Hello
In our previous post in this series, we gave an overview of what a stoma is and the different types of stoma. In this post, we’ll look at the surgery to create a stoma and what happens before and after it.
As many of you will have experienced, it’s difficult for surgeons to know exactly what will be involved in surgery for ovarian cancer. Scans help to give an indication of where the cancer has grown, but they don’t always show everything. Until the surgeon starts to operate, they don’t know exactly what they’re going to find. You can find more information about surgery for ovarian cancer at ovacome.org.uk/surgery-for-....
Therefore, as part of the process of getting your consent before surgery, a stoma will very often be discussed, even if it’s not clear yet whether one will be needed. This is so that, if the surgeon finds that they do need to create a stoma, they can do it. This can be very difficult for those having the surgery, as you don’t know whether you will wake up from surgery with a stoma or not.
If a stoma is planned, or thought to be likely, the stoma nurses will be involved. They can help with the practical and emotional aspects of preparing for a stoma. This can include planning the location of the stoma based on your lifestyle, for example the clothes you like to wear. The nurse can put a dot on your abdomen where you’d prefer the stoma to go. A colostomy is usually on the left side and an ileostomy on the right.
Before surgery, the stoma nurses can talk you through the options for daily stoma care and show you the different types of bags and products and help you to prepare. You don’t have to commit to a specific type of product or care regime, as you will find out what works best for you and your lifestyle, but having an initial plan may help you to feel more confident.
As we outlined in the previous post in this series, there are two types of bowel stoma: an end ileostomy or colostomy and a loop colostomy or ileostomy.
An end stoma is permanent. It involves the surgeon cutting through the bowel and bringing the end closest to the stomach through the abdomen and stitching it in place. Food will pass from the stomach, through the remaining part of the bowel and out of the stoma.
A loop stoma may be reversible. A loop of bowel is brought through the opening in the abdominal wall, opened and stitched in place. It has two openings, one leading from the large bowel and the other towards the rectum/anus. The part of the bowel that becomes the stoma will continue to transport contents from the gut out through the stoma into the bag. The other opening at times can produce a mucus like substance.
There is more information about the different types of colostomy and ileostomy surgery at nhs.uk/conditions/colostomy/ and nhs.uk/conditions/ileostomy/.
When you wake up from surgery with a stoma, you will have a transparent bag in place with a clip or clamp or velcro at the bottom to allow emptying. This first bag is to help nurses monitor output and empty it while you recover from surgery. The bags that you will use at home are sometimes smaller and aren’t clear.
The stoma will probably be bigger than its eventual size due to swelling from the surgery and will get smaller over the next few weeks. The stoma itself won’t be painful, as it doesn’t have a nerve supply, but you will be given painkillers to manage any pain from the surgery.
At first, you will only pass wind through the stoma, and there may be some bleeding and discharge. Within two or three days you will pass your first stool, which will probably be quite liquid. As your bowel function returns to normal, the stools will become more solid. The output from an ileostomy is usually looser than from a colostomy because it comes from a part of the bowel where the contents are more liquid (small bowel).
During your recovery from surgery, the stoma nurses will work with you while you learn how to care for your stoma. You will need to make sure that you’re using the right size bag, especially while the stoma is new and hasn’t yet reached its normal size. You will need to learn how to empty and change the bag and keep the stoma clean and dry. The nurses can also provide emotional support while you adjust to having a stoma.
You can find more information on recovering from stoma surgery and learning to care for your stoma at colostomyuk.org/wp-content/....
You will probably stay in hospital for between three and fourteen days, depending on how extensive your surgery was, how your recovery is progressing and the support available to you at home. You won’t be able to do any heavy lifting or strenuous activities for the first few weeks and you will probably feel very tired. You may need help during this time with daily activities such as bathing, housework and cooking. You can find more information on recovery from ovarian cancer surgery at christie.nhs.uk/media/2246/....
If you would like to share your experience of preparing for, having and recovering from stoma surgery, or if you have any tips for anyone going through the experience, please comment on this post. You can find more information on stoma surgery at:
colostomyuk.org/information...
colostomyuk.org/wp-content/...
Best wishes
Julia (Support Services Officer)
Making it through debulking surgery. It's been tough but so far, so good 👍
Post debulking surgery 3 weeks
Low grade - Major surgery is coming
Debulking surgery options 
Slowly recovering after surgery
