Having a colostomy for anal cancer

A colostomy is a procedure in which your surgeon makes an opening in your abdomen and stitches a section of your bowel to this opening. The opening on to your skin is called a stoma.

You will need a colostomy if you have an operation called an abdominoperineal resection to treat your anal cancer. This is because the surgeon removes your anus, rectum and part of your colon (bowel).

After your operation the stoma will be swollen but will get smaller as it heals. It is round or oval in shape, and red like the inside of your mouth. It has no nerve supply, so does not hurt. But you have to take care not to injure it because you won't be able to feel pain there. Your faeces (stools) will now pass out of the stoma, to be collected in a special bag which you put over it. As well as passing faeces (stools), the stoma oozes a white mucus substance. This is perfectly normal and collects in the bag with the faeces.

Learning to look after a colostomy takes time. You will not be expected to cope on your own. There are specialists to help, especially the stoma nurse. The stoma nurse is experienced in looking after colostomies and teaching patients. They will visit you on the ward before and after your operation and will help you to learn to look after your stoma. At the first visit, the nurse will answer your questions and show you the type of colostomy bag you will be using at first. You will learn how the bag works and how to fit and empty it. The stoma nurse or ward nurse will look after your colostomy and change your bag for the first few days. Gradually, you will be encouraged to take over.

The stoma nurse will also advise you on your diet, and answer any questions you have about practical things, such as travelling, doing sports and what to wear. It is helpful to keep everything you need to change your colostomy together in a bag or in one place. That way, you won't be halfway through and realise that something vital is missing.

Talk to your stoma nurse or the ward nurses about the kind of support you feel you will need at home. Before you leave hospital you may want the stoma nurse to show a close relative how to look after the colostomy so they can help out when you get home.

Your stoma nurse will give you their contact details before you leave the hospital. You can ring them for advice and support, and the nurse may arrange to visit you at home. Or a district nurse may visit for a few days to make sure you are coping.

Your stoma nurse will make sure you have colostomy bags to take home. You will have to get more from the chemist or direct from a local stockist. Make sure you order more well before you are likely to run out. They are free, but your GP needs to give you a signed prescription and, if you are between 16 and 65, will also need to sign a free prescription form for you.

The Colostomy Association has lists of stockists of colostomy equipment. They also give support and information to anyone with a colostomy.

Adjusting to living with a stoma is not easy, and takes time. There is more information on coping with a colostomy in the living with anal cancer section.