, monitoring of the stoma and monitoring for any complications. The patient will be given instructions from the doctor and must attend follow-up appointments to ensure a successful recovery.

What to expect after stoma surgery?

Some discomfort and pain will initially be felt, but this can be managed with prescribed medication.

Your stoma will be swollen, but this will start to go down over the first couple of weeks after surgery. You will be shown how to care for your stoma by your stoma nurse and you’ll be encouraged to take care of it yourself.

You may also experience fatigue and a lack of appetite, but these should improve as your body heals. To prevent infections, follow your doctor’s instructions for caring for your wounds.

In the first few weeks, you may also need to adjust your diet and daily routine. As your body adjusts to the stoma, you will gradually become more comfortable with it and may even find that it improves your quality of life.

How long does it take to recover from stoma surgery?

You should start feeling much better by 8 weeks after surgery, for some people this may be longer depending on the type of surgery and any complications. At this point, you can start thinking about returning to your usual day-to-day life. You must avoid lifting anything heavy for a few months to give your tummy muscles time to heal. As your body will have been through a major operation, you must allow time to rest and heal fully.

Post-Operative Care & Management

Proper post-operative care and management are key to a smooth recovery. The newly created stoma needs close attention to prevent complications and ensure everything works as it should.

This includes regularly cleaning and changing the stoma bag, monitoring for changes in the stool’s colour or consistency and keeping the surrounding skin clean and dry. At this stage, patients must use proper techniques to change the stoma bag and manage potential complications, such as blockages or leaks.

Speak to your stoma nurse if you have any doubts.

Cleaning the stoma

Proper cleaning and maintenance of the stoma site will help reduce complications and promote overall health. You should clean your stoma every day using water and gently pat your skin dry. It should be changed regularly to prevent leakage and skin irritation. If you are unsure about anything, your stoma nurse can help.

Diet & nutrition after stoma surgery

Your stoma nurse may recommend a low-fibre diet for the first few weeks after surgery to give your digestive system time to adjust. You may also be given meal ideas and recipes for stoma patients that will provide you with a balanced and nutritious diet.

Make sure you stay hydrated and drink plenty of fluids to prevent dehydration and/or constipation.

After your body has had time to heal, you can gradually increase your fibre intake to help regulate bowel movements. Your diet should also include lean proteins, healthy fats and a variety of fruits and vegetables, which add essential nutrients and help the healing process.

What should I do if my stoma isn’t working after surgery?

If your stoma isn’t working after surgery, you should seek medical assistance immediately. This could be a sign of complications or other underlying problems that need to be addressed by a healthcare professional. You might also need to adjust your diet or medication.

How long does pain last after colostomy surgery?

There will be pain in the first few days, which is a normal part of the healing process. This will be managed with pain medication prescribed by your doctor.

Any severe pain should be reported to your stoma nurse or doctor, as it could be a sign of complications. With proper care and follow-up, most patients report a significant reduction in pain within the first few weeks after stoma surgery.

Living with a Stoma After Surgery

Living with a stoma after surgery can be a challenging and life-changing experience. While a stoma can improve a person’s quality of life, it also requires a significant adjustment period. From learning how to properly care for the stoma and the surrounding skin to dealing with potential odour and leakage, living with a stoma can be physically and emotionally challenging.

With proper support and education, many people find ways to adapt and live full and active lives. Having a stoma does not define a person; with time and patience, it will become a natural part of everyday life.