![](https://www.plusonline.nl/sites/plusonline/files/styles/pol_carousel/public/gettyimages-499550525.jpg?itok=znr0pkVu)
‘A stoma is a major change in your life’
What do you have to deal with if you need a stoma? Stoma nurse Marga Boeijen of the Máxima MC Veldhoven answers these and other questions.
1. When do you have to deal with a stoma?
Marga Boeijen: “A stoma is an artificial exit that is created when the natural way of urinating or defecating is not possible. When the bladder is removed – for example because of bladder cancer or if someone has lost control of the bladder muscle due to a spinal cord injury – you get a urostomy. You get an intestinal stoma when a piece of intestine has been removed. This could be because of cancer or an inflammatory bowel disease such as ulcerative colitis, Crohn’s disease, or inflamed bulges of the gut wall (diverticulitis).”
2. What types of stomas are there?
“First and foremost: you don’t get to choose. Which stoma someone gets depends on the disease and the operation. If the bladder is removed, you will have a urostomy. There are also two types of intestinal stomas: a small intestine stoma and a large intestine stoma. With a small bowel stoma, the stool is thinner and the amount is larger, so you will have to empty the bag more often. Also, with thinner stools, the risk of skin irritation due to leakage is greater. If the stoma is in the last part of the intestine – and you therefore have a colon stoma – you need to empty the pouch less often. In the large intestine, among other things, moisture is removed from the food mush; therefore the slurry there is more solid in shape. The further towards the end of the body, the anus, the firmer is the slurry leaving the stoma.”
3. Having a stoma sounds very uncomfortable. How can you live well with it?
“Suppose you have abdominal pain day in and day out due to inflammation in your intestines and you have to go to the toilet very often. Then you experience little quality of life. A stoma then provides control. But a stoma does require a lot of adjustment of your living situation. For example, you should avoid prolonged lifting and pressure on your abdomen, because pressure can easily cause a fracture. It is also psychologically drastic. You will have to accept that poop or urine will come out of your stomach from now on. Many people are anxious or insecure about their stoma. Good guidance is therefore important. In our hospital we start with training material before the operation to become self-reliant. The sooner you learn to deal with it, the more independent you are. A potential partner will also have to deal with it. Interacting with each other can change, and for intimacy you have to feel comfortable in your own skin. But a stoma is not the end of a good relationship.”
4. Who does what if you get a stoma?
“When constructing a stoma, you have to deal with different people. For example, the surgeon carries out the surgical procedure and the gastrointestinal liver doctor or urologist carries out the diagnosis and treatment. You will visit the stoma care nurse before and after the operation. This is specialized in the care and guidance of patients who have or will receive a stoma. There are also continence nurses. They guide people with a urostomy and patients who suffer from urine loss. It is always important that you enter the operation with a position drawn on your abdomen where the stoma should be. The stoma care nurse is responsible for this. We look at how someone moves and where the skin folds are. That way we can find the best place. On the operating table, each abdomen is nicely straight, but when you stand or sit it looks different. It is important for the use of stoma equipment that you can see the stoma yourself.”
5. How does ostomy equipment work?
“There are two systems: one-piece and two-piece. The two-part material consists of an adhesive part and a bag that you stick to the skin, over the stoma. You attach the bag to the adhesive part with a coupling system and you replace it daily. With the one-piece material, the adhesive part and the bag are attached to each other. The disadvantage with the small intestine and bladder is that the system can leak. After all, the waste is thin. This can irritate the skin. There is always a cause for skin irritation, so if it bothers you, it is best to discuss this with a stoma care nurse. Perhaps you are not using the material properly or there is another material that is better for you. Don’t think that skin problems are part of it, but ask for help.”
6. How do you choose the right stoma material?
“There is a lot of choice in material. A stoma care nurse helps with the selection. It depends on how you live and what you can do. For example, if you are active in life and move a lot, a supple and flexible material is nice. You can change this yourself as long as you have no limitations with your eyes, have good hand function and understand how to do it. When you can no longer do it yourself, home care can always help with changing the stoma material.”
Tip
The Stoma App contains a wealth of information about wearing a stoma. The app has been developed by stoma wearers and healthcare providers and can be downloaded for free via the App Store and Google Play†
Thanks to Karin van Schaik (ostomy nurse) and Nancy Boers (continence nurse) from Máxima MC Veldhoven.
This article previously appeared in Plus Magazine May 2022. Want to subscribe to the magazine? You can do that in an instant!
Sources):
- Plus Magazine