Do I Have To Live With Stoma Forever ?

Do I Have To Live With Stoma Forever ?

Live With Stoma Forever ? – In the first blog about stoma before, I mentioned about stoma-forming surgery that could be permanent or temporary.

The formation of an intestinal stoma (usually ileostomy or colostomy) is an integral part of the surgical management of several pathologies of the gastrointestinal tract, in both emergency and elective patients.  A stoma may be created in a temporary or permanent role to reduce morbidity and mortality associated with several conditions of the gastrointestinal including perforation, inflammatory bowel disease, bowel obstruction and elective cancer operations.

Also Read What are the differences of these various COVID-19 vaccines?

A. History of Intestinal Stomas

In the pre-anaesthetic era the formation of intestinal stomas was uncommon. The names of the first few patients whose treatment comprised the forced creation of an intestinal fistula are known. The first among them was George Deppу, who had sustained an abdominal wound during the Battle of  Ramilles on 23 May 1706, after which he had a colostomy formed, which functioned for the remaining 14 years of his life. In 1737, the Queen of Great Britain, Caroline of Brandenburg-Ansbach, the wife of George II, had a spontaneous intestinal stoma (“Royal stoma”) after rupturing the membrane of strangulated umbilical hernia. Because the strangulation led not only to obstruction, but bowel gangrene as well, she died three days later. In 1750, William Cheselden operated on 73-year old Margaret White for strangulated umbilical hernia related to incoercible vomiting  and cut out 55 cm of the intestine, which was fixed at the level of the hernial orifice. Despite the horrible hygiene conditions, she survived and for a long time cared for the peristomal skin with a towel and a rag (Wu 2012, Cromar 1968 Kingsnorth 2006, Cheselden 1750). live with stoma forever

B. Types of Intestinal Stoma

Intestinal stomas can be temporary, diverting stomas designed to rest distal bowel, protect distal anastomoses (e.g. following low anterior resection) or to relieve obstruction.

Permanent stomas are indicated when primary anastomosis is not safe or possible due to the disease process (e.g. gross faecal contamination, poor blood supply or distal bowel resection precluding anastomosis as seen in abdominoperineal resection [APER] when the anus is removed).

Figure I. Different Types of Stoma

Indications for Intestinal Stomas

Table I
Table II

1. Colostomy. How it’s performed

The main surgical techniques are:

  • Open surgery (laparotomy), where the surgeon makes a long incision in the abdomen to access the colon
  • Laparoscopic (or keyhole) surgery, where the surgeon makes several smaller incisions and uses a miniature video camera and special surgical instruments to access the colon

Where possible, keyhole surgery is the preferred choice. This is because research has shown that patients recover quicker and have reduced risk of complications. However, in emergency situations, such as a bowel obstruction, the staff and equipment needed for a keyhole operation may not be available, so an open operation needs to be performed. live with stoma forever

There are 2 main ways a colostomy can be formed, a loop colostomy and an end colostomy.

1.1 Loop Colostomy

To form a loop colostomy, a loop of colon is pulled out through an incision in your abdomen. This section of colon is opened up and stitched to the skin to form an opening called a stoma. The stoma will have 2 openings, but they will be close together and you may not be able to see both.

One of the openings is connected to the functioning part of your bowel. This is where waste products leave your body after the operation. The other opening is connected to the “inactive” part of your bowel, leading to your rectum. This opening only produces small amounts of mucus.

The position of the stoma depends on which section of the colon is diverted, although it’s usually on the left-hand side of your abdomen, below your belt line. If the operation is planned in advance, you’ll meet a specialist and stoma nurse before the operation to discuss possible locations for the stoma. This may not be possible if the operation is performed as an emergency.

The stoma will appear large at first, as the effects of surgery cause it to swell. It usually shrinks during the weeks after surgery, reaching its final size after about 8 weeks. The stoma will be red and moist. It has no nerve endings, so it isn’t painful to touch. It may bleed when touched, but this is entirely normal and no cause for concern. In some cases, a support device (called a rod or bridge) may be used to hold the loop of colon in place while it heals. This will usually be removed after a few days.

