The importance of stoma care

Nurses and health care staff will come across patients with a stoma during some point in their career.

They may work in a variety of clinical settings, including the nursing home, and so it’s important that both nurses and care staff know how to manage a stoma, and that they are able to offer advice and support.

Ongoing health care training and support must be given to all staff to ensure that this happens.

📌Related: Stoma Care Training.

👉Relevant: Stoma Care Train the Trainer.

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What is a stoma?

The word ‘stoma’ actually comes from the Greek word meaning opening. A stoma is when a surgeon has made an opening from the abdominal wall, allowing part of the bowel to be pulled through.

Here faeces can exit the body, as opposed via the rectum.

A stoma is pink or red in colour and is wet to the touch, somewhat like the inside of your mouth.

Although a stoma may look painful, it isn’t because there are no nerve endings. However, this also has its downsides as it can be difficult for the individual to know if any damage has occurred.

This is why the from a needs to be observed regularly during bag changes. A stoma can be temporary, allowing the area to heal after treatment or surgery, or it can be permanent, depending on the condition and its severity.

The decision to create a stoma is made based on the person’s medical needs and the potential to improve their quality of life.

What then is Stoma Care?

Stoma care is the process of looking after a surgically created opening on the abdomen, which helps the body get rid of waste.

This opening, called a stoma, requires special care to keep the skin healthy and prevent problems.

The main tasks in stoma care include changing the stoma bag, cleaning the skin around the stoma, and checking for any changes or issues.

Good stoma care helps avoid skin irritation, infection, and other health problems. It is important to make sure the stoma bag fits properly and to empty or change it when needed. The skin around the stoma should be cleaned carefully using warm water and mild soap.

People with a stoma, or their caregivers, should watch for any signs of problems, such as skin redness, swelling, or changes in how the stoma looks.

They should also pay attention to their diet to avoid issues like constipation or diarrhoea.

Regular visits to healthcare professionals, such as stoma care nurses, are important to get support and help with any concerns.

Stoma care also includes learning how to manage everyday activities like bathing, exercising, and travelling, while taking care of the stoma.

Importance of Stoma Care

Stoma care is very important for patients who have had stoma surgery. Here’s why proper stoma care matters:

1. Better daily life

Good stoma care helps people get used to living with a stoma (a small opening in the body to remove waste). It lets them do normal things again and feel happy and healthy.

2. Stops problems early

Checking the stoma regularly helps spot issues like sore skin, infections, or bulges around the stoma. Fixing these early keeps people safe and comfortable.

3. Teaches people to help themselves

Nurses teach patients how to clean their stoma, change the bag that collects waste, and care for their skin. This helps people feel confident to look after themselves.

4. Emotional help

Having a stoma can be scary or upsetting. Nurses give kind advice and support to help people feel calm and positive about their new life.

5. Ongoing support

Nurses help before and after surgery, and for as long as needed. They answer questions about food, clothes, staying clean, and even relationships.

6. Less time in hospital

When people learn to care for their stoma, they can go home sooner. It also means fewer trips back to the hospital for problems.

7. Saves money

Good care at home means fewer emergencies or extra treatments, which is better for the NHS and families.

8. Staying active

With the right care, people can go back to work, enjoy hobbies, meet friends, or play sports.

9. Happy patients

Most people feel very happy with the help they get from stoma care nurses.

10. Holistic Care

Nurses don’t just focus on the stoma—they help with everything, like eating well, staying clean, and feeling good about life.

A stoma can be temporary, helping the body heal after treatment or surgery, or it can be permanent, depending on the health problem and how serious it is.

The decision to have a stoma is made based on the person’s health and whether it will improve their quality of life.

Why do people need a stoma?

So, why do people need a stoma? There are so many medical reasons as to why a person may need to have a stoma.

Reasons include those of cancer of the bowel, inflammatory bowel disease (IBD) and diverticular disease, in which parts of the bowel ‘die’.

Common reasons include:

1. Cancer
   • Bowel cancer or cancers in the pelvic area (like bladder or womb) that damage the gut or bladder.
2. Long-term bowel swelling
   • Diseases like Crohn’s or ulcerative colitis that cause pain, bleeding, or blockages in the gut.
3. Infected pouches in the gut
   • Diverticulitis (when small pouches in the bowel get infected or burst).
4. Blocked bowel
   • When something (like scar tissue or a tumour) blocks the gut, stopping poop from passing.
5. Injuries
   • Accidents (like car crashes) that damage the stomach or bowel.
6. Birth problems
   • Some people are born with bowel or bladder issues that make a stoma necessary.
7. Nerve issues
   • Conditions like spinal injuries or multiple sclerosis that stop the brain from controlling the bowel or bladder.
8. Problems after cancer treatment
   • Radiotherapy in the pelvic area can sometimes harm the bowel or bladder.
9. Severe constipation
   • When medicine or other treatments don’t help someone pass poop normally.
10. Can’t control bowel movements
    • After spinal injuries or nerve damage, some people can’t hold in poop.

