What is a Stoma.
A stoma is an opening, either natural or surgically created, which connects a portion of the body cavity to the outside environment. Surgical procedures in which stomata are created are ended in the suffix -ostomy and begin with a prefix denoting the organ or area being operated on.
In anatomy, a natural stoma is any opening in the body, such as the mouth. Any hollow organ can be manipulated into an artificial stoma as necessary. This includes the esophagus, stomach, duodenum, ileum, colon, pleural cavity, ureters, urinary bladder, and kidney pelvis.
One well-known form of an artificial stoma is a colostomy, which is a surgically created opening in the large intestine that allows the removal of faeces out of the body, bypassing the rectum, to drain into a pouch or other collection device.
I was given an ileostomy - which is when the colon is removed and the stoma (opening) is formed from the ileum or small intestine. I also have a mucus fistula which is a small opening where the end of my rectum is attached to my body.
This video explain the differences between a colostomy, ileostomy and a urostomy.
Once you have your stoma the stoma nurse will show you how to care for your stoma. This will involve emptying your pouch if you have a drainable pouch (common in ileostomies), how to remove a bag, how to clean the stoma and the skin around the stoma, how to prepare the bag (initially at least you will have to cut your own holes in the adhesive flange) and how to make sure that the bag is securely fitted.
I was not allowed out of hospital until the nurse was confident that I would be able to manage a bag change at home on my own.
The process of cleaning and changing the bag is relatively straightforward. The supplies that you are given make the process easier. My stoma essentials include adhesive remover spray and wipes to make it easy to take the bag off, wet wipes to clean, dry wipes, a barrier wipe, scissors, scented disposal bags and the pouches.
Gradually you will develop your own routine. I use a one piece drainable pouch. These can stay on for two days, however I prefer to change my bag daily. I found that if the bag is left for the two days it began to itch and the chance of leakage increases. Changing the bag simply becomes part of your daily routine
The key things to remember are to make sure everything is kept as clean as possible. I like to shower without the bag on so that everything gets a really good wash.
Sore Skin - This is usually due to the skin being in contact with output for a long period of time. It can also be due to an allergy to the adhesive used on the flange. There are loads of different products on the market so it is a matter of trial and error. If the skin is in contact with output this will heal quickly once cleaned. It is worth always using a barrier wipe or cream over the skin to help prevent this.
Bleeding on the suface of the stoma - Generally this is nothing to worry about. The surface of the stoma is very delicate (a bit like the surface inside your mouth). If the bleeding is severe and doesn't stop immediately then you need to get medical help!
Diarrhoea - As with any part of the gut you can get diarrhoea. With an ileostomy the biggest risk associated with this is dehydration so it is even more important to drink plenty of water. There are over the counter diarrhoea treatmenst that may be effective (Loperamide is one that I have used) however as with any form of diarrhoea if you are concerned or if symptoms persist then you should contact your doctor.
Blockage - This is not unusual with ileostomies and is caused by food getting stuck and not able to proceed through the stoma. Signs of a blockage include stomach cramping, nausea, swelling of the stoma, any output is likely to be minimal and watery. These can lead to hospitalisation, but can also often be resolved on your own. I have learned to drink plenty of fluids to try and wash the blockage through (which is essentially all they will do in hospital), take a warm shower and massage the area of skin around the stoma. Usually by applying gentle pressure I can move the blockage and gradually clear it. Be warned when it does clear it is worth being in the shower or over the toilet!
There are many sources on the net whic provide more detailed information about many of these common problems. Some of the delivery companies (in the UK companies such as Fittleworth or Securicare) have good information pages on their site.
As with anything if you are concerned about your stoma you should always consult the hospital or your stoma nurse.
Equipment for a Stoma.
Soon after your operation the stoma nurses will visit you and give you your first basic supplies. The appliances and equipment that you will need will depend on the type of stoma that you have.
My supplies were left in a black satchel hanging in my room. The stoma nurse then came and spent some time with me showing me the contents and helping me with my first bag change!
The stoma nurse will make your first template (the size of the hole you will need to cut in the bags). The template will change as the size and shape of your stoma settles down - straight after the operation it will naturally be swollen and larger than you expect. Your hospital bag will be kept topped up whilst you are in and you will be given enough supplies when you leave to get you to your first visit by the community stoma nurse. The community stoma nurse will then encourage you to try a variety of different bags and products until you find things that you are happy with. They will then help you to set up a prescription with a delivery company. Of course you do not have to use these products for ever more - delivery companies are always happy to provide you with samples of other products. I started with the bag I was given in hospital as it worked well for me and I liked the fact it had beige coloured plastic to hide the contents. After a few months I started having some problems with the bag - it began leaking regularly. I researched some new products online, asked for some samples and after a few trials I asked my delivery company to start providing me with the new bags.
Information sourced from Wikipedia, information leaflets and personal experience.
Please consult a medical professional at all times.