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Living with a stoma: temporary vs permanent
A stoma brings the bowel out through the abdominal wall so that stool collects in a bag. A temporary stoma protects a healing join and is usually reversed a few months later. A permanent stoma is needed when the rectum or anal muscles have to be removed. Most people with a stoma return to work, sport, travel and a normal social life.
Ileostomy and colostomy
| Ileostomy | Colostomy | |
|---|---|---|
| Bowel used | End of the small bowel | Large bowel |
| Usual position | Right side | Left side |
| Output | Liquid to porridge-like, frequent | Formed, less frequent |
| Main watch-point | Dehydration if output is high | Constipation, parastomal hernia |
Why a temporary stoma is made
- To protect a join low in the pelvis, for example after rectal cancer surgery or pouch formation. Stool is diverted while the join heals, so if a leak happens it is far less dangerous.
- In an emergency, such as perforated diverticulitis, when joining the bowel is unsafe (Hartmann's procedure).
- When you are unwell from infection, malnutrition or high-dose steroids.
A loop ileostomy is usually reversed after around three to six months, once a check shows the join has healed, and sometimes after chemotherapy has finished. Reversal of a Hartmann's colostomy is a bigger operation, and some people choose to keep their stoma.
Why a stoma may be permanent
- A low rectal cancer involving the anal muscles needs removal of the rectum and anus (abdominoperineal excision).
- After removal of the colon and rectum for colitis when a pouch is not chosen.
- When bowel control is poor, a stoma can give better quality of life than incontinence.
Daily life
- Bags: modern appliances are flat, odour-proof and invisible under normal clothing. Most people change a bag in a few minutes.
- Diet: most foods are fine. People with an ileostomy should chew fibrous foods well and keep up fluids and salt.
- Exercise: walking from day one; core strengthening, guided by your stoma nurse, may reduce the risk of a hernia.
- Work, travel and swimming are all possible. Carry spare supplies in hand luggage.
- Relationships and intimacy continue for most people; specialist nurses can advise.
Possible problems
Sore skin from leaks, high output, a parastomal hernia, prolapse or retraction can occur. Most are managed by the stoma nurse; some need surgery. See parastomal hernia repair.
Stoma reversal
Closing a loop ileostomy is usually a short operation through the stoma site, with a stay of a few days. Bowel habit can be irregular for months afterwards, especially after rectal surgery, when frequency and urgency (low anterior resection syndrome) are common and improve with time and pelvic floor support.
Peer support from Colostomy UK and IA is invaluable.
Common questions
How long will I have a temporary stoma?
A loop ileostomy is usually reversed after around three to six months, once the join has healed. It may be longer if you need chemotherapy first.
Can people tell I have a stoma?
Usually not. Modern bags are flat and odour-proof and are not visible under normal clothes.
Can I exercise with a stoma?
Yes. Walking starts immediately, with a gradual return to sport. Your stoma nurse will advise on core exercises and support garments.
Is a stoma reversal a big operation?
Closing a loop ileostomy is a relatively small operation with a stay of a few days. Reversing a Hartmann's colostomy is a larger abdominal operation.
This guide is general information, not personal medical advice. If you have severe abdominal pain, heavy bleeding, a high temperature or vomiting, call 111, or 999 in an emergency.