Why a stoma helps:

These problems can make the body’s usual way of removing waste (poop or pee) stop working. A stoma creates a new, safe way for waste to leave the body, which can ease pain, prevent emergencies, and help people live a healthier life.

Stoma pouches and other appliances

The stoma pouch collects the faces as it exits the stoma. The individual has no control over when the stoma is emptied.

Another word for the pouch is the stoma bag.

This pouch has a hole that can be cut to the correct size to fit snugly around the stoma.

Every stoma is different, so one size bag does not fit all. The bag has a sticky circle that is applied to the skin around the stoma, with the bag attached.

When the pouch becomes full, it is removed by gently unsticking this circle and a new bag is applied.

The skin around the stoma is known as peristomal, and needs to be kept clean to avoid any irritation or infection.

It’s also important that the stoma bag is a snug fit as any faeces that makes contact with this delicate skin can cause irritation and skin breaks over a period of time.

🟣Related Course: Bowel Care Management Training – Book Today.

Stoma accessories

Individuals also have access to a wide range of accessories that can help with their daily stoma care.

These include adhesives to help the bag be more secure, and to prevent any embarrassing leakage.

Other products help to protect the skin by providing a barrier. You can also buy wipes, and powders to help manage the skin around the stoma.

In most cases stoma accessories are not needed. It is usually the stoma nurse who will suggest and then prescribe any of these items, to help protect the skin.

📌Helpful Post: What is complex care and why is it important.

There are three types of stoma

There are also three different types of stoma, and the type and placement of the stoma on the abdominal wall very much depend upon the primary disease, and if the stoma is to be permanent or temporary.

A temporary stoma will later be reversed, allowing normal function of the bowel. The three types of stoma, the urostomy, colostomy and ileostomy.

A surgical incision is made in the abdominal wall and the bowel pulled through. A stoma can be an ‘end’ or a ‘loop’ stoma.

An end stoma is when the end of the bowel is pulled through the abdominal wall and secured in place via dissoluble stitches. This type of stoma is usually permanent.

A loop stoma is as the name suggests, as it’s a loop of bowel that is pulled through the abdominal wall, with each end sutured to the skin.

One end will pass the faeces, while the other end passes nothing or mucous. This type of stoma is usually reversible, as the two ends can be reattached.

👩‍⚕️Related: How to Become a Stoma Care Nurse in the UK.

Table: Comparing the Types of Stoma

Type of Stoma	What It Does	Where It’s Placed	Waste Removed	Common Reasons
Colostomy	Diverts poop from the colon (large bowel) to a bag outside the body.	Left or right side of the abdomen	Poop (solid or semi-solid)	Bowel cancer, Crohn’s disease, ulcerative colitis, diverticulitis, bowel blockages.
Ileostomy	Diverts poop from the small intestine (ileum) to a bag outside the body.	Right side of the abdomen	Poop (liquid or loose)	Crohn’s disease, ulcerative colitis, bowel cancer, trauma, or birth defects.
Urostomy	Diverts urine from the bladder or kidneys to a bag outside the body.	Lower abdomen	Urine (liquid)	Bladder cancer, spinal injuries, nerve damage, or birth defects.

This table shows the main differences, but each person’s stoma is unique depending on their medical condition and needs.

Key Differences:

1. Colostomy vs. Ileostomy:
   • A colostomy removes waste from the colon (large bowel), so the poop is usually more solid.
   • An ileostomy removes waste from the small intestine, so the poop is looser and more liquid.
2. Urostomy:
   • A urostomy is different because it removes urine, not poop. It’s used when the bladder isn’t working properly.
3. Temporary vs. Permanent:
   • Some stomas are temporary (e.g., to let the bowel heal after surgery) and can be reversed later.
   • Others are permanent (e.g., when part of the bowel or bladder is removed).

👉Relevant Course: Trainer-led Complex Care Training.

1. Colostomy

A colostomy is formed from the colon (large bowl) and it can be from the descending or sigmoid colon.

The faeces that are emptied will tend to be of a soft consistency and flatus (wind) will also be passed. A colostomy bag should be changed when three thirds full to prevent the bag from ripping.

The bag should only be removed when absolutely necessary, as frequent changes can damage the skin.

There are different types of colostomy that are classified according to where the stoma is located in the colon or intestine.

