Providing care and support for patients living with stomas as well as those considering ostomy surgery

At the University of Chicago Medicine, our specialty nurses, certified in ostomy wound and continence care, work with adults anticipating the creation of an ileostomy or colostomy. Our team provides post-operative education and care to patients who have recently undergone surgery. We also see patients living with stomas that need additional assistance and/or are interested in updates to their ostomy management systems.

We believe that all people who undergo ostomy surgery should have access to a specialized ostomy nurse to help with the adaptation and adjustments that are necessary following surgery and on an ongoing basis. We suggest that all patients with an ostomy be examined by an ostomy nurse annually to identify any issues before problems arise.

Ostomy: Frequently Asked Questions

An ostomy is surgically created opening in which the small or large intestine is brought out through an opening in the abdominal wall. The end of the intestine is everted and attached to the abdominal skin. Waste material passes out of the intestine into a pouching system, which is attached to the skin around the ostomy or stoma. A pouching system must be worn at all times. Because there is no sensation in the ostomy opening, there will be no feeling when the stool passes from the stoma.

There are several different types of ostomies. An ileostomy is an opening into the small intestine (ileum). A colostomy is an opening into the large intestine (colon).

An ostomy may be temporary or permanent. A temporary or permanent ostomy may be required when the gastrointestinal tract needs to heal from disease or injury.

An ostomy diverts waste material from a diseased or removed section of the GI tract to an opening in the skin (a stoma).

After surgery, it may take several days for the ostomy to start functioning. It will then produce gas and liquid output, with volume gradually increasing as the body resumes a normal process of digestion. During this time, the texture of output changes from liquid to a pasty stool.

Normal excretion from an ileostomy has liquid to pasty output with the number of bowel movements varying in frequency. Normal excretion from a colostomy has pasty to semi-solid consistency, with bowel movements occurring in a more regular pattern. Because there is no sensation in the ostomy, there will be no feeling when the stool passes from the stoma. A pouching system worn 24 hours a day and will collect the output.

There are several reasons that a person might need to have an ostomy created. In some instances, patients with inflammatory bowel disease (ulcerative colitis and Crohn's disease) or colorectal cancer may require ostomy surgery. Other indications for stoma creation include diverticulitis, trauma and ischemic disease.

Living with an ostomy requires making some adjustments and learning new skills. Specifically, you will need to learn how to apply and empty your pouching system. Once you acquire these skills and move toward healing, you will return to your normal lifestyle.

Stomas: Frequently Asked Questions

A stoma is a surgically-created opening into the small intestine (ileostomy) or large intestine (colostomy). The stoma protrudes through the abdominal wall to the outer surface of the skin. Stool exits from the stoma and is collected by a pouching system attached to the skin around the stoma.

A stoma is round or oval, red and moist, and has a texture similar to the inside of the mouth. A stoma is swollen (edematous) for the first few weeks after ostomy surgery, as the tissue heals. Over time, it will change and shrink to a permanent size, which varies from person to person. A permanent stoma should maintain protrusion or upright position above the skin level.

Ileostomy

An ileostomy is created from a section of the small intestine called the ileum and is surgically moved through the abdominal tissue to a previously marked site on the skin. The two types of ileostomies are an end and a loop stoma.

Colostomy

A colostomy is created from a section of the large intestine or colon, is surgically moved through the abdominal tissue to a previously marked site on the skin. There are four areas of the colon that a colostomy can be created from: ascending, transverse, descending and sigmoid. The two types of colostomies are an end and a loop stoma. A surgeon decides which type of stoma to create based on each patient's disease, type of surgery that is required, the patient's physical condition, and the overarching goals of health care and maintenance.

The basic principles of ostomy care and stoma management are the same for all types of stomas. There are differences in the type and frequency of stoma output, stoma construction and patient preference for a particular pouching system.

An ostomy is a surgically created opening. The opening is called a stoma.

No, there is no sensation of any kind in a stoma. This is because no nerves are present in the tissue.

Minor temporary bleeding is normal and no cause for alarm. A stoma may bleed if it is grazed, bumped or rubbed.

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