A loop colostomy is usually formed temporarily to treat conditions such as diverticulitisCrohn’s disease and bowel cancer.

1.2 End Colostomy

To form an end colostomy, one end of the colon is pulled out through an incision in your abdomen and stitched to the skin to create a stoma.

Like when a loop colostomy is formed, the position of the stoma depends on which section of the colon is diverted. However, it’s usually on the left-hand side of your abdomen, below your belt line.The stoma will have one opening, through which waste products pass. The other end of the colon, which goes down to your rectum, is sealed and left inside your tummy.

End colostomies are often permanent, although temporary end colostomies are sometimes formed as an emergency to treat bowel obstructions, colon injuries or bowel cancer.

Figure 2: (a)End Colostomy and (b)Loop Colostomy

2. Ileostomy, How it’s performed  

2.1 End Ileostomy

An end ileostomy normally involves removing the whole of the colon (large intestine) through a cut in your abdomen. The end of the small intestine (ileum) is brought out of the tummy through a smaller cut and stitched on to the skin to form a stoma. Over time, the stitches dissolve and the stoma heals on to the skin.

After the operation, waste material comes out of the opening in the tummy into a bag that goes over the stoma. This type of ileostomy is often, but not always, permanent.

2.2 Loop Ileostomy

To form a loop ileostomy, a loop of small intestine is pulled out through a cut in your tummy. This section of intestine is then opened up and stitched to the skin to form a stoma. The colon and rectum are left in place. In these cases, the stoma will have 2 openings, although they’ll be close together and you may not be able to see both.

One of the openings is connected to the functioning part of your bowel. This is where waste products leave your body after the operation.

The other opening is connected to the “inactive” part of your bowel that leads down to your rectum.

The loop ileostomy is usually temporary and may be reversed during a second operation at a later date.

Figure 3 completed J-pouch procedure using two loops from the small intestine

2.3  Ileo-anal Pouch

In some cases, it may be possible to have a permanent internal ileo-anal pouch, also known as a J pouch, formed instead of an ileostomy. An ileo-anal pouch is created from the ileum and joined to the anus, so waste material passes out of your body in the normal way.

The pouch stores the waste material until you have a poo. The area around the pouch usually needs to heal before it’s used, so a temporary loop ileostomy may be created above the pouch.

A second, smaller, operation is usually carried out a few months later to close the loop ileostomy.

C. So, I have a chance to not live with my STOMA forever, right?

Due to the explanation above, we can conclude that not all stoma-formed surgery will end up with having stoma forever. There is a chance for stoma patient to have stoma closure/reversal.

The decision to have a reversal operation depends on how much and which part of the bowel has been removed. If very little of the rectum remains, then it is likely that bowel control will be impaired. Your healthcare professional will advise whether stoma reversal is possible, it is estimated that around 35% of ostomates have a temporary stoma.

The main considerations for the stoma reversal are: Journal Reversal of Stoma

  1. The doctors must be happy that you are fit enough for another operation.  n
  2. The bowel that your temporary stoma was created to protect has healed or improved since the first operation.
  3. The anal sphincters which control the flow from your bowels are working, so that loss of control of your bowels (faecal incontinence) will not develop afterwards.

Depending on what operation you have had, the surgeon may need to perform a rectal examination, and possibly arrange some further test before making this decision.

D. What does the surgery involve?

The closure of your stoma is ‘technically’ not as demanding as your previous surgery when the stoma was created. This operation involves making a cut around the stoma, to free it from the tummy wall and stitching the bowel back together to restore continuity, the stitching may be referred to as an anastomosis. The joined bowel is dropped back inside the tummy. This is followed by the stitching of the tummy wall muscles and skin. It is still considered a significant operation. Very occasionally it is necessary to reopen the original laparotomy wound scar to be able to reverse the stoma.

  • Colostomy and Ileostomy Reversal

Basically, both colostomy or Ileostomy have the same procedure during closure/reversal surgery.

If your colostomy/ileostomy is intended to be temporary, further surgery will be needed to reverse it at a later date.

