From the Ovacome Magazine Spring 2019

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Surgery for ovarian cancer may mean you have a stoma, either temporarily or permanently. For more information about this, please read our fact sheet about surgery for ovarian cancer.

After having a stoma placed it can be more difficult to maintain your bowel function. There are two types of stoma – colostomy and ileostomy.

An ileostomy brings part of the small intestine (ileum) to the surface of the abdomen, usually on the right side. Bowel motions will be a mixture of bowel liquid and semi-solid motion. A colostomy brings part of the large intestine (colon) to the surface of the abdomen, usually on the left side. Bowel motions are more solid than with an ileostomy.

People with an ileostomy often need to be more careful as it can be more difficult to maintain bowel function, particularly with high output stomas (over two litre output in 24 hours) shortly after surgery. However with medical and dietary management this can be reduced to a manageable level.

A colostomy tends to be easier to manage. Post surgery we would recommend a low fibre diet and gradually increasing oral intake. After six weeks fibre can start to be reintroduced gradually, monitoring stoma output all the while.

The same as with frequency of opening your bowels, stoma output will vary among different people. It is a case of monitoring what is different for you.

After having a stoma it can be more difficult to have as varied a diet in terms of fruits and vegetables, however many people eat the same as pre surgery. Some foods can cause stoma outputs to be looser or more firm, this is no different to not having a stoma as there are just some foods our bowels just do not like! Your local hospital should be able to give you a diet sheet with low fibre foods.

The ongoing advice to keep your bowels healthy with a stoma, is the same as for those without. Where possible try and have as varied a diet as possible and gradually increase the amount of fibre in your diet. Avoiding nuts, peas and sweetcorn is often advised as these can cause a blockage at the stoma site as they are not very well digested.

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After a stoma reversal

After a stoma reversal it will take some weeks or months for bowels to settle and in a small amount of cases it may take up to six months. You may experience loose motions or constipation, urgency, pain when passing motions, sore skin around the back passage, incomplete emptying and a degree of incontinence for up to a few months following surgery.

You may find it easier to have small, low fibre meals and increase the amount and variety of food and fibre over time. Make sure you are well hydrated – aiming for two litres of fluid every day.

Pelvic floor exercises may be helpful as they can help strengthen and tone the rectal and pelvic floor muscles, which will help you gain better control of your bowel functions as they may be weaker than before your stoma surgery.

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• Advice from Rachel White, oncology dietitian at Guy’s Hospital.