General Information About Stoma - Dubai General Surgery Clinic at DRHC

A stoma is an artificial opening in the abdominal wall that allows feces or urine to pass out, used mainly to divert the normal pathway to resolve an obstruction or to allow treatment of some other abdominal conditions. There are 3 types of stomata:

Colostomy (from the large bowel)

• End colostomy – after removing part of the large bowel, the remaining is brought to the surface of the abdomen as a stoma. It can be permanent or temporary.
• Loop colostomy - it consists of two stomas (double barrel). This is a temporary procedure in acute cases.

Ileostomy (from the small bowel)

• End ileostomy – the end of the small bowel is brought to the surface of the abdomen. It can be permanent or temporary.
• Loop ileostomy – the technique is similar to that of loop colostomy. It is temporary to protect the joinings of the large bowel, especially the rectum.

Urostomy – after urinary tract surgery with diversion.

• After the surgical procedure, the feces will pass through the stoma and not any more through the anus anymore. There is no more control because there are no more muscles surrounding the stoma, as with the anus. This artificial opening in the abdomen should be covered with a bag (colostomy bag).
• There are several types of colostomy bags: waterproof and even with a filter. The site of the stoma should be established before surgery, unless in emergencies. This can affect post-operative care and even the type of clothes. A drainable colostomy bag is always recommended.
• There are two types of stoma bags: a one-piece system (the collection bag is attached to the base plate) and a two-piece system (the collection bag is separated from the base plate and it will be clipped together).
• Taking care of the stoma is the most important thing. You should know how to change the stoma bag to avoid problems later on. Preparing the new bag starts with the exact cutting of the base plate. The second step would be the removal of the old bag, and this should be performed very gently.
• The application of the new colostomy bag should be done in a way to avoid the passing of faeces under the base plate. The content of the faeces is aggressive, especially that of the small bowel. That is why direct contact with the skin causes irritation, inflammation, and even ulcers of the skin.
• The skin should always be smooth without any broken spots. To do that, you should be seeking support from a very highly qualified person.
• Another important issue regarding stomas is the formation of a Parastomal hernia. This is a bulge of the abdominal content between the abdominal wall and the stoma. This may cause pain, even strangulation (obstruction, loss of blood supply). It is a life-threatening case. Factors causing such a hernia are overweight, cough, infection, and even the skills of the surgeon during the surgical procedure.