It IS a Stoma!

What is a stoma?

A stoma is an opening on the surface of the abdomen which has been surgically created to divert the flow of feces or urine.

There are three main types of stoma – colostomy, ileostomy and urostomy – all are diversions from the bowel or bladder and there are some differences between them.

Generally, a stoma will be pink and moist (like the inside of our mouths). A stoma will initially be swollen after the operation but this will reduce after 6-8 weeks.  There are no nerves in a stoma so there are no sensations when touching it. All Stomas are different in size and shape, and some protrude outward while some are flat or recessed. 

A Colostomy is the term used to describe an opening from the colon (large intestine).

An ileostomy is the term used to describe an opening from the small intestine, specifically the ileum.

A urostomy (also called an ileal conduit) is the term used to describe an opening for a person’s urine.

Things to know about your stoma:

  • Your stoma is the lining of your intestine.
  • It will be pink or red, moist, and a little shiny.
  • Stomas are most often round or oval.
  • A stoma is very delicate, but has no nerves, so does not hurt.
  • Most stomas stick out a little over the skin, but some are flat.
  • You may see a little mucus.
  • Your stoma may bleed a little when you clean it.
  • The skin around your stoma should be dry. 

The feces that come out of the stoma can be very irritating to the skin. So it is important to take special care of the stoma to avoid damage to the skin.

When to Call the Doctor:

Call your provider if:

  • Your stoma is swollen and is more than a 1/2 inch (1 cm) larger than normal.
  • Your stoma is pulling in, below the skin level.
  • Your stoma is bleeding more than normal.
  • Your stoma has turned purple, black, or white.
  • Your stoma is leaking often or draining fluid.
  • You have a discharge from the stoma that smells bad.

Stoma Care

After surgery, the stoma will be swollen. It will shrink over the next several weeks.
The skin around your stoma should look like it did before surgery.

The best way to protect your skin is by:
  • Using a bag or pouch with the correct size opening, so waste does not leak
  • Taking good care of the skin around your stoma 

Stoma appliances are either 2-piece or 1-piece sets. A 2-piece set consists of a baseplate (or wafer) and pouch. A baseplate is the part that sticks to the skin and protects it against irritation from feces. The second piece is the pouch that feces empty into. The pouch attaches to the baseplate, similar to a Tupperware cover. In a 1-piece set, the baseplate and appliance is all one piece. The baseplate usually needs to be changed only once or twice a week.

To care for your skin:
  • Wash your skin with warm water and dry it well before you attach the pouch.
  • Avoid skin care products that contain alcohol. These can make your skin too dry.
  • DO NOT use products that contain oil on the skin around your stoma. Doing so can make it hard to attach the pouch to your skin.
  • Use fewer, special skin care products to make skin problems less likely. 

If you have hair on the skin around your stoma, your pouch may not stick. Removing the hair may help.

Ask your ostomy nurse about the best way to shave the area.
  • If you use a safety razor and soap or shaving cream, be sure to rinse your skin well after you shave the area.
  • You can also use trimming scissors, electric shaver, or have laser treatment to remove the hair.
  • DO NOT use a straight edge.
  • Be careful to protect your stoma if you remove the hair around it. 

Carefully look at your stoma and the skin around it every time you change your pouch or barrier. If the skin around your stoma is red or wet, your pouch may not be sealed well on your stoma.

Sometimes the adhesive, skin barrier, paste, tape, or pouch may damage the skin. This may happen when you first start using a stoma, or it may happen after you have been using it for months, or even years.

If this happens:
  • Ask your health care provider about medicine to treat your skin.
  • Call your provider if it is does not get better when you treat it. 

If your stoma is leaking, your skin will get sore.

Be sure to treat any skin redness or skin changes right away, when the problem is still small. DO NOT allow the sore area to become larger or more irritated before asking your doctor about it.

If your stoma becomes longer than usual (sticks out from the skin more), try a cold compress, like ice wrapped in a towel, to make it go in.

You should never stick anything into your stoma, unless your doctor tells you to.

When to contact a WOCN:

Call if the skin around your stoma:

  • Pulls back
  • Is red or raw
  • Has a rash
  • Is dry
  • Hurts or burns
  • Swells or pushes out
  • Bleeds
  • Itches
  • Has white, gray, brown, or dark red bumps on it
  • Has bumps around a hair follicle that are filled with pus
  • Has sores with uneven edges

Also call a doctor or WOCN if you:

  • Have less waste than usual in your pouch
  • Have a fever
  • Experience any pain
  • Have any questions or concerns about your stoma or skin

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