Stoma surgery and care
A stoma is an opening on the abdomen, made during surgery, through which stool leaves the body into a bag. An ileostomy brings out the small bowel and a colostomy the large bowel. A stoma can be temporary, often to let a join in the bowel heal before a smaller operation reverses it, or permanent when the rectum or anal muscles must be removed or do not work. A stoma nurse teaches you to change the bag. Most people return to their usual activities, including sport and work, once healed.
What is a stoma?
A stoma is an opening on the abdomen made by surgery, through which stool passes into a pouch. An ileostomy connects the small bowel to the skin and a colostomy connects the large bowel. A stoma may be temporary and reversed later, or permanent when normal bowel function cannot be restored.
Stoma surgery, also called ostomy surgery, changes the way bowel contents leave the body when part of the bowel is diseased, injured, resting or removed. The surgeon brings an end or loop of bowel through the abdominal wall and stitches it to the skin. A pouch with an adhesive skin barrier fits over it. Stomas are made for conditions such as bowel cancer, inflammatory bowel disease, diverticular disease and bowel obstruction.
Why is a stoma needed?
A temporary stoma is often made to divert stool while a new join in the bowel heals. A permanent stoma may be needed for low rectal cancer, inflammatory bowel disease or when the anal muscles do not work. Stomas are also made in emergencies such as bowel obstruction, perforation or infection.
- Protecting a new join in the bowel while it heals, often after an anterior resection
- Low rectal cancer where the rectum and anal muscles need to be removed
- Ulcerative colitis or Crohn's disease needing removal of the colon
- Diverticular disease, infection or a burst bowel in an emergency
- Bowel obstruction or poor blood supply to the bowel
- Severe bowel control problems that do not respond to other treatments
When should I seek help with my stoma?
Contact your stoma nurse or doctor urgently if the stoma has not worked for more than 12 hours, you have severe cramps, nausea or vomiting, lots of blood in the bag, signs of dehydration or a high temperature. Swelling around the stoma or worsening skin damage also needs review.
The warning signs below need prompt attention.
- A stoma that has not been active for more than 12 hours
- Severe cramps, nausea and vomiting
- Lots of blood coming from inside the stoma or in the bag
- Signs of dehydration, such as tiredness, a dry mouth or very high stoma output
- A high temperature or feeling hot, cold or shivery
- Swelling around the stoma or skin damage that is getting worse
How is stoma surgery planned?
Stoma surgery is planned by discussing why a stoma is needed and whether it is likely to be temporary or permanent. A stoma nurse explains pouches and daily life before surgery and helps choose a position on the abdomen. Your fitness for surgery and anaesthesia is checked as for any operation.
- Discussion of why a stoma may be needed and whether it is likely to be temporary or permanent
- Meeting a stoma nurse before surgery to learn about pouches and daily life
- Choosing a suitable position for the stoma on the abdomen
- Standard checks of your fitness for surgery and anaesthesia
What types of stoma are there?
An ileostomy brings out the small bowel and a colostomy the large bowel. A loop stoma is often temporary, protecting a join further down. Pouches are one-piece or two-piece, drainable or closed, chosen with a stoma nurse. A temporary stoma can be closed later in a reversal operation.
- Ileostomy: the end of the small bowel is brought to the skin
- Colostomy: part of the large bowel is brought to the skin
- Loop stoma: a temporary stoma to divert stool while a join further down heals
- One-piece or two-piece pouches, drainable or closed, chosen with your stoma nurse
- Teaching on emptying and changing the pouch and caring for the skin around the stoma
- Stoma reversal, a later operation to rejoin the bowel when the stoma is temporary
Is it covered by MediSave or insurance?
Dr Wong is a panel doctor under Alliance Medinet. Before your procedure, he can request pre-authorisation from Prudential and AIA, and the clinic writes in to other insurers in the same way. Prudential patients can claim when Dr Wong operates at Aptus Surgery (Paragon), a day surgery centre listed on Prudential's PRUPanel Connect. Pre-authorisation is decided by the insurer and is not a guarantee of payment. Eligible charges may be paid from MediSave within the limits for your procedure, and any uncovered balance is paid in cash.
How it works, step by step: fees, MediSave and insurance.