The reversal operation will only be carried out when you’re in good health and fully recovered from the effects of the colostomy formation operation. This will usually be at least 12 weeks or more after the initial surgery.

However, the reversal may need to be delayed for longer if you require further treatment such as chemotherapy, or haven’t recovered from the original operation when the colostomy was formed. There’s no time limit for having the stoma reversed and some people may live with their colostomy for several years before it’s reversed.

In some cases, reversing a colostomy may not be recommended. For example, if the muscles that control your anus (sphincter muscles) were damaged after surgery, reversing the colostomy may cause bowel incontinence.

Reversing a loop colostomy is a relatively straightforward process. An incision is made around the stoma to allow the surgeon to gain access to the inside of your abdomen. The upper section of your colon is reattached to the remaining section of your colon.

Reversing ileostomy A cut is made around the stoma (like colostomy reversal surgery) and the section of small intestine is pulled out of the tummy. The area that had been divided to form the stoma is then stitched back together and placed back inside the abdomen. But the surgeon will need to make a larger incision to locate and reattach the small and large intestines.

It’s also possible to reverse an end colostomy. However, the surgeon needs to make a larger incision to locate and reattach the 2 sections of the colon. Therefore, it takes longer to recover from this type of surgery and there’s a greater risk of complications.

E. What to expect after surgery

You may have a drip in your arm to give you fluids until you are drinking.  Once you are awake you can eat and drink normally, you may find small, light, low fiber meals are better tolerated. Most people are moderately sore at the reversal site afterwards, but this can be managed with pain killers. You may feel distended following the procedure, some patients describe this as a  feeling of being “bruised and bloated” but as the swelling decreases this discomfort will ease.

Possible side effects after stoma closure:

  • Diarrhea – After the reversal it is common to experience liquid bowel motions for the first few days up to a few weeks before it settles down. In a small percentage of patients it can take up to 6 months before the bowel motions become more firm. It is fairly common to pass looser and more frequent stools than you may have been used to previously. Adjusting the food you eat and taking bowel slowing medication can help with this.
  • Frequency and urgency – It is normal to have erratic bowel movements for several weeks after this operation. You may find that you need to go to the toilet more urgently and also more often. This can be more of a problem for those who have had a low join or anastomosis in the bowel and for those who have had pelvic radiotherapy and/ or were already suffering from a weak sphincter muscle. The patients who have weak pelvic floor and anal sphincter muscles may leak gas, liquid or solid stools.  Performing pelvic floor exercises may help to regain continence but need to be practiced at least five times a day and over a few months to be of benefit. When done correctly, these exercises can build up and strengthen the muscles to help you to hold both gas and stool in the back passage. Good hygiene and a light barrier cream may be useful to prevent the skin becoming sore if you are experiencing loose and frequent stools.
Figure 4 Representative abdominal images. (a)before ileostomy reversal, (b)before and (c)after application of NPWT(Negative-Pressure Wound Therapy), and (d)3 days, (e)30 days, and (f)90 days after ileostomy reversal. (Journal: 10.1007 Evaluation of negative‑pressure wound therapy for surgical site infections after ileostomy closure in colorectal cancer patients: a prospective multicenter study)


  2. . History of Medicine 6(2): 111-117
  3. Ileostomy how it’s performed. January 20th  2020
  4. . Ostomy Day: 9 myths about having stoma. January 20th 2020

live with stoma forever live with stoma forever live with stoma forever live with stoma forever

Live With Stoma ? What Would it be ?

Live With Stoma ? What Would it be ?

Live with stoma – In Europe, approximately 700,000 people are living with a stoma, and in the USA, more than 1 million people have a stoma. In the United Kingdom (UK), a national audit shows that just under 11,500 patients diagnosed with rectal cancer each year have a stoma formed and a UK charity website indicates that each year, around 2000 people with inflammatory bowel disease (IBD) have a stoma formed.

It’s never been easy living your life with something hanging in your tummy, right? Even before you get that stoma, preparing the surgery itself was challenging for you both mentally or even physically. You might feel anxiety, fear or even loss of confidence. That’s okay, that’s normal for us who doesn’t know nothing about stoma.

