#30 Top tips for living with a stoma in Crohn's disease and ulcerative colitis (IBD)

For Episode 30 of Wrestling the Octopus: the IBD patient podcast, we are joined by Lead Stoma Care Nurse, Natasha Rolls at University Hospital Foundation Trust Bristol and Weston. Natasha provides brilliant tips and practical guidance for everyday life and gut health for people with Crohn's disease and ulcerative colitis.

🌟 Key themes discussed

• 💬 Why stomas are not a last resort 
  Natasha explains how early conversations about stomas can reduce fear and help inflammatory bowel disease patients understand that stomas can be life changing in positive ways.
  “I wish I had not been so frightened of this because I now feel well.”
• 🏥 Emergency vs elective surgery  
  Emergency stoma formation can be emotionally challenging. Patients often need time to process shock, adapt and grieve for the life they expected.
• 🧠 Psychological impact  
  Support is vital, yet access varies. Stoma nurses provide listening, reassurance and guidance even when formal psychological services are limited.
• 🧩 Temporary and permanent stomas  
  Reversal depends on healing, safety and patient choice. Many people choose to keep their stoma because their quality of life improves significantly.
• 🧴 Learning stoma care  
  Confidence develops at different speeds. Some patients manage their stoma within days, others need weeks depending on recovery and emotional readiness.
• 🏡 Support after discharge  
  Follow up varies across the UK. Some services offer home visits and long term support, while others are more limited.
• 💊 Medication changes  
  After surgery for ulcerative colitis, some patients may no longer need previous treatments. Those with Crohn's often continue shared medical and surgical care.
• ⚠️ Common physical issues 
  High output, leaks, sore skin, hernias, blockages and prolapse are discussed with reassurance that most problems are manageable with simple interventions.
  “There are very few things in stoma care that are an emergency.”
• 🍽️ Diet and gut health  
  Early low fibre diets help ileostomy patients, but long term eating can be flexible and enjoyable. Food diaries help identify triggers for gas or disrupted sleep.
• 🏃 Exercise and activity  
  Most activities, including swimming, running and even mountain climbing, are possible with a stoma once recovery is complete.
• ❤️ Intimacy and body image  
  Stomas can affect confidence, but Natasha emphasises autonomy, communication and the importance of sharing at your own pace.
• 🛠️ Bags and accessories  
  Stoma nurses help patients choose products based on clinical need and personal preference. Needs may change over time.
• 💷 Prescriptions  
  Stoma supplies are exempt from prescription charges. Some patients may also qualify for full exemption.
• 🤝 Support organisations  
  Colostomy UK, Ileostomy Association, Urostomy Association and local groups offer community, advice and peer support.

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