Stoma location

candipa

Hi, for those of you who have a colostomy can you tell me what procedure you went through to determine where your stoma should be? Was this done immediately before surgery or on a separate day? What did they do to determine the best placement?
Thanks,
Cheryl

Shayenne

Hi Cheryl!
I didn't have any kind of appointment for my colostomy, and no say, I actually had bad pains in my belly area, and went to the hospital to get it checked out, and ended up with an emergency colostomy! my stools were going into my belly, and they had to do it fast, or I would have died, but it's ok, they put it in a really good place, very comfortable for me, and glad I had it done, it's something to get used too, but you do

Hugsss!
~Donna

Patteee

mine was also an emergency
mine was also an emergency as I was obstructed. It was also in the middle of the night. They did call a stoma nurse in just for me (this was at Mayo)- she had me stand, lay down, bend over, sit- and determined the best placement based on that. The surgeon then used her markings for the placement. Worked out very well.

KATE58

Shayenne said:

Hi Cheryl!
I didn't have any kind of appointment for my colostomy, and no say, I actually had bad pains in my belly area, and went to the hospital to get it checked out, and ended up with an emergency colostomy! my stools were going into my belly, and they had to do it fast, or I would have died, but it's ok, they put it in a really good place, very comfortable for me, and glad I had it done, it's something to get used too, but you do

Hugsss!
~Donna

IT IS MY UNDERSTANDING THAT
IT IS MY UNDERSTANDING THAT COLOSTOMYS (still have part of lg colon) ARE
ALWAYS ON THE LEFT SIDE,
ILEOSTOMYS (LG COLON GONE COMPLETY) ARE ON THE RIGHT.
NO CHOICE THERE.
THE ONLY CHOICE MY DOCTOR GAVE ME WAS,DID I WANT TO BE ABLE TO WEAR HIPHUGGERS
AFTER.
I HAVE AN ILEOSTOMY.

lizbiz

I also had to have emergency
I also had to have emergency surgery. I absolutely HATE where mine is placed. I'm going to ask my HIPEC surgeon if he can move it for me. Mine is placed exactly where all my jeans, pants - whatever has a waistband - naturally sit. I would definitely think about that beforehand, since you have a choice.

Of course, all of this also depends upon what segments have to be removed and how much colon is left.

Good luck with your surgery!

Hugs,
Elizabeth

just4Brooks

I had no sy.. But wish I did
I'd see a stoma nurse BEFORE if you can. I wish mine was a little higher then what it is.

Brooks

Buzzard

just4Brooks said:

I had no sy.. But wish I did
I'd see a stoma nurse BEFORE if you can. I wish mine was a little higher then what it is.

Brooks

My stoma placement was controlled.....
I went in for pre surgery consultation and was also "dotted" for the stoma placement. As I remember she took her hand and placed it in between the abs where the indention was between the ab muscles and placed a dot with the end of a Sharpie (permanent marker). She took into consideration where mens pants were worn and whether the belt would interfere etc. If it is controlled and not emergency ( in which I can't understand why anything should be done that fast without placement being a main concern whether temporary or being permanent) it should not interfere with your pantsline etc. If I wear a belt (which I hardly ever do) then I have to watch it to assure that it doesn't get under the snap on ring and pop it off. That is the reason for me never wearing a belt. But proper placement is a must if you want the best possible advantages of having to have an ostomy, and I am assuming that the spot they make will be the less invasive as far as how much muscle tissue will be cut. There has to be a lot of reasoning to it to allow for recovery, least amount of discomfort, and user friendlyness........Good luck with yours ...Love and Hope, Buzzard

WinneyPooh

placement
Wow, did not know you could choose, mine was also emergency surgery and hopefully being reversed this month, because i hate it. i hate where it is and it has never worked for me. I get side blow outs and this is because the place it is for lack of better terms is in a jelly roll area, and i can't get the collars to sit properly so they leak. don't want to scare you but the flatter the stomach area the better, and if you have belly fat, i hope you have better placement then me.

Good luck
I hope it all goes well.
Penny

karguy

Stoma
when I was in preop the stoma nurse came in and measured,then marked it with a magic marker after the nurse shaved every thing.I wanted it as low as I could get it,and it is about 4" below my belt line.That works out well for me,I can sit comfortably ,and bend over without many problems.But you do want the area to be as flat as you can.After a while you get used to it,and don't even think about it,unless your filter gets plugged,and you get gas.Then it blows up like a balloon,and you have to release the gas.Mine is a colostomy,good luck,I hope everything works out.

John23

Info
Well, a number of things....

The stoma should be at least 3/4 to 1 inch in length (protruding from the skin).

You should note wear your normal belt-line is, and have it placed
below the belt-line, so that it doesn't interfere.

With an Ileostomy, the stoma is placed as far to the side as
needed, so the pouch will point down the face of the leg while standing.

There once was a 4x4 rule; 4 inches below the belt, 4" to the side
(side of center/belly button).

You should have a WOCN nurse mark the area before the operation.

Usually they will fill a pouch with applesauce, or anything thick, and
let you wear it for a day where it would be going, to make sure it'll
be right for you. Ask if they will do that for you before you have
the stoma placed!

It is your absolute right to have it placed where it is best for you.

Most of us went in via the ER on a gurney, and got rolled out with
a stupid plastic bag dangling from our side. I was lucky, and it
was placed in a decent spot, with the stoma a decent length, but
there are too, too many out here with poorly formed stomas, having
a difficult time maintaining it.

