Stoma surgery is often part of a colorectal surgical treatment plan. When the transected end of the boweltemporarily cannot be reconnected, or when the bowel connection requires time to heal etc., with these clinical reasons, the medical team may create a temporary or permanent stoma. This allows stool to exit through an opening in the abdomen, reducing stress on the bowel anastomosis and supporting subsequent treatment and recovery.

A stoma connects the bowel to an opening in the abdominal wall, diverting faecal waste out of the body spontaneously. Patients need to wear a stoma bag (ostomy pouch) around the stoma to collect waste. The pouch must be emptied and changed regularly, and appropriate skin care around the stoma is required to reduce the risk of leakage, irritation, or skin discomfort.

Stomas may be classified as temporary or permanent.

Temporary stomas are commonly used in conditions such as diverticular disease, inflammatory bowel disease, bowel cancer, or bowel injury. Their purpose is to temporarily divert stool away from the bowel connection, allowing the anastomosis time to heal. Once the connection has healed, bowel function has recovered, and closure criteria are met, stoma reversal may be considered.

If a tumour is located too close to the anus and surgery requires removal of the anus and surrounding tissues, a permanent stoma may be necessary.

What Is the Difference Between a Temporary and a Permanent Stoma?

Whether a stoma is temporary or permanent depends mainly on the location of the disease, the extent of surgery, the condition of the bowel reconnection, and recovery progress.

Stomas may be classified according to the part of the bowel connected to the abdominal wall, including:

• Small Bowel Stoma – A portion of the small intestine is brought through the abdominal wall to create a stoma. A common example is an ileostomy. Since the output from the small intestine is usually more liquid, special attention is required to ensure an adequate seal of the stoma pouch and protection of the surrounding skin.
• Large Bowel Stoma – A portion of the large intestine (colon) is brought through the abdominal wall to create a stoma, also known as a colostomy. The consistency of the output may differ from that of a small bowel stoma, and the care routine may be adjusted according to individual circumstances.

The care requirements vary according to the type of stoma. Patients can learn how to clean the stoma, apply and change the pouch, and monitor the stoma condition under the guidance of the stoma care team.

After stoma surgery, patients need to gradually learn how to use a stoma pouch, care for the skin around the stoma, and monitor the stoma on a daily basis. Good stoma care can help reduce leakage, skin irritation, and inconvenience in everyday life.

Daily care should include attention to the following:

• Empty and change the stoma pouch regularly to prevent it from becoming overly full or detached
• Clean the skin around the stoma and keep it dry
• Watch for redness, swelling, soreness, skin breakdown, or leakage around the stoma
• Monitor for significant changes in the stoma's colour, size, or output
• Seek medical advice promptly if there is persistent bleeding, severe pain, blackening of the stoma, significant leakage, fever, or abdominal pain
• If you have concerns regarding pouch fitting, odour control, or managing your stoma while travelling or going out, consult your stoma care team for personalised advice