Effective stoma care is essential for maintaining health and wellbeing, but if you're new to it, you might feel uncertain. You may be concerned about how you'll manage, especially if you have no direct experience caring for a stoma. We want to reassure you that with the right knowledge and stoma support, it is entirely manageable.
Not every person with a stoma requires personal care, as many people manage their stomas independently. However, for those with additional health needs or who are recovering from major surgery, a care assistant can provide crucial help with routines for care of stomas. They can also assist when a dedicated stoma care nurse is not present.
There is much to consider, from changing the disposable bag to cleaning the skin with warm water and managing diet. Whether you are a professional care assistant or a family member, you can help someone enjoy an excellent quality of life. Our guide provides the essential tips you need.
We've put together a comprehensive guide to the different types of stoma, bags, and some practical tips for providing excellent care for a person with a stoma.
A stoma is a surgically created opening on the surface of the abdomen. This surgery connects it to the digestive or urinary system, allowing waste to be safely diverted from the body. It is a necessary treatment when the bladder or bowel can no longer function as it should.
A special pouch or bag is placed over the stoma to collect waste. The skin around the stoma is delicate, so proper care is vital to keep it healthy. A normal, healthy stoma should be pink or red, moist, and should not be painful. A well-fitted bag is essential to prevent leaks and protect the surrounding skin.
For someone with an ileostomy, the stoma is created from the small intestine. The operation is a serious medical procedure, but it can dramatically improve a person's health. The stoma itself is the visible part of the intestine that is stitched to the surface of the abdomen. Often, it is located on the right side of the body.
There are many reasons a person might need a stoma, including:
People of all ages may require a stoma. Over 170,000 people in the UK are living with one, leading full and active lives. Some stomas are temporary, designed to give a part of the body time to heal. Others are permanent, often required when a part of the bowel or bladder has been removed, which is why a bespoke care plan is important.
A colostomy is a procedure where a part of the colon (large bowel) is brought through the abdominal wall to create a stoma. A bag, also called a pouch, is then used to collect stools. Following this surgery, a person's quality of life can be significantly improved, especially if they were suffering from a painful condition beforehand.
There are two main types of colostomy:
A colostomy can be temporary to allow the bowel to heal, or it can be a permanent solution. If you ever have concerns about the stoma's appearance or function, you should contact your doctor or specialist nurse immediately.
An ileostomy is where the ileum (the final section of the small intestine) is used to create the stoma. The opening on the abdomen allows waste to leave the body before it reaches the large intestine. The output from an ileostomy is typically more liquid and frequent than that of a colostomy.
The bag will likely need to be emptied several times a day. It's normal for the stoma to appear slightly swollen in the weeks following surgery, but this should reduce over time. When cleaning the area, it is best to avoid harsh soap, as this can irritate the skin. Instead, plain warm water is recommended.
Just like colostomies, ileostomies can be either loop or end procedures and may be temporary or permanent. The constant flow of digestive fluid means it is especially important to protect the skin around the stoma with a well-fitted adhesive barrier.
A urostomy diverts urine away from a diseased or damaged bladder. During the procedure, a small section of the intestine is used to create a passageway, known as an ileal conduit. The ureters are connected to this passageway, and it is then brought through the abdomen to create a stoma.
Urine flows continuously into the bag, which has a tap or bung at the bottom for easy emptying. Good management of a urostomy is key to preventing urinary tract infections and skin irritation. Keeping accurate data on fluid intake and output can be helpful for medical reviews. This type of stoma is usually permanent.
Several different types of stoma bags are available, and the choice often comes down to personal preference and the type of stoma. Your loved one’s medical team will provide guidance on the best options. We often find that users of our service feel more confident once they find the right product for them. A GP may refer them to a specialist supplier to find the best fit.
Modern stoma bags are discreet, rustle-free, and designed with odour-proof materials. If you have a question, your stoma nurse can provide an answer. The right appliance makes a significant difference. We can help arrange for supplies to be delivered to your home.
If a stoma is permanent, bags and other supplies are typically available for free on the NHS. For a temporary stoma, prescription charges may apply unless the person is exempt.
One-piece stoma bags are, as the name implies, an all-in-one system, including the bag and adhesive. When you need to change a bag, you remove the whole thing and attach a new one.
Two-piece bags mean that you don’t need to change everything each time. The adhesive part remains on the skin, and you just unclip the bag when it needs changing. You can then clip on a new bag.
Closed stoma bags are used by people with colostomies who have more solid stool. They need to be changed whenever they are full – usually between one and three times a day.
Drainable stoma bags are often used by people who have had ileostomies, or people with colostomies who have softer or looser stool. These bags have a drainable opening at the bottom. This means they can be emptied into the toilet when they are full. You don't need to change the bag each time it's emptied.
Urostomy bags collect urine. They usually have a tap at the bottom to drain urine into the toilet. Your client or loved one may need to use a larger bag or drainage system at night.
