NHS Forth Valley – Enhanced Recovery Journey with a Stoma

What is Enhanced Recovery?

Enhanced Recovery is a programme designed to help you recover as quickly and safely as possible after planned surgery. It includes:

Reducing fasting times before surgery
Using smaller (keyhole) cuts where possible
Supporting you to eat, drink and move around sooner

This approach helps your body recover more quickly and may allow you to go home within a few days.

What is a Stoma?

A stoma is a small opening made on your tummy (abdomen) during surgery. Part of your bowel is brought out onto the skin surface so waste (poo) can pass into a special pouch. This can be temporary or permanent depending on your surgery.

Types of stoma:

Ileostomy: from the small bowel (output is runny, like porridge)
Colostomy: from the large bowel (output is thicker, like soft toothpaste)

You may hear the terms end stoma or loop stoma – these describe how the stoma is formed.

It’s natural to feel worried about a stoma. Please remember you are not alone. Our Stoma Care Team will support and teach you how to care for your stoma. With time and practice, most people become confident in managing their stoma at home.

On the Day of Surgery

When you arrive:

You will meet your surgeon to go over the operation again and give your consent
An anaesthetist will check your health and explain pain control
A Stoma Nurse will mark your tummy to show the best place for your stoma
Nurses will complete a checklist with you, including medicines and allergies

Fasting:
Stop eating 6 hours before surgery. You may drink clear fluids until 2 hours before surgery.

After Surgery

When you wake up, you will:

Have a pouch over your new stoma
A healthy stoma looks pink, warm and moist. It may be swollen at first
You will not feel pain from the stoma itself, but the skin around it may be tender

At first, nurses will help you care for the stoma. Soon, you will begin to practice with their support. Each day you will build confidence in looking at, touching, emptying, and eventually changing the pouch yourself.

Getting Ready to Go Home

Before you go home, you will:

Be able to look after your stoma (with or without some help)
Have enough supplies to get started, along with information about suitable delivery services
Receive written advice and contact details for support
Know when your Stoma Nurse will follow up (usually by phone in 2–3 days and at a clinic visit in 1–2 weeks)

Remember: Everyone learns at their own pace. Our team will support you until you feel confident.

Questions You May Have

How often will my bowels move?

With an ileostomy: You may need to empty your pouch up to 7 times a day (and sometimes at night).
Tip: Always empty your pouch before bed. If you’re a deep sleeper, set an alarm to avoid leaks.
With a colostomy: Your bowels may move up to 3 times a day.

Other tips: