Your pre-operative assessment
Most hospitals offer a pre-op assessment a few days to a few weeks before your surgery date. By this point, your surgeon will already have explained the procedure and you'll have given your consent, so this appointment is really about making sure you're physically ready and answering any last questions.
You may meet your Stoma Care Nurse or Colorectal Nurse Specialist, and possibly the Anaesthetist to talk through pain management after surgery. A nurse will usually take some blood to confirm you're well enough for the operation, and you may also have an ECG to check your heart rhythm which is a quick, painless test using small sensors placed on your chest, arms and legs.
Some surgeons may provide laxatives to take home for bowel preparation the day before surgery, though this isn't standard practice everywhere, as clearing the bowel can affect your mineral and electrolyte balance. Your surgical team will let you know whether this applies to you, along with instructions on fasting. Keep any written instructions somewhere safe and read them in good time.
Marking your stoma site
Either at your pre-op assessment or on the morning of surgery, your Stoma Care Nurse will examine your abdomen to decide the best position for your stoma. They'll look for an area of skin that's as smooth and flat as possible, without dips or creases, and may ask about the clothing you usually wear to help choose a spot that stays comfortable day to day. A colostomy is typically sited on the left side of the abdomen, and an ileostomy or urostomy on the right, though this can vary depending on your individual anatomy.
Once it’s decided, the position is marked on your skin in permanent ink. Your nurse will also show you what a stoma and pouch look like and talk you through how the pouches attach, so nothing feels unfamiliar on the day.
The day before stoma surgery
If you've been given bowel preparation instructions, this is the day to follow them. You'll also need to stop eating and drinking for a set period beforehand — usually around six hours, though your hospital will confirm the exact timing. Some people are asked to stay in hospital under observation the night before their operation.
It's worth packing your hospital bag in advance: pyjamas or a nightdress, a dressing gown and slippers, a book or tablet, headphones, and earplugs if you're a light sleeper. If you take regular medication, bring it in its original packaging, and check with your team beforehand whether you should take it as usual that morning.
It also helps to let family or friends know your surgery date and recovery timeline, so they can support you afterwards. If you have children or pets, arranging cover for the first few days home is one less thing to think about once you're back.
On the day of stoma operation
You'll usually be asked to wash with a special shower gel before changing into a hospital gown and compression stockings. Makeup, nail varnish and jewellery all need to come off, along with dentures, glasses, contact lenses and hearing aids.
You'll be taken down to theatre, usually on a trolley, and settled into a pre-op room where the Anaesthetist places a cannula in your hand or wrist to administer the anaesthetic. If you're having an epidural for pain relief, this is usually put in place at this stage too.
FAQ: Stoma surgery
How difficult is it to live with a stoma?
Most people adjust well over time. The first few weeks involve learning new routines around pouch changes, but stoma care becomes second nature for the vast majority of ostomates.
Should I see a stoma nurse before ostomy surgery?
Yes — meeting your Stoma Care Nurse before surgery is a valuable part of preparation. They can answer questions, show you what a pouch looks like, and mark your stoma site.
How long before I can drive after stoma surgery?
This depends on the individual and procedure, so always confirm with your surgical team. Many people are advised to wait several weeks until they can comfortably perform an emergency stop without discomfort.
What can and can't you do with a stoma?
Life with a stoma is generally compatible with work, travel, sports and most everyday activities once you've recovered. Your Stoma Care Nurse can give tailored advice for your situation.