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A defunctioning stoma to relieve a blocked bowel | CION Cancer Clinics
A defunctioning stoma is an opening on the belly that lets stool leave the body above a bowel blocked by cancer. It does not remove the tumour, but it often eases pain, bloating and vomiting and lets the patient eat again. This page explains the types of stoma, what the operation involves, who it may not suit, and what living with a bag is really like. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What is a defunctioning stoma, and why is it offered?
- Which type of stoma might be made?
- What happens before and after the operation?
- Who does a stoma help, and who may it not suit?
- What do the words the surgeon uses mean?
- What do families worry about with a stoma bag?
- Common questions about a defunctioning stoma
The short answer
What is a defunctioning stoma, and why is it offered?
A defunctioning stoma is an opening made on the belly so that stool leaves the body before it reaches a blockage further down the bowel. It does not remove the cancer. It lets the bowel empty again, which usually eases the pain, bloating and vomiting that a blockage causes.
What "defunctioning" means
The word means that the part of the bowel below the stoma is rested and no longer carries stool. The tumour stays where it is. Stool comes out through the stoma into a small bag stuck to the skin, and the bag is emptied or changed during the day.
When a surgeon may suggest it
It is most often discussed when a tumour in the lower bowel or rectum has narrowed the passage, when a stent cannot be placed or has not worked, or when a larger operation to remove the tumour would be too much for the patient. It is sometimes also used to protect the bowel while other treatment, such as radiotherapy, shrinks a tumour.
What this page cannot tell you
It cannot tell you whether a stoma is right for your father, mother or yourself. That depends on the scan, the type of cancer and how strong the patient is, and it is a decision for the treating team and the family together.
A stoma made to relieve a blockage from advanced cancer is often permanent. Ask the surgeon directly whether reversal is ever likely in your situation.The kinds of stoma
Which type of stoma might be made?
The name depends on which part of the bowel is brought out and how. Your surgeon chooses on the basis of where the blockage sits.
Colostomy
Made from the large bowel, usually on the left side of the belly. Stool is often thicker and comes out less often, so the bag may need emptying only a few times a day.
Often used when
- The blockage is in the rectum or lower large bowel
- The bowel above the blockage is healthy
Ileostomy
Made from the end of the small bowel, usually on the right side. The output is looser and more frequent, so drinking enough and watching for dehydration matter more.
Often used when
- The large bowel is blocked in more than one place
- The large bowel cannot be used safely
Loop stoma
A loop of bowel is lifted to the skin and opened on one side. It is often quicker to make and can sometimes be done through a smaller cut or by keyhole surgery, which suits a patient who is already weak.
End stoma
The bowel is divided and one end is brought out. It tends to be flatter and easier to fit a bag around, but it can mean a slightly longer operation.
The shape matters less than a good position on the belly. That is what makes the bag easier to manage.Not sure whether this applies to you?
Ask an oncologistFrom decision to home
What happens before and after the operation?
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Marking the spot
A stoma nurse or the surgeon marks a good place on the belly while the patient sits and lies down. A spot away from skin folds and the waistband makes the bag much easier to live with.
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The operation
Done under general anaesthetic. Depending on the patient and the blockage, it may be keyhole or through a cut. It is usually a shorter operation than removing the tumour.
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The first days
Fluids start first, then light food. The stoma may be swollen at first and shrinks over the following weeks. Wind and stool often start coming through within a few days.
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Learning the bag
A nurse shows the patient and one family member how to empty and change the bag and care for the skin around it. It helps if the person who will help at home is there for these lessons.
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Going home
You go home with supplies, a list of what to watch for and a number to call. The length of stay depends on how quickly eating returns and how strong the patient was before.
Weighing it up
Who does a stoma help, and who may it not suit?
A stoma tends to help most when there is one blockage low in the bowel and the bowel above it is working. In that situation it can bring quick relief and let the patient eat again. The treating team weighs the scan, the patient's strength and what the patient wants from the time ahead.
When it may not help
If cancer has spread across the lining of the belly and blocked the small bowel in several places, a stoma higher up may not solve the problem. A patient who is very frail, bedbound or struggling to breathe may find the operation and recovery harder than the blockage itself. Large amounts of fluid in the belly also make healing more difficult.
