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Life with a Stoma

Types of stoma in rectal cancer

Temporary stoma (protective ileostomy)

  • Made from the small intestine (ileum)
  • The purpose is to protect the anastomosis (suture) after low anterior resection
  • Stools are more liquid and more frequent compared to a colostomy
  • Closed (transit restored) after the anastomosis has healed, usually at 3-6 months
  • Requires a separate surgical procedure for closure

Permanent stoma (colostomy)

  • Made from the colon (large intestine)
  • Required when the rectum has been completely removed (abdominoperineal resection — APR)
  • Stools are more formed compared to an ileostomy
  • Usually located on the left side of the abdomen
  • Patients can lead an active and normal life with a permanent stoma

Stoma care

Daily routine

  • Emptying the bag — several times a day, when the bag is one-third full
  • Changing the appliance (baseplate + bag) — every 2-4 days or as needed
  • Cleaning the skin around the stoma — with warm water, no harsh soap
  • Checking the appearance of the stoma — pink-red color, slightly moist (normal appearance)

Skin protection

  • Use protective pastes and powders to prevent irritation
  • Cut the baseplate correctly — 2-3 mm from the stoma edge
  • Avoid irritating products (alcohol, perfume) on the peristomal skin
  • Consult the stoma nurse if irritation, bleeding or stoma changes appear

Eating with a stoma

General recommendations

  • Chew food well — prevents stoma blockage
  • Introduce new foods one at a time, to observe the effect
  • Adequate hydration — especially with an ileostomy, where fluid losses are greater
  • Regular meals — avoid long periods without food

Foods that may cause problems

  • Fibrous foods (corn, mushrooms, fruit with skin) — risk of blockage especially with ileostomy
  • Gas-producing foods (beans, cabbage, beer, carbonated drinks)
  • Foods that change odor (garlic, onion, fish, eggs)
  • Foods that thin stools (alcohol, plums, fruit juice)

Daily life

Physical activity

  • Activity can be resumed gradually, usually 6-8 weeks after surgery
  • Contact sports should be avoided or done with a protective belt
  • Swimming — mini bags or waterproof stoma caps can be used
  • Avoid heavy lifting (over 5 kg / 11 lb) in the first 3 months

Clothing

  • Regular clothes are fine — the stoma is discreet under clothing
  • Avoid tight belts directly over the stoma
  • High-waisted underwear or special stoma belts are optional

Travel

  • Bring enough stoma supplies (double the necessary amount)
  • Carry supplies in hand luggage (when flying)
  • Check toilet access at your destination
  • A medical certificate can be useful at airport security

Intimate relationships

  • Intimate life can be resumed after complete surgical healing
  • Open communication with your partner is essential
  • Special underwear and accessories that discreetly cover the stoma are available
  • Psychological support can be very helpful in adjusting

Support and community

  • Stoma nurses — nurses specialized in stoma care
  • Support groups — patient associations for people with a stoma
  • Online resources — forums, educational videos, communities
  • Psychological counseling — emotional adjustment to life with a stoma is a normal process