A stoma is often described as resembling a rose bud. It may have a small spout and is pink and moist, much like the inside of the mouth. Although it looks raw, there are no nerve endings in the stoma so it has no feeling.
Where should a stoma be situated?
Where your stoma is situated will depend on whether you have a colostomy, ileostomy or urostomy. A colostomy is generally situated on the left side of the abdomen; an ileostomy or urostomy typically being situated on the right.
End or loop stoma
You can have either an end stoma or a loop stoma. An end stoma is when just one end of the bowel is formed into a stoma; a loop stoma is where a loop of bowel is brought out through the abdomen and cut so you will have two openings, one where waste will come out and the other leading down to the rectum. The opened edges of the bowel are then sutured to the skin. A loop is sometimes supported by a bridge in the early stages.
End Colostomy
End Ileostomy
Loop Ileostomy
Should a stoma change size after surgery?
Your stoma will gradually settle down during the first six to eight weeks after surgery and will normally reduce in size. Check it at least weekly with a measuring guide to make sure the hole in your stoma bag is a snug fit. This will help prevent leaks and sore skin. (You can get a measuring guide by calling our CliniMed Careline on 0808 1596017)
Things to watch out for
If your stoma is or becomes black, dusky, pale or sloughy (separating from the body), report it to your doctor or stoma nurse. You should also report any soreness, inflammation or ulceration of the skin around the stoma, and any sudden or unexplained swelling of the stoma.
A colostomy is an operation to divert 1 end of the colon (part of the bowel) through an opening in the tummy. The opening is called a stoma. A pouch can be placed over the stoma to collect your poo (stools). A colostomy can be permanent or temporary. A colostomy may be needed if you cannot pass stools through your anus. This could be the result of an illness, injury or problem with your digestive system. You may have a colostomy to treat: A colostomy is often used after a section of the colon has been removed and the bowel cannot be joined back together. This may be temporary and followed by another operation to reverse the colostomy at a later date, or it may be permanent. Read more about reversing a colostomy A colostomy is carried out while you're asleep under general anaesthetic, using either: Generally, keyhole surgery is the preferred option because recovery is quicker and the risk of complications is lower. There are 2 main types of colostomy: a loop colostomy and an end colostomy. The specific technique used will depend on your circumstances. A loop colostomy is often used if the colostomy is temporary as it's easier to reverse. In a loop colostomy, a loop of colon is pulled out through a cut in your tummy. The loop is opened up and stitched to your skin to form an opening called a stoma.Loop colostomy
The stoma has 2 openings that are close together. One is connected to the functioning part of your bowel, where waste leaves your body after the operation.
The other opening is connected to the inactive part of your bowel, leading to your anus.
In some cases, a support device (a rod or bridge) may be used to hold the loop of colon in place while it heals. It's usually removed after a few days.
End colostomy
With an end colostomy, 1 end of the colon is pulled out through a cut in your tummy and stitched to the skin to create a stoma.
An end colostomy is often permanent. Temporary end colostomies are sometimes used in emergencies.
The stoma
The position of the stoma will depend on the section of your colon that's diverted, but it's usually on the left-hand side of your tummy, below your waist.
If the operation is planned in advance, you'll meet a specialist stoma nurse to discuss the positioning of the stoma.
The stoma will be red and moist and may bleed slightly, particularly in the beginning – this is normal. It should not be painful as it does not have a nerve supply.
After having a colostomy, you'll need to recover in hospital for a few days.
You may have:
- a drip in your vein to provide fluids
- a catheter to drain urine from your bladder
- an oxygen mask to help you breathe
A clear colostomy bag will be placed over the stoma so it can be easily monitored and drained. The first bag is often quite large – it'll usually be replaced with a smaller bag before you go home.
Stoma nurse
While you recover in hospital, a stoma nurse will show you how to care for your stoma, including how to empty and change the bag.
The nurse will teach you how to keep your stoma and surrounding skin clean and free from irritation, and give you advice about preventing infection.
They'll also explain the different types of equipment available and how to get new supplies.
When you leave hospital, a local stoma nurse will visit you at home, or you may be asked to go to a stoma care clinic.
Going home
Most people are well enough to leave hospital 3 to 10 days after having a colostomy.
Once home, avoid strenuous activities that could place a strain on your abdomen, such as lifting heavy objects.
Your stoma nurse will give you advice about how soon you can go back to normal activities.
At first you will pass wind through your stoma and then, usually within 2 or 3 days, you poo through it.
This should start to improve as your bowel recovers from the effects of the operation.
Adjusting to life with a colostomy can be challenging, but most people get used to it in time.
Colostomy equipment is discreet and secure, and you should be able to do most of the activities you enjoyed before.
Your specialist stoma nurse will be able to give you further support and advice to help you adapt to life with a colostomy.
Read more about living with a colostomy and complications of a colostomy.
Colostomy UK
Colostomy UK provides support, reassurance and practical advice to anyone who's had, or is about to have, stoma surgery.
Their website has information about products you may find useful, and also provides details of stoma support groups in your area.
