After the diseased portions of the bowel have been removed in surgery, the bowel may have to be rested for healing and a bypass of the resting bowel is made through an artificially created opening called a stoma.
This opening (stoma) is made in the abdomen so that faeces can still leave the body. A stoma may be temporary or permanent.
Patients may have an ileostomy, in which an opening made in abdominal wall through which a part of small intestine is brought out, or a colostomy, in which an opening is made to bring out a part of large intestine.
Stomal Therapy Nurse Kate Brereton at St John of God Murdoch Hospital says although it can be hard to adjust to a stoma, it’s not all “doom and gloom”, many stomas are temporary and in some patients, particularly those with inflammatory bowel disease, their quality of life improves with a stoma.
“Often, patients find it difficult to cope as they haven’t had time to prepare for the changes that come with having a stoma, but armed with helpful information and support, it is possible to overcome these challenges,” Ms Brereton says.
Before surgery, a stomal therapist will usually meet with the patient and his or her family to ensure they understand the surgery and the reasons for a stoma. Not all colorectal surgeries will result in a stoma.
An explanation of pre- and post-operative care is provided along with advice about stoma supplies and how to access them. With some stomas, there are some dietary restrictions that the nurse will explain, followed by a visit with the dietician while the patient is in hospital.
The nurse marks the site/s for the stoma position on the patient’s abdomen prior to surgery. This facilitates optimal positioning so the patient can manage their stoma well.
“There are aspects of diet/fluid intake and skin care you will need to learn before you go home from hospital,” Ms Brereton says.
“Once you have fully recovered from the surgery, there are a few limitations on diet for some stomas but you can continue to live a full life.”