You should have an experienced colorectal surgeon doing this, btw...
If you don't, get one. You have the time to get this right, so don't
give it away!

Good luck, and even better health!

UOAA Forum Link

Annabelle41415

Placement
My stoma placement was done before surgery but I knew I was having one. The surgeon told me I would probably have a temporary one and ileostomy, but the ostomy nurse marked both sides of me, just in case the ileostomy was not temporary and he had to do a permanent colostomy. I was prepared for the good and the not so good, but educated myself on an ostomy two months before and after I had it, I was ok with it. It's just a matter of dealing with a new normal. I just went through a reversal and this is harder than the ostomy. Hope all goes well, which I'm sure it will.

Kim

VickiCO

before surgery...
I met with a Certified Ostomy practitioner 2 days before my surgery. She had me bring several changes of clothes, especially underwear, so she could mark a good location for the surgeon. I, too, wore a 'pretend' pouch and wafer until the surgery. She was wonderful and really helped me get past all the baggage that comes with knowing you are getting an ostomy. (Mine is permanent.)

John, you mention the stoma should protrude 1 inch. Mine does not...it is level with my abdomen. I know several others who have "innies' like mine. It's not a problem for me. They do make convex wafers for just this purpose. I also do not seem to have a problem with bleeding that others have mentioned. Occasionally, yes, but very little.

Many hugs, Vicki

KATE58

VickiCO said:

before surgery...
I met with a Certified Ostomy practitioner 2 days before my surgery. She had me bring several changes of clothes, especially underwear, so she could mark a good location for the surgeon. I, too, wore a 'pretend' pouch and wafer until the surgery. She was wonderful and really helped me get past all the baggage that comes with knowing you are getting an ostomy. (Mine is permanent.)

John, you mention the stoma should protrude 1 inch. Mine does not...it is level with my abdomen. I know several others who have "innies' like mine. It's not a problem for me. They do make convex wafers for just this purpose. I also do not seem to have a problem with bleeding that others have mentioned. Occasionally, yes, but very little.

Many hugs, Vicki

FLAT MAY WORK WITH A
FLAT MAY WORK WITH A COLOSTOMY,WHERE THINGS ARE MORE SOLID,
BUT I HAVE AN ILEOSTOMY WHICH IS LIQUID TO A PASTE AND CONSTANT
DRIPPAGE,FLAT WOULD LEAD TO A LOT OF LEAKING,MINE PROTRUDES ABOUT AN INCH OR SO,
TO ASSURE IT DOESNT LEAK UNDER WAFER.
THE FECES FROM THE SMALL INTESTINE STILL HAS DIGESTIVE JUICES IN IT AND CAN BE VERY IRITATING TO THE SKIN. I HAVE TO MAKE SURE THE WAFER FITS SNUG AROUND THE STOMA SO THE FECES WILL NOT TOUCH MY SKIN.
MY UNDERSTANDING IS WITH A COLOSTOMY,YOU NEED TO LEAVE A LITTLE ROOM AROUND STOMA.

zenmonk

stoma
mine was done by a stoma nurse about a week before surgery. They look for specific muscle structure.

JIM

stoma placement
Hi, I went in 2 days before surgery and had the ostomy nurse talk to me and she helped me determine a good place for it. Mine is above the belt line and 3inches left of the belly button. She marked it for the surgeon and there is is.

menright

Ask the Questions Now!
Cheryl:

I hoped and prayed that I would not need a colostomy. As a result, I did not discuss the placement other than a brief comment by my surgeon. Mine is adjacent to my belly button and well above my normal belt line. I think it should and could be placed much lower.

Be sure to ask the questions and request some of the care and planning that others have mentioned in their replies. As I read this I realize I missed the boat on planning this properly.

Best of luck.

Mike

VickiCO

KATE58 said:

FLAT MAY WORK WITH A
FLAT MAY WORK WITH A COLOSTOMY,WHERE THINGS ARE MORE SOLID,
BUT I HAVE AN ILEOSTOMY WHICH IS LIQUID TO A PASTE AND CONSTANT
DRIPPAGE,FLAT WOULD LEAD TO A LOT OF LEAKING,MINE PROTRUDES ABOUT AN INCH OR SO,
TO ASSURE IT DOESNT LEAK UNDER WAFER.
THE FECES FROM THE SMALL INTESTINE STILL HAS DIGESTIVE JUICES IN IT AND CAN BE VERY IRITATING TO THE SKIN. I HAVE TO MAKE SURE THE WAFER FITS SNUG AROUND THE STOMA SO THE FECES WILL NOT TOUCH MY SKIN.
MY UNDERSTANDING IS WITH A COLOSTOMY,YOU NEED TO LEAVE A LITTLE ROOM AROUND STOMA.

Kate
Yes, my doctor said ileostomy stomas protrude, but colostomy stomas do not have to - some do, some don't. Fortunately I haven't had issues. I did have to try several different products until I was happy...and now I am trying a convex wafer. I think it's the right one for me.

Yes, I leave a little room around it, but not much. If I leave too much, my skin gets irritated. Also, it depends on what I eat, of course! Ah...it's a new way of life. But I'm getting there. Two months since surgery and I feel like I am getting a handle on it all.

Hang in there....Vicki

John23

Stoma length
To avoid problems:

The stoma should protrude 3/4 to 1" from the surface of the skin.

It should be located under the belt-line far enough to wear your clothes normally.

It should be off to the side far enough not to interfere with your sexual organs,
or so far to the side as to interfere with the side of your leg.

I found the UOAA forum to be the best for information regarding ostomys.


Good health!!