Living with a Stoma

A stoma is made when the bowel cannot be used normally or needs to rest or be bypassed. Reasons include severe Crohn’s disease or ulcerative colitis, bowel cancer, complicated diverticulitis, bowel obstruction or perforation, severe injury, bowel problems from radiation, and problems at the anus or rectum. A temporary loop stoma is often made to protect a newly joined section of bowel so it can heal. Your surgeon will explain why you need yours and whether it can be reversed.

Many thousands of people live with a stoma. They are of all ages, from children to older adults. Some stomas are temporary, and many people go on to have them reversed.

Hot weather, sweating and long travel can loosen appliances and increase fluid loss, so carry extra supplies and keep up your fluids. Ask your hospital whether a stoma nurse clinic and supplies are provided through your health coverage, and plan supplies well before Hajj, Umrah or summer travel. Many people find it easier to talk about stoma care with a nurse of the same gender; you can request this.

There is no single test. Your surgeon and a specialist stoma nurse assess the stoma and the skin around it at regular visits: its colour, size and shape, how the bag fits, the type and amount of output, your weight, fluid intake and urine, and any pain or skin damage. Blood tests may be taken for dehydration, salts (such as sodium and potassium), kidney function and vitamin B12 (especially after surgery on the end of the small bowel). A scan may be needed for a suspected hernia or blockage. The team also decides, over time, whether the stoma can be reversed, based on why it was made and your general health.

Confidence grows with practice. Your stoma nurse will teach you and give you a plan before you leave the hospital.

• Empty the bag when it is about one-third to one-half full, and change the whole appliance as often as your nurse advises. A bag that is too full can pull off and leak.

• When changing: wash the skin with warm water (soap is not needed, and avoid scented or oily products), pat dry, and cut the opening of the base plate to fit the stoma. Gentle removal using adhesive remover helps protect the skin.

• You can shower or bathe with the bag on or off; water does not enter the stoma. Rinse away soap residue so the bag sticks well.

• Wear what you like. High-waisted, soft clothing is comfortable, and a stoma support garment can help prevent a hernia. Avoid belts or tight bands over the stoma.

• Travel: carry double the supplies you expect to need in your hand luggage, as well as a supply of spares, a travel certificate or doctor’s letter, and wipes. In hot weather, keep supplies cool, as heat and sweat may loosen the adhesive. For Hajj and Umrah, plan toilet access, carry water and extra supplies, and ask your team in advance.

• Be active. Gentle exercise and walking are encouraged. For the first 6 to 12 weeks after surgery avoid heavy lifting as your surgeon advises, to reduce the risk of hernia.

• Talk to your partner, family or a support group about how you feel. Feeling anxious or low at first is common and help is available.

Skin care: keep the opening of the base plate cut to size, and never ignore a leak. The skin is damaged quickly by output, so change the appliance rather than patching it.

Most people can eat a normal, varied diet. Hydration matters most, especially with an ileostomy.

• Drink enough fluid through the day (often 1.5 to 2 litres, more in hot weather or with high output). Add salt to meals unless your doctor has advised otherwise. Your team will tell you what is right for you.

• High-output stoma (more than about 1.5 litres a day from an ileostomy): drink an oral rehydration solution rather than plain water, and sip drinks slowly. Plain water or tea in large amounts can make output worse. Contact your team the same day because medicines and salt replacement may be needed.

• Ileostomy blockage: chew food very well and eat slowly. Foods that can block include nuts, seeds, skins of fruit and vegetables, raw celery, sweetcorn, mushrooms, coconut, dried fruit, popcorn and tough meat gristle. Introduce them one at a time in small amounts, after a few months, once healed.

• Gas and odour: eat regular meals and chew with your mouth closed; avoid fizzy drinks and chewing gum. Foods that may increase gas include beans, onions, cabbage, and fizzy drinks. Foods that may reduce smell include yoghurt and parsley, and odour-neutralising bag products can help. Vent or change the bag as taught.

• Colostomy: constipation or loose output can both occur. Fibre and fluids usually help constipation; ask your team before using laxatives.

• Do not follow strict restrictive diets or detox products. If you lose weight unintentionally, tell your team and ask for dietitian support.

Medicines are used to control output, protect the skin, and prevent problems. Always check with your doctor, stoma nurse or pharmacist before starting or stopping anything, as some tablets (for example slow-release or coated tablets) may not be absorbed well with an ileostomy.

• Loperamide can thicken the output of an ileostomy, but use it only on the advice of your doctor or stoma nurse. Do not use it if there is a blockage, fever, or blood.

• Skin barrier products (barrier films, rings, pastes or powders) protect the skin and fill uneven areas. Your nurse will choose the products that suit you.

• Treat skin infection or rash only as advised; do not apply creams under the base plate unless your nurse says so, as they stop it sticking.

• If you take medicines for another illness (for example inflammatory bowel disease, diabetes, heart or blood pressure), ask whether the dose or form needs adjusting with your stoma.

• Supplements such as vitamin B12 or electrolyte replacement may be advised if tests show low levels.

Regular review by a stoma nurse is the most important “procedure”. Surgery is considered for reversal or for complications.

• Stoma nurse review before surgery (to mark the best site), soon after surgery, and then regularly and whenever you have a problem. Nurses can resize the appliance, treat skin problems and teach you.

• Reversal surgery (closing the stoma and rejoining the bowel) is possible for many temporary stomas after healing, often several months later. It is not possible or advised for everyone; your surgeon will discuss the benefits and risks, including the risk of bowel function changes afterward.

• Hernia repair (a bulge next to the stoma, called a parastomal hernia) is considered if it is painful, causes leaks or blockage, or interferes with life. Surgery is not always needed; support belts help in some people.

• Prolapse (stoma sliding out), retraction, narrowing or severe skin problems may need a minor operation or revision.

• Stoma care education sessions and peer support groups, if available, can build confidence.

Most people adjust well within a few months and return to work, exercise, travel and relationships. Learning to look after the stoma gets easier with practice and the support of a stoma nurse. Temporary stomas are often reversed some months after the first operation, depending on healing and the underlying illness. Permanent stomas are life-changing at first but very manageable long term.

• Is my stoma temporary or permanent, and when could it be reversed?

• How often should I change and empty my bag, and is my appliance the right size?

• How much should I drink, and when is my output too high?

• Which foods may block my ileostomy?

• Which medicines are safe and well absorbed with my stoma?

• Who do I call if I have a leak, skin problem or blockage out of hours?

This guide comes from the Saudi Gastroenterology Association (SGA) patient library, prepared by the Approved for publication by SGA; individual clinician review is ongoing. Last reviewed: 2026-04-24. It is for education and does not replace your doctor's advice.