Live with stoma pouch ? What would it be ? Some of you might feel depressed only by seeing your tummy, or maybe you are having problems with how to deal with that stoma thing. Stoma affect the patients’ quality of life although they help them to continue their lives

Both physically or mentally reasons, someone with stoma needs support to continuing their lives. As a person who have the stoma, or as a caregiver, or a family members who took care of it you must be understand and known many things that usually happen after you get the stoma.

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Here below the most common problems that effect of daily living activity on patients with stoma.

Daily Living Activities n%
Social LifeDifficulty in performing their religious duties2953.7
 Restricted their exercises2750.0
FoodingFeeding Time Arrangements2851.9
 Food/Beverage restriction1527.8
HygieneDifficulties in bathing3055.6
 Changed their clothing style2953.7
Problems of Stoma CarePlacement of stoma adapter in the skin627.3
 Skin Cleaning522.7
 Change of Stoma Bag418.2
 Apply Stoma Powder318.2
Stoma ProblemsDiarrhea2037.0
Psychological problemsFear937.5
 Low self-esteem625.0
 Getting away from friends/family414.8

*This descriptive study was carried out in the general surgery clinic of an university hospital in İzmir between the 1 January 2016 and 1 June 2016. The sample of the study consisted of 54 patients who were in the general surgery clinic at the time of the study, who were over 18 years of age, who had a stoma duration of at least one month.

Beside all the problems above there are still many questions that commonly the stoma’s patient asked based on what they really concern about. I would love to share this information to you, and I hope it will help you.

1. My Skin is Itchy and Irritated, what can cause and what should I do then

This can be a problem for many people that live with stoma. Redness on the skin around the stoma can be from several sources. Some of the more common reasons can include irritation from stool, sensitivity/allergy to the products you are using, or yeast.

Most commonly with an ileostomy , redness to the skin around the stoma, accompanied by burning and itching, is the result of stool having direct contact with the skin. Stool from an ileostomy is corrosive and can cause damage to the skin within a short period of time. Damaged skin will often result in itchiness and burning, particularly when the stoma is functioning. You may also notice small amounts of bleeding from the skin if the irritation has been for a prolonged period of time.

There are several possible reasons why the skin may be exposed to the stool. The opening of the flange may be too large for the size of the stoma. You should ensure that the opening of the flange is the correct size. Most ostomy suppliers have measuring devices that can help you to determine the correct size of flange opening. You can also reserve the release paper from the back of your flange (usually paper or plastic), and place it over your stoma, making sure your stoma is centered in the middle of the opening. Look in a mirror and measure the gap between the base of your stoma and the inner edge of the release paper. If you are having difficulty measuring the gap or determining the correct size, contact your nurse to help you.

Skin exposure may also be the result of an inappropriate appliance. Different characteristics of the stoma, and different characteristics of the skin around the stoma may prevent you from obtaining a “good seal” with your appliance. If you don’t have a good seal, this can allow stool to leak under your flange and to come in contact with your skin. You may require an alternative type of appliance (e.g. perhaps switching from a flat flange to one with convexity) or the addition of another product (such as a barrier ring) to help prevent leakage and skin exposure. Sometimes, a light dusting of stoma powder can dry the skin enough to provide an adequate pouching surface. Many patients also report success with something as simple as a light coating of calamine lotion, another well-known drying agent. The most important course of action is to determine if the pouch in use is the best for that stoma and for that patient’s contours.

The redness and itchiness may also be the result of a yeast infection to the skin.  Yeast infections tend to be bright red (in the initial stages; the color will change as the infection resolves), have irregular borders or edges, and will likely have several smaller pink dots on the skin away from the main part of the redness /infection. These are called satellite lesions and are new areas of yeast growth. Yeast likes to grow in moist, dark, warm places, like under an ostomy appliance. Yeast will sometimes start after someone has been on antibiotics. It can also result from frequent soaks in hot-tubs or baths, or with excessive perspiration, like in warm weather or with exercise. Yeast is easily treated with a silver based powder. The powder is applied directly onto the skin, and must be “sealed” with a skin barrier wipe. If you don’t seal the powder, the flange will not adhere to your skin. Equally, you should not use a cream based anti-fungal preparation as this will also prevent the flange from adhering. You will need to apply the powder for about a two week period. Usually, you do not need to change your flange more often than normal while using the powder. You should also check other common body sites for signs of yeast, such as under breasts, in the groin, or axillae (underarms). If you notice yeast in these areas, you will need to treat as well (though here, a cream based preparation is okay) to prevent re-infection under your flange.

