Stoma Care

A stoma is a surgically created opening on the abdomen where part of the bowel or urinary system is brought to the surface. This lesson explains the three main types: a colostomy, from the large bowel; an ileostomy, from the small bowel; and a urostomy, which carries urine. It covers why people have a stoma, such as bowel cancer, inflammatory bowel disease, injury or bladder removal, and that a stoma can be temporary or permanent. Key point: knowing the type helps you understand what output to expect.

Knowing what a healthy stoma looks like helps you spot problems early. A healthy stoma is moist and pinkish red, similar to the inside of the mouth, and has no feeling, so the person may not notice if it is injured. This lesson explains the equipment used, including one piece and two piece pouches, drainable and closed pouches, and urostomy night bags. It also explains the role of the stomal therapy nurse and how supplies are usually accessed through a stoma association. Key point: the plan sets out each person's equipment and routine.

Drainable pouches need emptying several times a day. This lesson describes a hygienic routine: prepare, perform hand hygiene and put on gloves, empty the pouch into the toilet when it is about a third to half full, clean and dry the outlet, close it securely, dispose of waste correctly and perform hand hygiene again. It explains why not letting the pouch get too full prevents leaks, and how the person's own routine and preferences guide what you do. Key point: support the person to do as much as they can themselves.

Pouches and wafers are changed on a schedule set by the stomal therapy nurse, or sooner if they leak. This lesson outlines a typical change: gather equipment, remove the old pouch gently, clean the skin around the stoma with warm water, dry it well, check the stoma and skin, measure if needed, and apply the new pouch so it fits snugly. It explains why the wafer opening must match the stoma size, why sore skin must be reported, and why you should not use products unless the plan says so. Key point: follow the individual plan and your training.

Most stoma problems can be managed if they are noticed early. This lesson covers warning signs: changes in stoma colour, bleeding that does not stop, swelling or a stoma that pulls in or sticks out further than usual, sore or broken skin, and changes in output. It explains signs of a possible blockage, such as no output with cramping, bloating or vomiting, and signs of dehydration in people with an ileostomy. Key points: report changes promptly, and call 000 for a black stoma, heavy bleeding or severe pain with vomiting.

Living with a stoma affects body image, confidence and relationships, and stoma care is intensely personal. This lesson covers how to provide support with dignity: privacy, consent, a matter of fact manner, respect for the person's routine and choices, and discretion with odour or leaks. It also sets out your responsibilities and reminds you that this course builds knowledge only. You must be trained and assessed as competent by a qualified health practitioner for each participant and follow their support plan. The lesson ends with a course summary.

This case study follows Priya, a woman in her forties who has come home from hospital with a new ileostomy after surgery for inflammatory bowel disease. Her support worker, Tom, has been trained by the stomal therapy nurse to support her routine. The lesson looks at how a new stoma can change size in the early weeks, why the wafer fit needs checking, and how to respond when Priya's skin becomes red and sore. Key points: follow the plan, notice and report early changes, keep the stomal therapy nurse involved, and support Priya's growing confidence.

This case study follows Mr Russo, an older man with an ileostomy who lives at home with support from a home care package. During a hot weekend his output increases and becomes very watery, and he begins to feel dizzy and tired. The lesson shows how his support worker recognises the signs of dehydration, follows his plan, reports promptly and knows when to call 000. It also covers recording output clearly. Key points: high, watery ileostomy output can cause dehydration quickly, act early, follow the plan and never stop a person drinking.

This case study follows Jamal, a young man with a colostomy who loves going to the football with his mates. After a leak at a game he starts to say he would rather stay home. The lesson looks at how his support worker plans ahead with him, handles a leak calmly and discreetly, protects his privacy, and supports him to keep doing what he enjoys. It then brings together the key messages of the whole course. Key points: dignity, privacy, planning and choice matter as much as the practical steps of stoma care.