Stoma surgery at Cambridge Hospital

What is stoma surgery?

Stoma surgery can be performed to allow waste to bypass your digestive organs if they are damaged. It's usually performed on patients who have diseases of the colon, bowel and bladder, such as Crohn’s disease, ulcerative colitis, bowel cancer and bladder or bowel endometriosis.

Following your surgery, faeces will leave your body through the new opening in your abdomen (ostomy), which is connected to a special collection pouch that you'll need to empty and change regularly.

Ostomies can be temporary or permanent depending of the level of damage, for example if you've had surgery on your bowel and it needs to heal for a while, you may have a temporary ostomy.

What types of stoma surgery are there?

There are three main types of stoma surgery:

• Ileostomy: This connects your small intestine (ileum) to an opening in your abdomen, so faeces bypasses your colon and rectum
• Colostomy: This connects your large intestine (colon) to an opening in your abdomen, so faeces bypasses your rectum
  
• Urostomy: A pouch is made using your small intestine and your ureters are connected to this pouch, so urine bypasses your bladder.

Sometimes a pouch is made internally, connecting your small intestine to your anus (back passage) with an ileal pouch (J-pouch) procedure. This is used if your large intestine needs to be removed completely, and as part of this procedure you may have a temporary ileostomy.

There are two methods of stoma surgery:

• End ostomy: The cut end of your intestine is pulled through and sewn to the opening
• Loop ostomy: A loop of intestine is pulled through the opening, which is then cut and both ends are attached to two openings – one for mucus, the other for faeces.

Is stoma surgery right for me?

Before your surgery, you'll meet with one of our specialist nurses to discuss how the stoma works and where it will be on your body. They'll also show you a variety of stoma bags and explain how they work.

There's no need to change your lifestyle if you have a stoma, and you won't need to wear any special clothing to hide your stoma bag. There are even smaller bags that can be worn discretely under swimwear.

Be sure to discuss any concerns you have with our stoma specialist. We understand this is something new and different, and we're here to help.

What happens during stoma surgery?

Stoma surgery is usually performed under general anaesthetic. The length of your procedure and type of surgery will depend on your own medical condition. Make sure you discuss what method will be used with your surgeon.

Once your operation is over, you'll be taken to the recovery room where you'll wake up from the anaesthetic.

You may have a tube in your wound to drain away any excess fluid. You'll have a stoma bag attached to your stoma. 

Recovery from stoma surgery

It can take up to 8 weeks before you can resume normal activities. 

Short-term recovery

Your stoma may feel swollen and sore, but this will ease in time. You'll be given medication to control any post-operative pain. Be sure to tell one of our healthcare team if you are uncomfortable.

You may need to stay in hospital for 7–10 days, depending on what method of surgery was used.

Once you begin to pass wind and stool, you can begin to take fluids by mouth. Your diet will gradually be increased over the next few days.

A specialist nurse will teach you all about managing your stoma.

Managing your recovery at home

Your abdomen may be sore, but it should settle over time. Make sure you follow the dietary and activity advice we give you, and attend any follow-up hospital visits.

Avoid strenuous activities for about 3 months. Discuss any return to work with your consultant.

Complications of stoma surgery

As with any surgical procedure, there's a small chance of complications, including:

• bleeding
• pain
• infection
• bruising.

Specific complications of an ileostomy/colostomy may include:

• leaking of the pouch
• infection in the pouch (pouchitis)
• obstruction or blockage in the intestine
• drainage from the anus.

The healthcare team will do their best to minimise any risks. Make sure you discuss any concerns you have about these complications with your consultant.