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 is the opening through which part of the bowel is brought to the skin, diverting stool. It is created to protect a low anastomosis, to divert in an emergency, or as a permanent solution; a temporary one is later closed.
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 is done once the situation has recovered.
Preparation
Decisive are stoma site marking and education by a specialist stoma nurse, both before and after the operation.
How it's done
In formation, a segment of bowel is brought out and fixed to the abdominal wall as a stoma. In closure (reversal), the stoma is freed and bowel continuity is restored with an anastomosis — often through a small incision around the stoma.
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. After reversal, a gradual return of bowel function follows. The timeline is individualised.
Risks & outcomes
With correct technique and support, quality of life with a stoma is very good. Possible complications: skin irritation, parastomal hernia, prolapse or stenosis; the reversal has its own, low risks.
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.