A healthy stoma

A stoma is an opening in your stomach that allows food to pass through into the bowel or small intestine. Thus, it formed when part of your bowel gets cut out, and the two ends are brought up to the skin's surface to be easily attached to a bag.

Your stoma will look different depending on its placement, but it should not feel painful. Your consultant will discuss with you how to care for your stoma before you go home after surgery. 

Signs that your stoma has problems

1. Skin irritation

Your skin around your stoma will be red and sore at first because it is irritated by stool passing out of your bowel into the bag. This usually settles over time but follow any advice given about caring for your skin. If pain persists, see your doctor. 

2. Distorted vision

You may get distorted vision if the omentum covers your stoma or causes swelling which presses on an optic nerve. This will usually settle over time but see your ER if it persists.

3. Constipation 

Some people find that their bowel takes longer than usual to work after surgery, which may cause constipation. It would help if you drank enough fluid throughout the day not to become dehydrated, but avoiding drinks containing caffeine can help. Your doctor may advise the use of laxatives

4. Bleeding 

If there is blood on the outside of your bag, change the bag as soon as possible. Blood coming out of the stoma is usually just around its base, attached to the surrounding skin. This should settle within a few days but see your ER if it doesn't improve. Changing the posture you use to apply pressure can sometimes help with pain caused by bleeding around the stoma.

5. Your stoma appears black or dark brown. This may mean that your bowel is not working correctly. The doctor should investigate it.

6. If there is still no change in your stoma's appearance after two weeks, you should see your ER. Do not attempt to pull out any black or dark stomas yourself because leaving fragments behind can damage the bowel.

Improving your stoma 

1. Wearing a support belt: You may need to wear an abdominal support belt for six weeks, particularly during heavy work that puts strain on your abdomen, such as weightlifting or carrying heavy objects.

2. Nutritional supplements: You can take any vitamins, minerals, or other dietary supplements that you would typically take unless they are contraindicated (not recommended) by your consultant.

3. Your stoma may be more sensitive to stimulation, such as during sexual intercourse.

4. Avoid removing the appliances put in place at the time of surgery unless they need change for another type. 

5. Exercises are vital. Your stoma will not function if you aren't getting the blood flowing correctly through it and within your body. You can use many workout regimens for this purpose, so find what works best for you. Swimming is one exercise that's especially good for those carrying around an ostomy bag because it doesn't put any pressure on your stomach area.