An Overview Of Stoma And Its Types

The first step towards anticipating the impact of a stoma is to know what a stoma is and how it functions. A stoma is an opening in the belly to allows a diversion in the digestive or urinary tract to move wastes out of the body.

The purpose of creating a stoma is to eliminate the root cause of problems in the digestive or urinary tract. The surgeon constructs this artificial opening using the end of the intestine. The stoma you see is the end of the intestine sticking out on the belly.

The appearance of the stoma

After surgery, the stoma will be swollen, but it shrinks over time. It will settle down to a permanent shape and size in 6 weeks, which is the exact duration required for the postoperative recovery to complete.

Because a stoma doesn’t have any nerve endings, it won’t feel anything. It, however, has a lot of tiny blood vessels that might result in bleeding when you rub the stoma.

Generally, a stoma is pink or red and moist. Its overall appearance is much like the inside of the mouth.

What are the types of stoma?

There are three types of stomas, with each one differentiable based on the location or type of the excretory tract where it exists. These three types include colostomy, ileostomy, and urostomy.

Colostomy

A colostomy operation refers to a procedure in which the surgeon brings a part of the colon out through a small incision in the belly to create a stoma. Although the stoma of a colostomy is usually on the left side of the abdomen, it can be at a different location depending on where on the colon you need it. With no sphincter muscles in the stoma, you will not be able to control when to expel your body wastes.

There are two types of colostomies: end colostomy and loop colostomy.

• An end colostomy is when your surgeon wants to remove a part of the colon or rectum. After removing the diseased segment of the bowel, he will bring the end of the healthy bowel out through the belly. The end colostomy can be permanent or temporary, depending on why you had to undergo the surgical procedure.
• In some conditions, the surgeon may want to pull a loop of the colon out through the belly. He will then make a small incision on the top of the loop to create a stoma. This incision opens two ends, one of which expels waste materials from the active part of the bowel, and the other one leads to the diseased segment of the colon along with the rectum and anus. The surgeon will create this stoma to give the diseased section of the bowel some time to heal.

Ileostomy

In some cases, your surgeon may want to remove or rest the entire colon. The resultant stoma that you get will bring out the end of the small intestine, and it will be called an ileostomy. With the whole colon removed, the ileostomy will have to evacuate waste materials in a more liquid form. The waste content will also contain digestive enzymes in abundance. These enzymes can be highly corrosive to the skin around the stoma. An ileostomy, too, can be of two types: an end ileostomy and a loop ileostomy.

Urostomy

The stoma that bypasses your urinary bladder is known as a urostomy. The surgeon may want to create it if you need your bladder to be removed due to any underlying condition. The surgeon will then take a piece of the small intestine, which will serve as a conduit to transport urine from the ureters to the opening in the belly. He will attach ureters to one end of the conduit and pull the other end through a cut in the abdominal wall to create a stoma.

Intimacy After an ostomy

An ostomy is a major change to your life, so it’s definitely important to find out what it’ll do to impact your activity, social life, and even diet. Your sex life and dating is another reason, but there is good news. You can still have intimacy even after an ostomy. 

How does an Ostomy Impact your intimacy 

After an ostomy surgery, you’ll learn how to clean and maintain the stoma, but also you may fee new changes due to using an ostomy pouch, but also new feelings too. You may experience anxiety, grief, even depression, and you might feel concerned about your ostomy, or worried about pouch leakage, or sometimes pain. You also may feel more energy and a better attitude, especially if the illness drained you before bowel surgery, especially if you had cancer, ulcerative colitis, or Crohn’s disease. It does impact your life, and you’ll be able to have sex lives that are normal and healthy still. 

Tips for Intimacy with an Ostomy 

First, you should make sure to give your body a chance to heal after you’ve had an ostomy surgery, and you should be doing this with all physical activities. Remember that ostomy surgeries are not a small little procedure, they can take months before you’ve fully recovered. Be gentle and patient with yourself as you get yourself together. This is a major change for many different people. Some people might need a longer recovery time, while others may need it sooner. You may also struggle with processing emotions too, including body image issues, issues with self-esteem, feeling attractive, and other complications as you get used to your stoma. Getting help and seeking out therapy and support groups is an option if you find yourself struggling. 

If you notice some side effects when you try to get intimate with someone, talk to your doctor.  This is usually quite common for those who have a rectum or large bowel removed. You may find that your sex drive has decreased, or you’re struggling to get or maintain an erection. You also may feel los of sensation around your genital area, or pain during sex. It can be embarrassing but if you talk to this now, you can figure out ways to possibly have sex without feeling pain or other complications of intercourse. You should also discuss your ostomy and intimacy with your partner. If you have someone that you’re dating that doesn’t know about the ostomy, talk to them about this. The more you talk to them about it, the better your confidence will be. You may wonder as well how to discuss feelings about the ostomy and fears too.  Try to keep open communication about the issues, surgeries, and the needs that you have surrounding intimacy and how you can work through your ostomy with this. 

