What is a stoma?
A stoma is an artificial connection between a hollow organ and the surface of the body, i.e. an opening in the body. Examples of this are
- the gastrostomy (stomach stoma) for artificial nutrition
- the enterostoma (artificial bowel outlet) for excreting stool
- the urostoma (artificial bladder outlet) for urinary excretion
The procedure in which the doctor creates the stoma is called a gastrostomy, enterostomy or urostomy, depending on the organ affected.
Depending on the underlying disease and previous operations, the stoma can be removed again after some time; the doctor can then also perform a stoma repositioning. In many cases, however, a permanent, i.e. lifelong, stoma is necessary.
When is a stoma placed?
The primary purpose of a stoma is to help the patient to absorb or excrete if this is no longer possible by natural means.
Urostomy The artificial bladder outlet helps the patient to pass urine. The doctor inserts the urostomy if the bladder has had to be removed due to an underlying disease (such as bladder cancer) or if there is a dysfunction of the urinary tract.
Urostomy
You can read about when an artificial bladder outlet is necessary and how it is created and cared for in the article Urostomy.
Enterostomy
An enterostomy, i.e. an artificial bowel outlet, is fitted if the patient is no longer able to empty their bowels naturally, especially if the rectum has been surgically removed, for example as a result of an inflammatory bowel disease or cancer.
Artificial anus
You can read about when an artificial anus is necessary and how bowel evacuation works in the article Artificial anus.
What is done when a stoma is created?
Gasterostomy
Percutaneous endoscopic gastrostomy is normally used for the medium and long-term artificial feeding of a patient via a stoma. The procedure is guided and controlled via an endoscope. First, the endoscope is inserted into the stomach via the oesophagus. The device is used to inflate the stomach and a site on the front wall of the stomach is selected. The patient is punctured there and a feeding tube is inserted. This is attached to the inside and outside of the stomach.
Enterostomy
The surgeon gains access to the abdominal cavity either through an abdominal incision (laparotomy) or via a probe. The further surgical procedure depends on whether the patient is to be treated with a terminal stoma or a double-run stoma:
Urostomy
What are the risks of a stoma?
The creation of a stoma is not a complicated procedure and is often carried out. Nevertheless, there are some risks associated with stoma care, despite careful adherence to current standards. The risk of complications generally increases with the length of time the stoma is worn.
Risks of the gastrostomy
The following problems can occur with a gastrostomy:
- Blockage of the gastrostomy tube
- Internal or external pressure injuries that lead to tissue death
- Accumulation of air in the abdominal cavity or abdominal wall
- Excessive new tissue formation, which may need to be removed with laser therapy or surgically
Risks of the urostoma
The complications that occur with a urostomy can be found in the article Urostomy.
Risks of the enterostoma
The complications that occur with an artificial bowel outlet can be found in the article Artificial bowel outlet.
What do I have to consider with a stoma?
You can continue to take part in sporting activities with the stoma as long as your basic condition allows it. We recommend wearing a customized stoma bandage for this purpose, which creates counter-pressure when the abdominal cavity is under pressure. Water protection belts are also available for water sports.
Self-help groups
Sharing experiences with other people with a stoma helps many patients to get used to living with an artificial bowel or bladder outlet. There are numerous self-help groups for patients with a stoma, for example from the specialist association Stoma Kontinenz und Würde e.V. or the Deutsche Solidargemeinschaft von Stomaträgern und von Menschen mit Darmkrebs sowie deren Angehörigen.
