Stomas

A stoma is an opening in the abdomen which allows waste to collect in an external pouch. It can be temporary, giving the body time to heal, or sometimes they are permanent.

Types of stomas:

• Colostomy: the colon (or large bowel) is attached to an external pouch, usually producing solid waste
• Ileostomy: the ileum (or small bowel) is attached to an external pouch, usually producing liquid or paste-like waste
• Urostomy: urine is diverted to an external pouch

Sex with a stoma:

It can take time to adjust to having a stoma, but a healthy and pleasurable sex life is possible. Below are some of our top tips for this:

Tips:

• Empty the bag first – remember stimulation can stimulate everything.
• Consider different positions that are most comfortable and reduce pressure over the stoma site
• Try using support wraps to secure the stoma and keep it out of the way
• Consider using a fabric pouch cover to reduce irritation by preventing the plastic bag from rubbing against the skin

Exercise with a stoma:

Exercising with a stoma is safe and encouraged for your overall physical, mental, and pelvic health. Below are some tips to help you feel comfortable exercising with a stoma:

• Empty the bag first
• Start slow and gradually build up the exercise as you feel able
• Gentle and low-impact exercise is a great place to start e.g. walking, swimming, cycling, or Pilates and Yoga
• Avoid heavy lifting and intense abdominal straining (e.g. sit-ups) for the first 8 weeks after stoma surgery, to allow the body time to heal
• Drink plenty of water before, during and after exercise to prevent dehydration – exercise can also help with reducing constipation
• Listen to your body and speak to your stoma nurse for individualised advice

Emotional impact of a stoma:

People may experience:

• Difficulty adjusting to having a stoma
• Feelings of anger, frustration, embarrassment or shame about their stoma and its appearance
• Anxiety about their stoma leaking, their appearance, smell
• Isolating themselves/not leaving home as much
• An impact on sex and intimate relationships

In addition to the general tips about managing your emotional wellbeing on the psychological wellbeing pages, it may be helpful to consider the following:

• Allow yourself time to adjust to having a stoma and living with it. Over time you will likely feel more comfortable with your stoma and managing your stoma will become a part of your everyday routine.
• Spend time talking about and explaining your feelings and experience to your loved ones to help them understand you and let them know the best way they can support you.
• Be prepared with spare supplies for your stoma when leaving the house to help you feel more comfortable.
• If you are finding it hard to leave the house, try to take steps to slowly challenge yourself to getting back out. This may look like initially taking a walk locally for 10 minutes near your house, and then gradually increasing the amount of time or distance from home. This is helpful as when people stay at home, they may lose connection with others and their hobbies, and as a result feel more isolated and lower in mood.
• If you are worried about what others may think of you, sometimes it can be helpful to gently challenge your thoughts or ask yourself “what would I tell a friend in this situation”. We can often make assumptions that others may see or judge us in a certain way.
• If you are worried about your appearance spend time thinking about other parts of your body that you like or are grateful for. You can do this by thinking about it, or by looking at a mirror and working downwards from your head and saying what you like and appreciate out loud.
• Thinking about the positives alongside the difficulties of having a stoma, for example “it saved my life”.
• You may find the following helpful to read through: Managing Emotions Post-Stoma Surgery | Dansac UK
• For more information on sex and intimacy see sex & intimacy

Further Support

Your stoma nurse will be able to offer lots of support regarding stoma care and activities of daily living with a stoma. Below is some additional support we have found can be helpful:

Support groups:

Ilieostomy association – We are strong – Ileostomy & Internal Pouch Association

Colostomy association – Colostomy UK – A UK charity supporting people with a stoma

Instagram:

Adelle Roberts – @adeleroberts

Mesha Moinirad – @mrcolitiscrohns

Louise Thompson – @louise.thompson