If all those problems persist, make sure contact your doctor.

2. I’m Having Leakage. What can I do now?

To help solve the issue, we would ask several questions including the current pouching system being used, and the frequency of it being changed. Other questions that would assist us in problem solving might be—How are you preparing your skin before putting on your pouch? If the products are not being properly applied, it could cause adherence issues. Are you cleaning out your pouch or do you put anything in it? Most important, where is the leakage occurring? If it’s always in the same area, evaluate the area for any creases or uneven surfaces such as scar tissue, incisions, or your belly button that may cause an uneven surface under the barrier. If this is the cause, you might try a barrier ring as a filler to even out the surface area. However, make sure that the stoma size is correct in the barrier. You’ll know it’s a correct fit when the barrier fits where the skin and the stoma meet. There should be no skin exposed between the stoma and the opening of the barrier.

3. I’m not sure with My Food. What I should and What I shouldn’t Eat?

You are still having the possibility to taste your normal food or your favorite food even after you got a stoma. Although, you may get some advice from your doctor or your stoma nurse for maintaining your proper diet after your surgery.

Follow the guidelines below for the first few weeks after your surgery. This will help prevent discomfort while your colon heals.

  • Eat small, frequent meals. Try to have 6 small meals throughout the day instead of 3 large ones.
  • Eat slowly and chew your food well.
  • Drink 8 to 10 (8-ounce) glasses of liquids every day.
  • Eat mostly bland, low-fiber foods. Read the “Recommended foods” section for more information.
  • When you add foods back to your diet, introduce them one at a time.

It’s best to eat mostly bland, low-fiber foods for the first few weeks after your surgery. Bland foods are cooked, easy-to-digest foods that aren’t spicy, heavy, or fried. Eating bland foods will help you avoid uncomfortable symptoms such as diarrhea (loose or watery bowel movements), bloating, and gas.

Milk and Dairy
Foods to include in your dietFoods to limit
Non-fat (skim) or low-fat (1% or 2%)*Powdered milk*Non-dairy milks (such as soy milk and almond milk)Lactose-free dairy products (such as Lactaid products)Yogurt*Cheese*Low-fat ice cream or sherbetEggs*High-fat milk and dairy products, such as: Whole milkRegular Ice Cream or sherbetMilk and dairy products with lactose (if you have diarrhea after having them)

*If you have diarrhea after having these products, try non-dairy milks or lactose-free cheese or yogurt instead.

**When trying eggs, start with a small amount (such as 1 egg). Eggs may cause a bad odor (smell) when you open your pouch.

Meats and proteins
Foods to include in your dietFoods to limit
Lean animal proteins, such as:Meat without visible fatSkinless poultryFish*Nuts and nut butter (such as peanut)High-fat foods, such as fried meat, poultry, or fishHigh-fiber foods, such as dried or canned legumes (beans)

*When trying fish, nuts, and nut butter, start with small amounts. These foods may cuase odor when you open your pouch.

Foods to include in your dietFoods to limit
Low fiber food, such as: White bread, pasta, and riceBagels, rolls, and crackers made from white or refined flourCereals made from white or refined flour, such as Cream of Wheat, Rice Chex, and Rice KrispiesWhole grains, such as whole wheat bread, brown rice, bran cereal, quinoa, and buckwheat
Foods to include in your dietFoods to limit
Low-fiber foods, such as: Well-cooked vegetables without skins or seeds, such as peeled potatoes, peeled zucchini with the seeds removed, and peeled tomatoes with the seeds removedLettuceStrained vegetable juiceHigh-fiber foods, such as raw vegetables (except lettuce)
Foods to include in your dietFoods to limit
Pulp-free fruit juice (except prune juice and grape juice)Peeled fruit (such as a peeled apple)Canned fruit (except pineapple)Fruits with thick skins. Examples include:Soft melons, such as watermelon and honeydewOrange without the membrane (the thin clear or white part around each orange section)Ripe bananaRaw fruits with the skin. Examples include:ApplesStrawberriesBlueberriesGrapesPrune juiceGrape juice

That’s it about live with stoma, hope this article will help you.

