“With a stoma, my body is different, but life is still possible.”

Interview with Agathe Ducrocq, Clinical Nurse Specialist, Stoma Care Nurse and Wound Care Specialist at Erasmus Hospital – H.U.B

To begin with, what exactly is a stoma?

A stoma is a surgically created opening that connects a hollow organ (such as the intestine or ureter) to the surface of the skin, allowing stool or urine to be diverted outside the body. Instead of passing through the usual route, stool or urine exits through the abdomen and is collected in a pouch attached to the skin.

There are many medical reasons, including cancer, inflammatory bowel disease, neurological disorders or an intestinal blockage. In these situations, surgeons may need to divert the normal pathway. A stoma can be life-saving or restore quality of life to people who had lost it.

How do patients react when they are told they need a stoma?

The news is delivered by the doctor or surgeon and, in most cases, it comes as a shock. By the time we meet patients before surgery, they have usually had some time to begin processing the information. The pouch is often what frightens people the most. It can trigger feelings of disgust towards the stoma and the way they imagine their body will look. Seeing urine or stool leaving the body through the abdomen is understandably difficult to accept. As stoma care nurses, our role is to address these fears and show patients that it is entirely possible to live well with a stoma.

What does the support provided in hospital look like?

Once surgery has been scheduled, we meet patients before the surgery. We explain what a stoma is, why it is needed and how to care for it. At this stage, our goal is to reassure them, answer their questions, guide them and provide education.

During the hospital stay, we provide daily follow-up alongside the nursing team. We help find the pouching system that best suits the patient's body shape, balancing comfort, safety and ease of use. We teach stoma care and, above all, take the time to answer every question, respecting each patient's pace.

Our goal is for patients to feel confident and comfortable living with their pouch. In the beginning, body image is often the greatest challenge. We explain what to expect, assess how each patient is coping according to their abilities, and discuss possible complications as well as the warning signs they should be aware of.

Family members are also involved in this education. They are not caregivers, but their support is invaluable, particularly if problems arise at home. We therefore maintain close communication with relatives and caregivers throughout the patient's journey: before surgery, during the hospital stay and after discharge. 

When patients are ready to leave the hospital, we help prepare them for their return home. We provide the necessary supplies, contact the medical equipment provider and coordinate with the home care nurse. Even when patients are independent, a home care nurse visits during the first few days to help them adapt to caring for their stoma in their own environment. This provides reassurance during an important transition.

The golden rule we always repeat is simple: it is always better to call with a small question than to wait several days and return with a serious complication.

What are the most common problems after discharge?

The most frequent issues involve the skin: the pouch coming loose or leakage due to incorrect application. Persistent itching, repeated leaks or skin irritation are all signs that patients should contact their stoma care nurse to arrange an appointment. Sometimes, simply switching to a different pouching system solves the problem.

"I'm going to have a hole in my abdomen. I'll never be able to leave the house again." This is by far the most common concern we hear. A stoma is not a wound. Daily care is clean rather than sterile: simply wash the skin with water, dry it thoroughly and that's it. Together, we will find the pouch that suits you best and give you the tools you need to live confidently with it. Modern pouches are secure, odour-proof and discreet under clothing. Going to a restaurant, flying, swimming—everything remains possible. Many patients also worry about their intimate relationships. This is a subject we always address openly and without taboo. Body image and self-confidence are just as much a part of our care as the practical aspects of stoma management.

And what about psychological support?

We often find ourselves listening to concerns that go beyond our own professional expertise. When a patient feels overwhelmed, we suggest meeting with a psychologist. We also try to normalise psychological support, although this is not always easy. Many people still associate seeing a psychologist with mental weakness. In reality, being able to speak freely and openly can make an enormous difference. Having a psychologist specialised in supporting people through this type of care pathway as part of our multidisciplinary team is a real benefit for our patients.

The news will undoubtedly come as a shock. But please know that a dedicated multidisciplinary team will be there for you—from your first consultation, throughout your hospital stay, when you return home and for as long as you need us afterwards. Nurses, stoma care specialists, surgeons, psychologists and medical equipment providers work closely together, communicate regularly and adapt to your individual needs. Each professional has a specific role, but everyone is working towards the same goal: your well-being.You do not have to face this alone.