Forgive my ignorance. I don't know anyone with a bag, and I've never even had surgery for the Crohn's. I'm just curious about some things.
What exactly is a stoma? Is it the piece of intestines that sticks out?
How does it stay in place and not go back in your body, leaving a hole?
For temporary ones, what happens to the disconnected colon? Does it just sit in there, open-ended?
How does the bag attach to the stoma? Is there a clamp that goes around it, or does it just stick on? If adhesive, doesn't that hurt every time you pull it off to empty it (like ripping off a bandaid)?
If you wear snug clothing, doesn't that smush the contents of the bag out? Or back into the stoma?
I think that's all for now. I hope nothing came across offensive. I'm truly curious how these things work, in case I ever need one.
Hi Steph,
No need to apologise. You are showing no ignorance. These are valid questions for someone who hasn't had a stoma! I'll try to answer to the best of my knowledge!
1/ What exactly is a stoma? In an ileostomy, it's part of the terminal ileum that has been pulled through a hole in the stomach so stool bypasses the colon and comes out of the stoma instead. In a colostomy it's part of the colon that forms the stoma end.
2/ Is it the piece of intestines that sticks out? Yup, see above!
3/ How does it stay in place and not go back in your body, leaving a hole? The end of intestine that forms the stoma is pulled out and then turned inside out and stitched to the skin through to the intestine (if that makes sense...it's tough to describe without a picture)
4/ or temporary ones, what happens to the disconnected colon? Does it just sit in there, open-ended? Some people have loop ileo. In this case you the upper end of the colon usually comes out in the same opening as the stoma and the bag goes around both the stoma and this end, which is called the mucous fistula. Others have the operation and the surgeons leave a rectal stump behind, which is a closed section of the colon around 6" to 12" from the rectum. This can be removed later on, or in some cases, worked on with the small intestine to create a J, S or even W Pouch (ileo-anal pouch). That operation is usually one for UC and not Crohn's patients.
5/ How does the bag attach to the stoma? A hole is cut in the flange of the stoma and this sticks to the skin around the stoma
6/Is there a clamp that goes around it, or does it just stick on? If adhesive, doesn't that hurt every time you pull it off to empty it (like ripping off a bandaid)? There are plenty of different types of flanges on stomas to suit different types of skin and plenty of products to protect the skin underneath while the flange is sticking to it. I use a product to protect the skin and spray it on before I stick the bag on. I then use another spray product to help remove the stoma bag flange with ease. I do not have any pain removing it.
7/If you wear snug clothing, doesn't that smush the contents of the bag out? Or back into the stoma? Not really. I wear a tight waistband at work for support and to help muffle noise. It's never stopped the flow. Occasionally it can hold up the stool closer to the top of the bag, but it eventually finds it way down.
I hope that helps. As I said I have answered to the best of my knowledge. However, it may not be the same as other ostomists see it. I've had my 4 years but still see myself as a learner!!
Gav
