What Is a Stoma? Complete Guide for Ostomates (2026)
If you or someone you love has been told they need a stoma, it's natural to feel overwhelmed by questions. What exactly is a stoma? What will life be like afterwards? In this comprehensive guide, we answer everything — from the medical basics to everyday living — drawing on the latest guidance from the NHS, UOAA, and leading ostomy specialists.
What Is a Stoma? Medical Definition
A stoma (from the Greek word meaning "mouth" or "opening") is a surgically created opening in the abdominal wall that allows either waste products or urine to exit the body into an external collection pouch, known as an ostomy bag or stoma pouch. The word "ostomy" refers to any surgical operation that creates this kind of opening.
According to the United Ostomy Associations of America (UOAA), approximately 750,000 to 1 million Americans currently live with a stoma, and around 100,000 new ostomy surgeries are performed in the United States each year. In the UK, the NHS estimates that 1 in 500 people live with a stoma — equating to roughly 135,000 people in the UK alone.
A stoma is not a disease or a condition in itself — it is a surgical solution that allows people with serious bowel, bladder, or other conditions to live full, active lives.
Types of Stoma: Colostomy, Ileostomy and Urostomy
There are three main types of stoma, each involving a different part of the digestive or urinary system:
Colostomy
A colostomy is formed from part of the large intestine (colon). It is the most common type of stoma, accounting for approximately 42% of all ostomy surgeries. In a colostomy, a section of the colon is brought through the abdominal wall to form the stoma. The output from a colostomy tends to be more solid, similar to normal stool, depending on where in the colon the stoma is formed. Colostomies are most often created as a result of colorectal cancer, diverticulitis, or bowel trauma.
Ileostomy
An ileostomy is formed from the small intestine (ileum) — the final section before the large intestine. The output is typically more liquid, as it bypasses the large intestine where most water absorption occurs. Ileostomies are most commonly associated with Crohn's disease, ulcerative colitis, and familial adenomatous polyposis (FAP). There are approximately 340,000 people in the United States living with an ileostomy.
Urostomy
A urostomy (also called a urinary diversion or ileal conduit) diverts urine away from the bladder through a piece of the small intestine. It is typically created following bladder removal surgery (cystectomy) due to bladder cancer or severe bladder damage. Unlike colostomies and ileostomies, a urostomy continuously produces output, meaning the pouch must be emptied regularly throughout the day.
Why Would Someone Need a Stoma?
Stoma surgery is not elective — it is typically performed when other treatments are no longer viable. The most common medical reasons include:
- Colorectal cancer — the leading cause, accounting for approximately 42% of ostomy surgeries
- Crohn's disease — an inflammatory bowel disease (IBD) affecting the digestive tract (approx. 19%)
- Diverticulitis — infected or inflamed pouches in the colon (approx. 13%)
- Ulcerative colitis — a chronic IBD affecting the colon and rectum (approx. 11%)
- Bladder cancer — most commonly requiring a urostomy following cystectomy (approx. 8%)
- Bowel obstruction, trauma, or perforation
- Congenital conditions such as Hirschsprung's disease in children
- Faecal incontinence — when all other treatments have failed
In some cases, a stoma may be temporary — created to allow another part of the bowel to heal after surgery, before being reversed in a follow-up operation. In other cases, a stoma is permanent.
What Does a Stoma Look Like?
Understanding what a stoma looks like helps many people feel more prepared before surgery. Here is what to expect:
Normal stoma appearance: A healthy stoma is pink to red in colour, moist, and slightly raised above the skin surface. It has no nerve endings, which means it is not painful to touch. The stoma will typically be 2–5 cm in diameter, though this can vary. In the first weeks after surgery, swelling is common — the stoma will reduce to its permanent size over 6–8 weeks.
One important thing to understand: a stoma cannot be controlled voluntarily. There is no sphincter muscle, so waste passes into the ostomy pouch continuously or periodically, depending on the type of stoma. This is why choosing the right ostomy pouch and well-fitting accessories is so important to quality of life.
The skin around the stoma — called peristomal skin — requires careful attention. A well-fitted appliance that sits flat against the skin is essential to prevent leaks and skin irritation.