If you’re ready to be intimate but your partner is not, talk to them to help discuss other concerns.  Maybe they’re worried they might hurt you or your stoma.  Work through this together. As with everything, talking to your partner about your ostomy and intimacy that surrounds it. And finally, you should make sure that your doctor gives you the green light before you start to be intimate again. Always be mindful of your stoma, and don’t do anything that could damage or hurt it. You can always discuss this as well with the medical professional to ensure nothing gets damaged during intimacy. A stoma is a big change, and it can impact your sex life. Here, we dove into what you can do to have a good sex life. 

How ostomy would affect my life

As a child, I loved to be outside. My dad works on cars a lot, and I enjoyed helping him change the breaks or do oil changes. I remember also following him around as he mowed with my own small plastic push mower, thinking I was doing something. As I grew up, I got into soccer and played that for a handful of years before entering high school. When high school hit, I wanted to try new things, so I played football my freshman year only to realize how much of a waste of money it was for me. In the spring, I did track and field, specifically pole vaulting. It was fun flying through the air. I also did it my sophomore year but was done with it after that. If I were born and needed an ostomy, I would not have been able to do half the things I did. However, today I believe it would not have a drastic effect on me. 

If I was born and had the need for an ostomy procedure, I believe my childhood growing up would have been much different. I enjoyed being outside and playing sports. I did soccer for a while. If I had an ostomy, I would not have been able to play soccer. With ostomy procedures, you need a pouch. The pouch is attached to the abdomen covering the ostomy hole, also called a stoma. The pouch is so any waste excreted from the body is collected here. If I had an ostomy, I could not play soccer because if I were to get hit there, it would not only burst the bag, but it would also cause a great deal of pain if it hit directly on the stoma.

In my high school days, I believe that an ostomy would not have been such a burden as it would have been growing up. When high school hit, I tried out a few different things. I played football and was a running back and cornerback. If I had an ostomy procedure, I would not have been able to play football because it is so rough, and I would have the same risks of my ostomy bag rupturing and hurting my stoma. Pole vault, on the other hand, could still be done if I were to remove the ostomy bag. I would need to remove it so that I won’t have any kind of restriction on my reach. I would have had to take great precautions when I land, though, because if I landed on the stoma, it would hurt a lot and possibly have some other consequences. 

Today if I had an ostomy, I believe it would not be all that bad. I like to be indoors mostly now and play on my custom-built computer. I also have a job that is mostly sitting at a desk writing. Having an ostomy would not affect me because I am mostly sitting around now. It could be beneficial because it would mean fewer trips to the bathroom; thus, I would be able to get more work done and be able to play games with more minor breaks. 

As a child, I believe having an ostomy bag would have limited me to a tiny few things I would be able to do, as a child, that would be devastating because I was very active then. Nowadays, I believe that having an ostomy would not be all that bad. Sure, I would not be able to play paintball as much as I do, but I believe I could live with that as I am older and understand things better now. 

Adapting to Life

When I was growing up, I loved sports. Sports were everything to me. I think I enjoyed sport so much because of how competitive I was. I hated losing and loved the feeling of victory, or winning. This feeling of victory and success drove me to play as much as I could. Even in physical education class, it didn’t matter what game we were playing, I wanted to win. I would often go over the top to get a victory. I can’t say I enjoyed this about myself, but I couldn’t control it. I remember thinking “I’m just going to take it nice and easy today and have fun”.

But then something would trigger me and I would go into full blown competitive mode. My classmates often said “stop taking this so seriously, it’s just a physical education game, calm down”. I didn’t appreciate their words, so I went even harder and took it even more seriously.

My eighth grade year of school, I decided to play baseball and run cross country for the junior high program at the exact same time.

I must admit, it was a lot. But, like I said, I loved the competition and playing two sports at once gave me all the chances to compete I needed. Playing sport involves risk of injury. Playing two sports at once increases that risk exponentially. And I could not escape the risk. Towards the end of cross country season, we were on the track doing 400 meter repeats. We would run a 400, then rest one to two minutes, then take off for another 400.

We had about 12 boys on the team and we would all start each 400 at the same time. Well, I had gotten tripped up by a teammate that was behind me in the first 20 meters of one of the 400’s. I ended up getting trampled on a concrete track. My entire abdomen was so skinned up. As I was looking for ways to help ease my pain, I came across some Hollister ostomy supplies.

