Stomas

A stoma is where intestine is brought out on the anterior abdominal wall to divert faeces, so that faeces no longer pass through the anus. A stoma appliance bag is applied to the stoma to prevent soiling.

Types of stomas

If the intestine brought out as a stoma is large intestine (i.e. colon), then the stoma is referred to as a colostomy. If the intestine brought out is small intestine (i.e. ileum) then the stoma is referred to as an ileostomy.

Most ileostomies are on the right side of the abdomen, and most colostomies are on the left side of the abdomen.

Temporary versus permanent stomas

Most stomas are temporary, and used to protect a joining (anastomosis) and are reversed after 3 months. Occasionally a permanent stoma is needed, and this is usually because the anus or rectum has to be totally removed (figure 1).

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Stomal therapists

Each hospital has a stomal therapist, who can educate you before and after your surgery on the use of a stoma. They will answer many questions you may have. If a stoma is a possibility with your surgery, a stomal therapist will see you prior to your operation (usually the day of your surgery) to site your stoma. This involves an assessment of size, shape and dexterity, to allow for the stoma to be placed in the best position for you to manage it. It is also an excellent opportunity to discuss any concerns you may have about stomas prior to your surgery. The stomal therapy website is http://www.stomaltherapy.com.

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