Understanding the journey to becoming an ostomate can help in the process of preparing for or recovering from stoma surgery.
Gaining knowledge about what to expect can ease anxiety and provide clarity, helping people feel more confident in adapting. This information is equally valuable for those supporting a loved one with a stoma, offering insight into their care and needs. After all, knowledge is power!
Here’s a helpful guide to understand what to expect when it comes to the stoma surgery journey.
Pre-operative assessment
Most hospitals offer a pre-operative assessment a few days before your surgery. By this stage the surgeon will have already explained about your surgery, and you will have consented for this to go ahead. The pre-op assessment is an opportunity for the Stoma Care Nurse or Colorectal Nurse Specialist to check you are well enough for the surgery to go ahead and prepare you for it. Take this opportunity to ask any questions or concerns you may have.
The Nurse Specialist will show you where the stoma will be positioned on your abdomen (stomach). There may be a discussion around the clothes/waistbands you usually wear and the nurse will look at your stomach for a smooth area without dips and creases in the skin, both of which help in deciding where to site your stoma.
The position will be marked on your skin in black permanent ink, either during this appointment or on the morning of your surgery. You will also be shown what a stoma and the pouches look like and how the pouches attach to your stoma and skin. Additional tests may be required such as blood tests or ECG’s, this is different for each patient and hospital.
You will also be given information about how to clear your bowel for surgery, this is called bowel preparation. Keep these instructions safe and make sure you have read them in advance of the surgery to ensure you know what is required, as they will need to be followed the day prior to your surgery. There will also be some information about fasting, again check with your Stoma Care Nurse if you are unsure of anything.
Preparing for surgery
We all recognise those feelings of apprehension during the days before your planned surgery. Use these days before to keep yourself busy and plan what you will need for your stay in hospital. Preparation can really help reduce anxiety and help you to feel more in control of the situation.
In your hospital bag, pack your pyjamas/nightdresses, a dressing gown and a pair of slippers. Taking a book or magazines is a good idea, a tablet/phone or music device plus headphones. A pair of earplugs might be help you get a good night sleep. If you currently take medication, check whether you need to bring this in with you (it might need to be in its named/labelled packages).
During your pre-op assessment the nurse may have provided you with instructions to clear your bowel (known as bowel preparation) the day before your surgery. Follow them as directed. There will also be some guidance about fasting, again follow the instructions you have been given.
Inform loved ones so they know where you are and can help support you during your recover time. You might need to arrange childcare for younger family members or pet sitters for any animals at home.
What happens on the day of surgery?
On the day of your operation, you will be checked into the ward by the nursing staff. Depending on the hospital, you may be given a special shower gel to wash and clean your skin.
You will need to remove any makeup, nail varnish and remove jewellery. Loose items such as dentures, contact lenses, glasses and hearing aids are all removed prior to surgery.
You will change into a hospital gown and will be give compression stockings to wear.
You will then be taken down to theatre and placed in a pre-op room where the Anaesthetist will place a cannula in your hand/wrist to administer aesthetic.
Post surgery experience
Waking up after surgery can be filled with a mixture of relief and apprehension about how your stoma looks. Your stoma may look different to how you expected.
Your abdomen and stoma will be swollen for the first few weeks, and this can make the stoma appear larger in size. You will be wearing a clear stoma pouch, and this is so the nurses can see your stoma and the output clearly, to monitor your progress. Around the stoma will be stitches, these are usually dissolvable and tend to dissolve over the next six weeks, if any are left in, your nurse will remove them for you.
Over the next 2-6 weeks the swelling will reduce. The stoma will need to be re-measured regularly by your Stoma Care Nurse so that she can guide you to the size of the aperture (hole) of your pouch. This will need to be cut to fit to prevent any issues such as leaks and sore skin. Your Stoma Care Nurse will support you in learning how to change your stoma pouch. Once you are physically well enough and you are able to change your pouch independently, your discharge from hospital can be planned.
Hospital stay after stoma surgery tends to be anywhere between 3 and 10 days depending on your recovery. Your Stoma Care Nurse will check that your stoma is fully functioning before you can be discharged.
Emotional and psychological adjustment
You may find that during the weeks following your stoma surgery you feel frustrated, angry, sad or a feeling of loss towards how your body used to look. Be reassured that these are all very normal feelings and over the next few weeks they will fade as you begin to move forward and adjust. Be kind to yourself and take your time, we all recover in different ways and at different stages.
Adjusting to life after stoma surgery involves not only physical changes but also emotional and psychological adjustments. It’s crucial to recognise the impact of these changes and find ways to maintain positive mental health. Don’t let your stoma define you, remember you are resilient! We all have days where we feel unmotivated or feel a little low, but if these days are persistent, speak to someone and talk things through.
Practical tips for recovery
Recovering from surgery takes time. You may feel extremely tired in the first few days and weeks, this is perfectly normal, so take the time to catch up on the some reading or watch some Netflix movies you never got round to seeing. It’s also important to keep pottering around your house, it is good to have equal doses of rest with very light and gently exercise such as walking. As the weeks go on, gradually building up these gentle walks. Gentle exercise can help rebuild your strength and support mental health. Remember not to push yourself, listen to your body.
Returning to everyday life
You will start to feel better and resume your daily life after 8 weeks. But a full recovery usually takes around three months as the abdominal muscles need to completely heal. Avoid any heavy lifting (a good rule of thumb is anything heavier than a kettle) or overly strenuous activities during this time.
By this time you should feel much more confident and your stoma care becomes part of your daily life.
When to seek help
It is hard to know when to reach out for help with a stoma, but you’ll soon get to know what is normal for you. Don’t hesitate to contact your stoma care nurse for support if you have concerns.
Here are some tips of when to contact a health care professional for help and advice:
- If your stoma stops functioning
- It you experience leaks
- If you skin becomes sore
- If there is blood in your stoma pouch
- If you have a high temperature
- If you have extreme pain
- If you feel very low in mood/depressed
More information on the different types of stoma can be found here…