Also Read Corona Virus Transmission and The Phenomenon of False Informations Spread Related to COVID-19


  1. Gill Hubbard, Claire Taylor, Angus J.M.Watson, Julie Munro.2020.A Physical Activity Intervention to Improve the Quality of Life of Patients with a Stoma: a Feasibility Study. Hubbard et al.Pilot and Feasibility Studies.6:12.
  2. Esma Özşaker, Tuğçe Yeşilyaprak.2018.The Problems of Patients with Stoma and its Effects on Daily Living Activities.Medical Science and Discovery.5(12):393-8.
  3. Skin Irritation. Canadian Society ofIntestinal Research.
  4. Peristomal Skin. Hollister.

live with stoma live with stoma live with stoma live with stoma live with stoma

What Stoma Really Is? Why Did I Have to Get Stoma?

What Stoma Really Is? Why Did I Have to Get Stoma?

What stoma really is? What it’s really look like? And why did I have to get that?

Maybe you kind of bit confusing about the term of stoma or maybe this is your first time hearing it. Here some information I would love to share with you about that.

The term of “stoma” or “ostomy” comes from the Greek and means “mouth”. In medicine, stoma/ostomy refers to surgically created opening of a hollow organ on the surface of the body to enable excretion of waste products.  

A stoma is a surgically created opening from an area inside the body to the outside. It looks like a small, pinkish, circular piece of flesh that is seen to your body.

Oh, no no wait? What ? there is a hole in my body? My tummy? Does it hurt ?

Actually, stoma-form through surgical by a surgeon, you will be under anesthesia and your stoma has no nerve endings so you should feel no pain from it.

Ostomy or stoma-forming surgery itself could be permanent or temporary, depending on the reason of the surgery.

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Why Do I Need Stoma ?

A Stoma-forming surgery may be undertaken for a number of reasons, such as to eradicate a disease or improve the patient’s quality of life. But what kind of diseases that really need stoma surgery ?

A stoma-forming surgery can be done by some techniques and types, due to where the main location of the diseases are held.

Small bowel ostomies (ileostomies) can be distinguished from large-bowel ostomies (colostomies), end ostomies from loop ostomies. Ileostomy are preferentially created in the right tummy, colostomies mostly in the left tummy.

A colostomy is a stoma created from a part of the colon. For this surgery, the surgeon brings the colon through the abdominal wall and makes a stoma. A colostomy may be temporary or permanent depend on what is the underlying diseases are.

Figure II
Figure III

In end (terminal) ostomies, the bowel is divided and the proximal stump is brought out (figure 2). In the case of a loop ostomy, the intestine is not transected; rather the anterior wall is opened to create the ostomy (figure 3)

The location of the colostomy or ileostomy will affect the type and consistency of stool (poop). Your colon normally absorbs water so when some or all of the colon is removed or bypassed, water may not be absorbed from stool as usual. For example, the stool from an ileostomy is mostly liquid because it doesn’t travel through the colon, which would normally remove most of the water. If you have a descending or sigmoid colostomy, your stool will be formed and solid as usual.


  1. Ostomy surgery of the bowel :
  2. Peter C. Ambe, Nadja Rebecca Kurz, Claudia Nitschke, Siad F.Odeh; 2018; Intestinal Ostomy: Classification, Indications, Ostomy Care and Complication Management. Deutsches Ärzteblatt International.
  3. National Cancer Institute Dictionary :
  4. Types and Indications of Colostomy and Determinants of Outcomes of Patients After Surgery :
  5. Colostomy and Ileostomy :