Living with a Stoma: What to Expect
The transition to life with a stoma can feel overwhelming at first, but the vast majority of ostomates report that they adapt well and go on to live full, active lives. A 2022 survey by Coloplast found that 95% of long-term ostomates reported their quality of life had returned to normal or better within one year of surgery.
Diet and Nutrition
In the early weeks after surgery, a low-fibre diet is typically recommended to allow the bowel to recover. Over time, most people can return to a relatively normal diet, though certain foods may cause gas, odour, or changes in output consistency. Common considerations include:
- Staying well-hydrated, especially with an ileostomy, to prevent dehydration
- Introducing foods gradually and noting which ones affect output
- Limiting carbonated drinks and gas-producing foods initially
- Chewing food thoroughly to aid digestion
Physical Activity
Most people with a stoma can return to regular physical activity, including swimming, cycling, and gym exercise. However, high-impact activities that create abdominal pressure increase the risk of parastomal hernia — a common complication where abdominal tissue pushes through the weak point around the stoma. Wearing a supportive ostomy belt during exercise is strongly recommended by clinicians.
💡 SIIL Ostomy Belt for Exercise: Our hernia-prevention ostomy belts are specifically designed for active ostomates. With adjustable compression and discreet design, they support the stoma during exercise without restricting movement. Explore the SIIL Ostomy Belt →
Bathing and Swimming
You can bathe or shower with your ostomy pouch in place or removed (depending on your stoma type). Most ostomates can swim without issue — a well-sealed, waterproof appliance combined with specialist ostomy swimwear provides confidence in the water.
Travel
Travelling with a stoma is entirely possible with some planning. Always carry more supplies than you think you'll need (typically double), keep supplies in your hand luggage, and carry a medical letter from your GP or consultant if travelling internationally.
Essential Products for Stoma Management
The right ostomy products make an enormous difference to comfort, confidence, and daily quality of life. Core products include:
- Ostomy pouching system — the bag that collects waste. Available in one-piece and two-piece systems from brands including Coloplast, Hollister, and Convatec.
- Ostomy belt or hernia support belt — provides abdominal support and reduces hernia risk. Essential for active individuals. Browse SIIL ostomy belts.
- Ostomy underwear — specialist underwear designed to hold the pouch securely, reduce pouch movement, and provide a smooth, discreet silhouette under clothing. View SIIL ostomy underwear.
- Skin barrier products — barrier wipes, rings, and pastes to protect the peristomal skin.
- Pouch deodorant drops — added inside the pouch to neutralise odour.
Frequently Asked Questions About Stomas
Is living with a stoma painful?
No — a stoma itself has no nerve endings and is not painful. There may be discomfort around the stoma site in the healing period after surgery, and some peristomal skin issues can cause irritation, but a healthy, well-managed stoma should not cause pain.
Can you live a normal life with a stoma?
Absolutely. With the right products, support, and adjustment period, the vast majority of people with stomas return to full, active lives — working, exercising, swimming, travelling, and maintaining intimate relationships. Many describe feeling better after surgery than before, particularly when the underlying condition was severely affecting their quality of life.
Can a stoma be reversed?
In some cases, yes. A temporary stoma — often created to allow the bowel to heal after surgery — can be reversed in a follow-up operation, usually 3–12 months later. However, permanent stomas (such as those following abdominoperineal resection for rectal cancer) cannot be reversed.
What is the difference between a colostomy and an ileostomy?
A colostomy is formed from the large intestine (colon), and typically produces more formed, solid waste. An ileostomy is formed from the small intestine (ileum) and produces more liquid output, as it bypasses the large intestine where water is normally absorbed. Both require an external pouching system, though the pouches differ in design.
Are ostomy supplies free on the NHS?
In England, Scotland, Wales, and Northern Ireland, ostomy supplies are available free of charge on NHS prescription for those with a medical exemption certificate (MedEx). This includes pouches, skin barriers, belts, and other accessories. Speak to your GP or stoma nurse to register for a prescription prepayment certificate or medical exemption.
Living confidently with a stoma starts with the right support
Explore SIIL's range of ostomy belts, underwear and swimwear — designed by ostomates, for ostomates.
Ostomy Belts → Ostomy Underwear →Sources: United Ostomy Associations of America (UOAA), NHS England, Cleveland Clinic Ostomy Care Guide, Coloplast Quality of Life Survey 2022, British Journal of Nursing — Stoma Care Supplement 2023.