These supplies are predominately used for folks that have had ostomy procedures. But I noticed one of the products looked like a thick belt that covered your entire abdomen. We decided to get one for me so my skin wouldn’t rub against my shirt. Although I never had an ostomy care procedure done, the Hollister ostomy supplies available definitely helped my healing process.

Looking at the Bright Side

A silver lining is when a good thing comes out of a bad thing. I’ve heard the saying “when it’s bad, it’s not all bad”. The problem is, many people have a negative mindset with most things in life. So, if something bad happens in their life they immediately think “what could go wrong next?” when really, there is plenty of goodness in our lives that we should be thankful for. For some reason, we as humans, seem to have minds that highlight and remember everything bad that has ever happened in our lives. We do this with big things and small things.

If we hit every single red light in a one mile trip, we will remember that and complain about it as it happens. But if we hit every green light in that same trip, we won’t think anything about it. We certainly won’t give thanks and appreciation that we were able to hit all green lights. I think there are silver linings in most bad things that happen if you look for them.

For instance, we have been trying to get the school district and boosters club to purchase a shooting machine for our basketball team. We have requested and requested but have been denied and denied. All of a sudden, we ended the season with three straight losses and shot a combined 23% from the field while doing so. The superintendent happened to be at the last game where we made 9 total field goals for 26 points in the game and shot eighteen percent. After the game, he sent a text to the athletic director saying “we are getting these guys that shooting machine, they really need it”.

So, even though we ended the season on a three game losing streak, and shot the ball terrible in that stretch, the silver lining is that we are going to be getting that shooting machine we’ve been desperately requesting.

Another silver lining that I have seen in my own life is when I had to have an ostomy procedure done.

Because of the ostomy supplies that are out there, I was not left with a hole in the side of my abdomen, I actually had equipment that almost simplified the process of passing stool. I no longer have to get up in the middle of the night to pee, my Hollister ostomy supplies keep my stool safe and in the bag that was provided for me after my ostomy procedure.

Changing the colostomy Pouch

After bowel surgery if you have colon cancer, you may need to use a pouch. The boxes of different supplies and the instructions for care that accompany this may be exciting but changing your pouch may scare you. If you’re good at this though, it does take less than 15 mins. 

How Often To change 

It ultimately depends on the following: 

• The ostomy location 

• The frequency and consistency of the bowels 

• The skin oiliness 

• How much activity you do 

• Temperatures both outside and inside 

• What type of appliance you like to use—whether one or two piece 

The location does determine the bowel consistency, since in a lot of cases the ones with looser stool do need to be changed more, but if it’s semi-formed, it doesn’t need to be changed as often. 

If you have moist or oily skin, or the temperature is hot, the colostomy pouch may not stick, which requires more and more changes. 

If you’re active and also like to exercise, you might need to change this more. 

Because some have to be changed more often, you should follow the guidelines and the instructions that your doctor or ET nurse have to show you how to change this. 

If you do notice leakage, it s time to change that. 

Don’t let it get more than a half to a third full, since this can impact the adherence of this. 

Supply gathering 

Before you change, you need the following. 

• Towels, water, and soap 

• The appliance and a clip if needed 

• Scissors for a two-piece type of appliance to make sure the barrier wafer is trimmed. 

• Skin adhesive 

• Stoma powder or paste 

• Disposable bag

Put all of the supplies in your bathroom and use a stool to empty the bag into the toilet before you go to change it. Some people also prefer sitting down. 

The Process 

First, you need to remove that appliance that you had before. Open up the clip, drain the contents towards the toilet before removal, and then put the clip to the side. 

Don’t rip off the wafer since that causes stress in the stoma and skin, which causes irritation and bleeding. Press down on your skin barrier with one of your hands and pull the skin away with the other. If you have hair there, trim the hair with scissors or using a razor, since this helps with discomfort. 

Get rid of the appliance in a shopping bag, and then tie the top of this in a knot to get rid of odor. 

Next you want to wash your skin and stoma. Do this gently, with a washcloth and no soap that’s scented. Air dry the area before you begin, and make sure that it’s a reddish color, or pink. 

Next, it’s then time to put the wafer skin barrier on. With a two-piece appliance, you must cut the opening near the center part. 

Cut this to match the skin before applying. Make sure the opening matches the stoma, not too big, not too small. 

Then, you hold it down there and seal it with the powder.  With two piece systems, it does require you to put the pouch in place with a snap, and make sure the clip seals the bag for an open drainage pouch. 

And that’s it! It’s not that hard to do, but it does take a little bit of experience. Hopefully though, as you go along, you can get better and better at this, and take less time with this as well.