These include ascending colostomy, transverse colostomy, and descending colostomy.

1.  Ascending Colostomy

An ascending colostomy is a special way to help someone who has a problem with their tummy.

Doctors make a small hole on the right side of the tummy and put a bag there to collect the waste.

This helps the person feel better and stay healthy.

2. Transverse Colostomy

A transverse colostomy is when doctors make a small hole on the top part of the belly to help people who have problems with their colon.

The hole helps remove waste from the body in a different way. Instead of the waste coming out of the body like usual, it goes into a bag that is connected to the small hole.

This can make them feel better and stay healthy.

3. Descending Colostomy

Descending colostomy is like a special doctor’s visit that helps people who have trouble with their colon. During the visit, a small hole is made on the left side of their belly.

This helps remove waste from their body in a different way. Instead of coming out of the body like usual, the waste goes into a bag that is attached to the small hole.

This can make the person feel better and stay healthy.

Why Colostomy Care is Important:

1. Healthy Skin – Prevents irritation and infections around the stoma.
2. No Infections – Keeps the area clean and safe from bacteria.
3. Avoid Blockages – Ensures waste passes smoothly.
4. Boosts Confidence – Reduces leaks and odors, helping people feel in control.
5. Emotional Support – Helps people adjust to life with a stoma.
6. Prevents Problems – Stops issues like hernias or skin damage.
7. Stay Active – Lets people live normally and enjoy daily activities.
8. Saves Time/Money – Reduces hospital visits and extra treatments.

Care Includes: Cleaning the stoma, changing the bag, eating well, and checking for issues. Proper care = a healthier, happier life! 😊

2. Ileostomy

An ileostomy is when a stoma is formed from the ileum (small bowel). Usually the end of the ileum is used, and this type of stoma is referred to as a terminal ileostomy.

The ileum passes faeces that is much looser than the colostomy. This is because the faeces has not yet passed through the colon, which removes excess water.

This collection of fluid faeces means that the ileostomy needs to be emptied four to six times a day.

The bag usually has a Velcro fastening, allowing the bag to be easily opened and emptied straight into the toilet.

Why Ileostomy Care is Important:

1. Keeps Skin Safe – Stops the skin around the stoma from getting sore or red from liquid waste.
2. Stops Germs – Keeps the area clean to avoid infections.
3. Prevents Dehydration – Liquid waste can make you lose water, so care helps you stay hydrated.
4. Avoids Blockages – Makes sure waste can pass easily by eating the right foods and checking for problems.
5. Feel Confident – Stops leaks and smells, so you feel more comfortable and in control.
6. Emotional Help – Gives support to help you feel okay about having a stoma.
7. Stops Problems – Prevents issues like hernias (bulges) or skin damage.
8. Stay Active – Lets you do normal things like work, travel, and have fun.
9. Saves Time/Money – Means fewer trips to the hospital or extra treatments.

Care Includes: Cleaning the stoma, changing the bag, drinking enough water, eating well, and checking for any issues. Good care = a healthier, happier life! 

3. Urostomy

A urostomy is formed to allow urine to exit the stoma, as opposed to faeces.

A urostomy is formed when a small part of the ileum is used to form a link to the ureters, enabling urine to pass through. Sometimes the colon can also be used, but this is fairly uncommon.

A urostomy is usually indicated when there is cancer of the bladder. A urostomy bag collects the urine, which is then emptied via a tap.

The urostomy will pass the same amount of urine as the individual did pre urostomy. Most individuals change their urostomy every two to three days.

Why Urostomy Care is Important:

1. Keeps Skin Safe – Stops the skin around the stoma from getting sore or infected from urine.
2. Stops Germs – Keeps the area clean to avoid urinary infections.
3. Prevents Leaks – Ensures the bag fits well to stop urine leaking onto clothes or skin.
4. Avoids Blockages – Makes sure urine can flow easily by checking for problems.
5. Feel Confident – Stops smells and leaks, so you feel more comfortable and in control.
6. Emotional Help – Gives support to help you feel okay about having a urostomy.
7. Stops Problems – Prevents issues like kidney infections or skin damage.
8. Stay Active – Lets you do normal things like work, travel, and have fun.
9. Saves Time/Money – Means fewer trips to the hospital or extra treatments.

Care Includes: Cleaning the stoma, changing the bag, drinking enough water, checking for blockages, and looking after your skin. Good care = a healthier, happier life! 

What Next? Get Trained

📌Caring for Care provides stoma health care training.

The course includes covering topics such as infection control, applying and removing a stoma pouch, why a stoma may be needed, and privacy and dignity.

To learn more about our health care stoma training, then please do contact us here at Caring for Care today.