What the family should weigh
Think about who will help with the bag at home, whether the toilet at home is easy to reach, and how the patient feels about a bag at all. These are fair questions to raise with the surgeon. The team will not decide on the patient's behalf, and it is reasonable to ask for time to think if the situation is not an emergency.
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What do the words the surgeon uses mean?
- Stoma
- The opening on the belly where the bowel comes to the skin. It is pink, moist and has no feeling, so touching it does not hurt.
- Appliance or pouch
- The bag and the sticky base that holds it to the skin around the stoma.
- Output
- What comes out into the bag. Nurses ask how thick it is and how much there is.
- Reversal
- A later operation to close the stoma and rejoin the bowel. In advanced cancer it is often not possible.
- Parastomal hernia
- A bulge around the stoma where the belly wall has weakened. It is common over time and is usually managed with a support belt.
Commonly believed
What do families worry about with a stoma bag?
"Everyone will smell it."
Modern bags have filters and seal closely to the skin. When the bag fits well, there should be no smell except while emptying it. A smell at other times usually means a leak, and the stoma nurse can help fix the fit.
"She will not be able to pray, cook or visit family."
Many people go back to prayer, cooking and visiting once they are confident with the bag. Carry a spare bag when you go out. Loose, comfortable clothing hides the bag well under a saree or kurta.
"A stoma means the doctors have stopped treating the cancer."
A stoma is often made so that the patient is well enough for other treatment, such as chemotherapy or radiotherapy. It deals with the blockage. Other decisions about the cancer are made separately.
"He must stop eating so the bag stays empty."
Eating too little makes recovery slower. Most people eat a normal diet in small, regular meals. Some foods cause more wind, and a dietitian can tell you which ones to go easy on.
Did you know
Stoma supplies are an ongoing cost at home. Ask the hospital which bags suit the stoma, where to buy them near where you live, and whether your scheme or insurance covers them, before the patient is discharged.
Questions we are asked
Common questions about a defunctioning stoma
Will the stoma be permanent?
Often it is, when it is made to relieve a blockage from advanced cancer. Sometimes a stoma is made for a while and closed later if treatment shrinks the tumour. Ask the surgeon before the operation which is more likely, so that the patient and family are prepared either way.
Does the stoma itself hurt?
The stoma has no nerve endings for pain, so touching it does not hurt. The wound from the operation will be sore for a while, and pain medicines help. Soreness of the skin around the stoma usually means the bag is leaking, and the stoma nurse can sort that out.
Who will change the bag at home?
Many patients learn to do it themselves. If the patient is weak, a family member learns alongside them before discharge. It takes some practice. Ask for a second lesson if you do not feel ready, and keep the stoma nurse's number handy for the first weeks.
What should we watch for after going home?
Call the team if the stoma turns dark purple or black, if nothing comes out along with vomiting or belly pain, if the output is very watery and the patient feels dizzy, or if there is heavy bleeding. These need to be seen the same day.
Can a stent be used instead of a stoma?
Sometimes. A stent can hold a narrowed large bowel open without an operation, but it does not suit every blockage, and it can move or block again. The team will explain whether a stent is possible for the patient and why they may prefer one over the other.
Can chemotherapy continue with a stoma?
Often yes. Relieving the blockage can make the patient strong enough for further treatment. Some chemotherapy medicines cause loose motions, which makes the bag fill faster, so tell the oncologist about the stoma and ask what to do if the output changes.
Will she be able to bathe and wear normal clothes?
Yes. Water does not harm the stoma, and bathing with the bag on or off is fine once the wound has healed. Most everyday clothes can be worn. A slightly looser waistband over the stoma is more comfortable and helps the bag drain.
Is the operation covered by Aarogyasri or insurance?
Stoma operations for cancer are often covered. Aarogyasri, CGHS, ECHS, EHS and most cashless insurers may apply, depending on the scheme and the policy. Supplies after discharge may be covered differently. Call the helpline with your card or policy details and we will check.
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Sources
- NHS — Colostomy
- NHS — Ileostomy
- Macmillan Cancer Support — Cancer information and support
- American Cancer Society — Colostomy guide
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Surgery for Bowel Obstruction in Advanced CancerAll the options when cancer blocks the bowelStenting vs Surgery for a Blocked BowelWhen a stent may be used instead of an operationWhat Families Should Ask Before Palliative SurgeryQuestions to take into the meeting with the surgeonCaretaker and Family Guide to SurgeryHelping someone recover at home
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