A stoma, also known as an ostomy, is an opening in the abdomen that leads to the intestine and allows faces to be passed (or bladder for urine). A bag is attached to the stoma to collect contents. A stoma operation is performed when the intestines cannot perform their usual function, usually because of a disease such as inflammatory bowel syndrome, bowel cancer, or obstruction. It may be temporary or permanent. There are different types of ostomies depending on where the connection to the abdomen is made from: a colostomy connects the large intestine, an ileostomy connects the small intestine and a urostomy which connects the bladder. Contents from a colostomy will be solid, and an ileostomy is generally fluid.
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Each type of stoma will require a different pouch, although some manufacturers make interchangeable pouches. They can differ in size according to output requirements; for an ileostomy, a larger bag may be needed to collect the fluid. The type of ostomy pouch can be tailored to an individual’s preferences and lifestyle.
Ostomy bags can come as one piece or two pieces. In a one-piece bag, the entire pouch and the flange (stoma connecter) come as one piece, and this must be replaced each time entirely. In a 2-piece bag, the flange is separate from the pouch. The flange attaches to the skin and secures the stoma, and can be left in place for a few days. Only the bag needs to be replaced each time. The advantage of a two-piece bag over a one-piece is that it is much quicker and easier to change pouches each time and less irritating to the stoma. The disadvantage is that the pouch systems tend to be bulkier, more expensive, and prone to leaks as the flange and bag can come apart.
Bags can be drainable or closed. In a closed system, once the pouch is full, it needs to be discarded and replaced, whereas in a drainable system, the contents can be emptied. A drainable bag may be more suitable for an ileostomy or urostomy, where fluid collects quickly and is easier to empty.
Many products are available to make it easier to manage to live with a stoma. Skin protectants or barrier creams are applied to the skin around the stoma to protect it from irritation. Stoma seals and pastes help to prevent leakages by providing a more secure fit between the stoma and pouch. An adhesive remover is used to remove any residual adhesive between pouch changes. Belts can be worn to secure a stoma close to the body for discretion and to help carry the weight. Deodorants can be applied inside the pouch to neutralise odours.
To potentially reduce the risk of the need for a stoma, individuals should prioritise the following:
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