If you have never seen a stoma before, the prospect of stoma care for one can seem daunting. Your loved one will have a dedicated stoma nurse or medical team who can offer advice. For family members feeling overwhelmed, organising personal care with a private carer or a care agency can provide much-needed support and peace of mind.
Your loved one's stoma nurse will provide a demonstration before they leave the hospital.
Here is a step-by-step guide:
Immediately after surgery, there may be strict dietary restrictions. If your client or loved one has a colostomy or ileostomy, they may be advised to eat a low-fibre diet for the first few weeks.
As time goes on, their diet may be able to return to normal. Some people will still need to restrict some foods, including fizzy drinks or food with tough skins such as corn, because these might lead to excess gas or blockages.
Some people with stomas develop a vitamin B12 deficiency. They should try and eat foods that are high in B12, such as meat, milk and dairy. If your client or loved one follows a vegetarian or vegan diet, they could include fortified plant-based milks and nutritional yeast in their diet, if possible, as well as supplements.
Your client or loved one’s medical team may have specific dietary advice for them. You should encourage them to follow this advice.
Caring for someone with a stoma will largely depend on their other personal care needs. They may need more support if they have just had stoma surgery. Equally, if they have dementia or significant mobility difficulties, they are likely to need more help from you.
You may be concerned about supporting someone with washing if they have a stoma. However, people with stomas can still bathe or shower normally, although they may find that some products irritate the skin around the stoma. Your client or loved one may prefer to bathe or shower with their bag on or off.
Some people with stoma bags need extra support with skincare. If urine or stools come into contact with the skin, this can lead to it feeling sore and inflamed. Some people may find that the adhesive irritates their skin. If this is the case, they may need to use a barrier cream, or ask their stoma nurse for
Most people with a stoma are able to continue exercising as they did before their operation, once they have recovered from surgery.
While recovering, most patients are encouraged to do some gentle exercise. You can help with moving around and walking. In the recovery period, take advice from their medical team about what exercise is right for them.
Once they have recovered, you can support them with any exercise that they enjoyed before their surgery. Stoma bags are waterproof, so swimming is a great exercise choice. People with stomas do all kinds of exercise, including hiking, running and even rugby!
Before surgery, your client or loved one may have spoken with their stoma nurse about the changes that will come with a stoma. However, a stoma might be done in an emergency, for example due to sudden trauma. If this happens, it may take a little while to adjust.
Lots of people feel relieved once the surgery is done, especially if they had very severe symptoms beforehand. For many people, having a stoma can improve their lives greatly.
Some people feel anxious about leaks, especially overnight, which means that they don’t always sleep well. You can help your client or loved one with sleeping positions that avoid putting pressure on the stoma bag. Some people, especially those with urostomies, use a larger bag at night. Others find that changing their food routine helps – if they eat their larger meal at lunchtime, they are less likely to have as much output during the night.
If your client or loved one is struggling with their mental health, encourage them to talk to a professional. Their stoma nurse may be able to recommend local support groups.
There could also be physical reasons for low mood and anxiety. People with stomas may struggle to absorb some vitamins and minerals, such as vitamin B12, which can lead to symptoms including depression.
Having a stoma is a life-changing event, but it does not have to be a limiting one. With the right support and care, a person can lead a full, active, and happy life. At Tiggo Care, we understand that providing this support requires a personalised and compassionate approach. Our care assistants are trained to help with daily routines, ensuring comfort, dignity, and confidence.
We work closely with other healthcare professionals, including NHS district nurses and specialist stoma nurses, to ensure the care we provide is perfectly aligned with medical recommendations. This collaborative approach means your loved one receives seamless, person-centred support tailored to their exact needs.
If you need support with personal care for a loved one with a stoma, contact the team at Tiggo Care today. We can arrange a consultation to discuss your needs and create a bespoke care plan that enhances your loved one’s quality of life.
If the skin around the stoma appears red, itchy, or broken, ensure the area is clean and completely dry before applying a new bag. You can use a barrier film or powder to protect the skin. If the problem persists or worsens, it is important to make an appointment with their GP for advice.
Once you have removed the used bag, fold it over to seal it and place it inside a disposal bag. This can then be put into your normal household rubbish bin. It should not be flushed down the toilet. Most stoma supply companies provide discreet disposal bags.
For routine cleaning, plain warm water and dry wipes are recommended. Many special wipes contain oils or moisturisers that can prevent the new stoma bag from adhering properly to the skin, increasing the risk of leaks. Avoid any products containing alcohol.
You can shower or have a bath with a stoma. Some people remove their bag to shower or bathe, whereas others prefer to leave theirs on. The bags are waterproof. If you want to remove your stoma bag to shower or bathe, you might prefer to plan your baths or showers for a time when you are less likely to have any stoma output, if possible.
Get in touch with Tiggo Care today to see how we can help you or your loved one.
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