What is recovery like?
In hospital Learning stoma care
A stoma nurse teaches you to empty and change the pouch
First 6 weeks Low-fibre diet while the bowel heals
Drink plenty and chew food well
Back to usual life Usually 6 to 8 weeks
Avoid heavy lifting for about 3 months while the abdominal muscles heal
What are the risks and complications?
Stoma complications include wound infection, dehydration, especially with an ileostomy, blockage of the stoma, skin irritation around it, and a parastomal hernia. The stoma can also sink back or come out too far. Well-fitting pouches, regular measuring and early advice from a stoma nurse help manage most of these.
- Wound infection
- Dehydration, especially with an ileostomy
- Blockage of the stoma, with cramps, nausea and swelling
- Skin damage around the stoma, often from a poorly fitting bag
- A parastomal hernia, a bulge under the skin around the stoma
- The stoma sinking back (retraction) or coming out too far (prolapse)
How much does it cost in Singapore?
The cost depends on the treatment you need and how complex it is. MOH publishes fee benchmarks for most surgical procedures, and Dr Wong's fees are guided by them. After your consultation the clinic gives you a written estimate before you decide. See fees, MediSave and insurance.
Medically reviewed by Dr Wong Nan-Yaw
MBBS (NUS), FRCS (Edinburgh). 33 years in medicine (since 1993), 23 years as an accredited specialist (since 2003) and 18 years in private practice at Mount Elizabeth (since 2008). Last reviewed 6 November 2026.
Frequently asked questions
Will my stoma be permanent?
Not necessarily. Many stomas are temporary, made to protect a join in the bowel while it heals, and are reversed later with a smaller operation. A permanent stoma is needed when the rectum or anal muscles must be removed or do not work properly.
Will people be able to tell I have a stoma?
Modern pouches are discreet and designed to be odour-free, and leaks are not common when the pouch fits well. Many people with a stoma go about daily life without others knowing.
Can I exercise, work and travel?
Yes. Once healing is complete, most people return to their usual activities, including active sports. Avoid heavy lifting for about three months after surgery while the abdominal muscles heal.
What should I eat?
A low-fibre diet is usually advised for about six weeks after surgery. After that most people eat their usual foods, introducing new ones gradually, eating regularly, chewing well and drinking plenty to avoid dehydration and blockage.
Will a stoma affect my sex life?
Most people with a stoma return to their usual sexual activity. Removal of the lower rectum for cancer can sometimes affect sexual function because of nearby nerves, which is unrelated to the stoma itself. This can be discussed before surgery.
References and further reading
- Singapore General Hospital: Stoma
- NIDDK: Ostomy surgery of the bowel
- MedlinePlus: Ostomy
- NHS: Why an ileostomy is done
- NHS: Recovering and lifestyle changes after an ileostomy
- NHS: Complications of an ileostomy
- MedlinePlus: Large bowel resection
- Cancer Research UK: Surgery to remove all or part of your bowel (colectomy)
- Diseases of the Colon and Rectum: ASCRS clinical practice guidelines for ostomy surgery (2022)
- MOH: Hospital bills and fee benchmarks
Looking after yourself at home
Related
Colorectal cancer
Colorectal cancer diagnosis and surgery by Singapore colorectal surgeon Dr Wong Nan-Yaw. Screening, symptoms, treatment, recovery and MediSave guidance.
Crohn's disease
Crohn's disease management and surgery by colorectal surgeon Dr Wong Nan-Yaw, with symptoms, treatment, cost and MediSave guidance.
Ulcerative colitis
Ulcerative colitis management and surgery by colorectal surgeon Dr Wong Nan-Yaw, with symptoms, treatment, cost and MediSave guidance.
Large bowel obstruction
Large bowel obstruction explained by Singapore colorectal surgeon Dr Wong Nan-Yaw: causes such as bowel cancer and volvulus, warning signs, CT scans, stents, surgery and recovery.
Keyhole bowel surgery (laparoscopic colectomy)
Keyhole bowel surgery explained by Singapore colorectal surgeon Dr Wong Nan-Yaw: right and left hemicolectomy, anterior resection, what happens, stomas, recovery, MOH fee benchmarks.