A stoma diverts bowel content to the abdominal wall, either to protect an anastomosis or as a permanent solution. It may be a colostomy or ileostomy, temporary or permanent; a temporary one is closed (reversed) at a second stage.
What is a stoma?
It covers the formation of a colostomy/ileostomy and its closure (reversal). A stoma diverts bowel content to the abdominal wall, either to protect an anastomosis or as a permanent solution.
It may be end (one end brought out) or loop (a loop of bowel) — the latter often used as a temporary diverting/protective stoma.
When is it needed?
It is created to protect a low anastomosis (e.g. after rectal resection), in emergencies (e.g. Hartmann), or as a permanent solution after abdominoperineal resection.
Closure (reversal) is planned once the underlying situation has recovered and, where needed, anastomotic integrity is confirmed on imaging.
Preparation
Decisive is stoma site marking by a specialist nurse — over the rectus muscle, away from creases, scars and the beltline, with the patient sitting/standing.
Education before and after surgery substantially reduces complications and improves quality of life.
How it's done
In formation, a segment of bowel is brought out and fixed to the abdominal wall as a stoma (end or loop). In closure (reversal), the stoma is freed and continuity is restored with an anastomosis, often through a small peristomal incision.
Correct siting, adequate spout and end perfusion are crucial for smooth function and fewer complications.
Diverting stoma
A temporary stoma that protects a low anastomosis while it heals.
End stoma
A permanent solution when restoring continuity is not feasible.
Closure (reversal)
Restoring bowel continuity once the situation allows.
Recovery
After formation, adaptation is supported by management education; particular attention is paid to hydration, as a high-output ileostomy can lead to dehydration.
After reversal, a gradual return of bowel function follows. The timeline is individualised.
Risks & outcomes
Possible: skin irritation, parastomal hernia, stoma prolapse or stenosis, and with an ileostomy high output/dehydration.
The reversal has its own, low risks (e.g. anastomotic leak, ileus). With correct technique and support, quality of life is very good.
Frequently asked questions
Is my stoma permanent?
It depends on the indication. Many stomas are temporary (diverting/protective) and are closed at a second stage; others are permanent, as after abdominoperineal resection.
Will I be able to live normally?
Yes. With proper marking, education and support from a specialist stoma nurse, most patients maintain a very good quality of life.
When is a temporary stoma closed?
Once the underlying situation has recovered and the anastomosis has healed — often after some weeks to months, as a separate operation.
Why is marking important?
The correct stoma position greatly eases its management and reduces complications; that is why it is done pre-operatively with a specialist nurse.