Page last reviewed: 16 September 2020
Next review due: 16 September 2023
A colostomy bag is a plastic bag that collects fecal matter from the digestive tract through an opening in the abdominal wall called a stoma. Doctors attach a bag to the stoma following a colostomy operation.
During a colostomy, a surgeon will bring out a portion of a person’s large intestine through the stoma. The colostomy bag can then collect stool as it passes through the gut.
A person often needs a colostomy due to injury, disease, or another issue with the lower bowels. In some cases, the colostomy is temporary. In other situations, such as the removal of the colon due to colon cancer, the colostomy may be permanent.
Keep reading for more information about colostomy bags, the types, uses, and how to live with one.
Share on PinterestA healthcare professional will attach a colostomy bag following a colostomy operation.
Following a colostomy, a person will have some choice about what type of bag they want to use. People often refer to each option as a pouching system. Pouching systems come in a variety of different styles and sizes.
Not every system works for all people. An individual must find the pouching system that performs best for them and their circumstances.
Useful things to look for when picking a pouching system include:
- odor resistance
- a bag that is easy to put on and take off
- a leakproof seal that lasts for up to 3 days
- a bag that is hard or impossible to see under clothes
- a bag that is gentle on skin around the stoma
A pouching system consists of:
- A flange, wafer, or skin barrier that attaches to the skin around the stoma.
- A pouch that attaches to the flange and collects the stool as it passes through the stoma.
Pouching systems come in two basic types:
- A one piece system where the bag attaches directly to the skin around the stoma.
- A two piece system where the flange attaches to the skin around the stoma and the bag attaches to the flange.
The type that a person selects is largely up to them. They should choose the style and size that best fits their needs.
For example, a person can choose between a reusable or single use bag. Also, a person may want some larger bags for overnight and smaller ones for the daytime.
A person should talk to their doctor about potential choices and what their recommendations are for pouch systems.
There are also other products a person may want that can help better protect the skin or help keep the bag in position. These products include:
- stoma paste to help the bag stick
- stoma powder to help absorb moisture and help the bag stay in place
- wipes to help keep the area clean
- belts to help keep the bag securely attached
Share on PinterestA colostomy bag should not prevent a person from doing most regular activities.
A person with a colostomy bag will be able to continue with many of the same activities that they did before their surgery. Most other people will be unaware that someone uses a colostomy bag unless that person tells them.
People with a colostomy bag will need to avoid lifting heavy items and may need to visit the bathroom more frequently to manage their pouching system. Otherwise, a colostomy bag should not impact too much on someone’s daily routine.
If a pouch is in position securely, an individual with a colostomy bag should be able to take part in most sports and physical activities, including running and swimming. Although people should be careful if taking part in contact sports, they may wish to wear a belt or guard for protection.
Some things a person has to consider when living with a colostomy bag include the following:
- Carrying extra bags and spare supplies when traveling.
- Taking care when using a seat belt, so it does not lie across the stoma.
- Thinking about maybe avoiding foods that cause flatulence.
- Taking extra care with children and pets to avoid damaging the bag.
- Leaving the bag in place or removing it when showering and covering the stoma if removing.
- Looking for high waisted clothes and underwear or considering buying specialty clothes.
Having a colostomy bag should not affect a person’s sexual activity or pregnancy.
The American College of Surgeons recommend changing the bag when it is between one-third and one-half full. This precaution can help prevent the bag from pulling away from the skin and leaking.
How often a person needs to change their bag largely depends on the size of the bag itself. A smaller bag will need to be emptied more frequently and is the best type to use during the day. A larger bag can last more time without emptying and is often good for overnight or sleeping hours.
Some bags are reusable while others are disposable after a single use.
To change a colostomy bag, a person:
- First, washes their hands with antibacterial soap and warm water.
- Next, gently peels the bag from the stoma.
- Removes or cuts the bottom of the bag and empties it into the toilet or puts it into a disposal bag.
- Cleans the stoma using warm water and gentle soap.
- Dries the stoma thoroughly.
- Prepares the next bag (and flange if using a two piece system).
- Attaches the bag with adhesive to the outside of the stoma.
A person may want to have wipes or other products around in case of accidental spills.
Share on PinterestA person can talk to their doctor about the type of colostomy bag that best suits their lifestyle.
Whether a colostomy is permanent or not depends on the condition that is affecting the colon.
A colostomy can be temporary in some cases. However, according to the American Cancer Society, a temporary colostomy may last weeks, months, or even years. Once the area below the colostomy heals, a surgeon can often reverse the colostomy, allowing the person’s bowels to work as they did before.
In other cases, the colostomy will be permanent, and the individual will need to live with a colostomy bag for the rest of their life. Some conditions that typically result in the colostomy becoming permanent include:
People use colostomy bags when they have a permanent or temporary colostomy. Colostomies are required when something injures, infects, or otherwise damages a person’s lower bowels.
Colostomy bags are widespread and do not interfere with most daily activities. Most people will not know that a person is using a colostomy bag unless that person tells them.
People should discuss their colostomy bag options with their healthcare team to find the system that works best for their needs. Many different types and sizes are available, so a person should be able to find one that fits the demands of their current lifestyle.