No matter what type of ostomy you have, all the output from the stoma must be collected in a secure and convenient way. That’s where your ostomy pouch comes in. These are designed to adhere to the skin on your abdomen around your stoma and collect the output.

Secure and discreet

The design of your ostomy pouch will depend on whether you have a colostomy, ileostomy or urostomy. Your stoma care nurse will show you which one is right for you, but the overwhelming majority of pouches are secure and discreet. Nobody will know you’re wearing one unless you decide to tell them.

Although it can be difficult at first to accept the fact that you will have to wear an ostomy pouch on your stomach, you should soon start to realise that it’s possible to live much as you did before.

Changing your pouch

How often you change or empty your pouch depends on the type of stoma you have:

• Colostomy: The pouch needs to be changed between one and three times a day, depending on the amount of output.
• Ileostomy: The pouch needs to be drained several times a day.
• Urostomy: The pouch needs to be drained several times a day. During the night, a urostomy bag or a small urostomy appliance can be attached to a night bag so you don’t need to get up to drain your bag.

The digestive system

The stomach
When you eat, the food travels down a long, narrow tube called the food pipe into your stomach. Here, the food is churned into smaller pieces and your digestive juices turn it into liquid.

The small bowels
The journey continues as the contents of your stomach move into the small bowel (ileum), where digestion finishes. Your body absorbs the nutrients it needs for energy, growth and building new cells and channels these into the bloodstream.

The large bowel
When all nutrition has been absorbed, the remains move into the large bowel (colon), where your body absorbs more fluid to make the waste more solid. The muscles in your colon wall then push any waste forward into your rectum, where it passes out of your body through your anus, with the aid of the sphincter muscles, as stool.

Colostomy 

In a colostomy operation, part of your large bowel (colon) is brought to the surface of your abdomen to form a stoma (opening). A colostomy is usually made on the left-hand side of your abdomen, but may in some circumstances be on the right-hand side. When a colostomy is made on your abdomen it alters the usual way you go to the toilet to pass faeces. Instead of coming out through your anus, your faeces will pass through the stoma. The passing of faeces is usually controlled by a special sphincter muscle in the anus. However, the main difference for you when you have a stoma, is that you are no longer able to hold on to or have control over, when you need to pass faeces. You also do not have any control over when you pass wind or flatus. 

Ileostomy

In an ileostomy operation, part of your small bowel (ileum) is brought to the surface of your abdomen to form a stoma (opening). An ileostomy is usually made on the right hand side of your abdomen, but may in some circumstances be on the left hand side. When an ileostomy is made on your abdomen, it alters the usual way you go to the toilet to pass faeces. Instead of coming out through your anus, your faeces will pass through the stoma. The passing of faeces is usually controlled by a special sphincter muscle in the anus. However, the main difference for you when you have a stoma, is that you are no longer able to hold on to or have control over, when you need to pass faeces. You also do not have any control over when you pass wind or flatus. 

The urinary system

Urine is made by your kidneys and travels down two tubes called the ureters to your bladder. Urine is produced all the time, but it is stored in your bladder until you get a sense that you need to urinate. The urine then passes out of your body through the urethra.

Urostomy
When a urostomy is made, it alters the usual way you pass urine. A passage is made for urine to pass from your kidneys to the outside of your abdomen, ending in a small spout. This is called a stoma (opening).  Instead of coming out through your urethra, your urine will pass through the stoma. The passing of urine is usually controlled by a special muscle in the urethra. However, the main difference for you when you have a stoma, is that you are no longer able to hold on to or have control over, when you need to pass urine.     

After surgery, your stoma may be quite swollen to begin with, but will reduce in size over time – usually after six to eight weeks.

No sensation, no pain

A stoma is red in colour. This is because it is a mucous membrane, just like the mucous membrane inside your mouth. There is no sensation in the stoma, so it is not at all painful to touch. The stoma can bleed a little when being cleaned, especially in the beginning, but this is quite normal, and should stop shortly afterwards.

Stomas come in all different shapes and sizes - some are quite short and sit flat against the belly, while some protrude a little. Some people will have more than one stoma, depending on their condition. 

After your stoma operation you will need some time to recover. This is perfectly normal, and the time needed will vary from person to person. Your stoma will change in the first weeks following surgery, in terms of both size and output. Also, you might lose or gain weight in these weeks.

Getting started with a pouch
Having a stoma means you have no control over when you defecate or, in the case of a urostomy, when you urinate. This means that you always need to wear a pouch to collect your output.

Healthy skin
In order for your pouch to adhere properly, it is very important to keep the skin around your stoma healthy. When the pouch is attached correctly, there is no risk of smell from your stoma and less risk of skin irritation. Before you leave hospital, you will be trained in how to choose and manage your stoma pouch and how to take care of your skin.

What about food and drink?
In general you can eat and drink as normal. Try to see how your stoma reacts to different foods. Your stoma care nurse or surgeon will advise if you need to take special precautions.
In general, your stoma is no hindrance to working, socialising, playing sports, travelling or other hobbies. Your general state of health – physically as well as mentally – will play a big role in determining your quality of life as you move forward.

Talk about it
Nothing is more helpful than someone who really understands what you are going through. You are certainly not alone – the number of people with a stoma worldwide is 1.9 million. Local patient organisations and online support groups offer support through meetings and online chats, to get handy tips, inspiration and personal support.