A stoma is an opening connecting an internal organ to the surface of the body that is formed by surgery. The most common types of stoma in intestinal surgery are an "ileostomy" (connecting the small intestine to the skin) and a "colostomy" (connecting the large intestine to the skin).
A stoma may be temporary or permanent. In colorectal surgery, a temporary ileostomy is most often created at surgery to divert stools away, so that the operation site below is allowed to heal without irritation by stools passing through. This can be reversed with a subsequent small operation, with minimal or no loss of intestinal function.
A permanent stoma may be required when disease, or its treatment, leads to loss of normal intestinal function, or when the muscles that control the anus do not work properly or require removal. The most common conditions where a permanent stoma is required are low rectal cancers and inflammatory bowel disease.
How do I control my bowel movements with a stoma?
Once your stoma has been created, your surgeon or a stomatherapist (a nurse who specializes in stoma care) will teach you to apply and wear a bag called an stoma appliance. The pouch is made of a special form of plastic which is held to the body with an adhesive skin barrier. Many sizes and styles of stoma pouches are available. The pouch is disposable and is emptied or changed as needed. The system is quite secure; "accidents" are not common, and the pouches are odor-free. The frequency of your bowel movements will vary, depending on the type of ostomy you have, your diet, and your bowel prior to surgery.
Will my physical activities be limited?
No.You may have friends or acquaintances with a stoma of which you are unaware. Public figures, prominent entertainers, and even professional athletes have stoma that do not significantly limit their activities. All your usual activities, including active sports, may be resumed once healing from surgery is complete.
Will a stoma affect my sex life?
Most patients with stoma resume their usual sexual activity. In men, removal of the lower rectum for cancer may result in sexual dysfunction due to injury to nerves that pass close to the rectum. This is unrelated to the stoma. Many people with stoma worry about their sexual partner will think of them because of their appliance. This perceived change in one's body image can be overcome by a strong relationship, time and patience. Support groups are also available in many cities. If the surgical procedure will require removal of the rectum, you may wish to discuss sexual function with your surgeon or a stomatherapist prior to surgery.
Patient who require a permanent stoma may find it useful and reassuring to visit with another person who has already been through the surgery and adjusted to his or her stoma. Such visits can often be coordinated by stomatherapist.
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