A stoma is a surgically made opening in the abdomen that allows faeces or urine (stoma output) to leave the body. A piece of intestine comes through a surgical incision made in your abdominal muscles and skin, and it is then stitched to your skin. The skin around the stoma (peristomal skin) can be easily damaged by the stoma output due to the disturbance of the natural pH of the skin in the presence of urine, faeces or digestive enzymes.

A stoma can be either permanent or temporary. A permanent stoma cannot be reversed, while a temporary stoma can be reversed after an initial healing process, usually within 3–12 months or longer, depending on your overall health and recovery after surgery.

There are 3 main types of stomas, depending on which part of the body is diverted: the end of the small intestine (ileum), the large intestine (colon), or the bladder. The main stomas are ileostomy, colostomy and urostomy; while a more rare type of stoma is the one made to divert the upper part of the small intestine (jejunum), called a jejunostomy.

The stoma output is collected in a bag attached to your abdomen, called a stoma bag, pouching system or appliance.

An ipouch stands for ileoanal pouch, also known as ileal pouch, internal pouch, but also j-pouch, s-pouch or s-pouch.

It is a surgically created internal reservoir fashioned from the end of the small intestine (ileum) to restore bowel continuity after removal of the colon and rectum. It provides storage for stool and allows for more natural evacuation through the anus (back passage).

There are 3 main types of ipouches:

• J-pouch

• S-pouch

• W-pouch

How the surgery works:

1. Removal of colon and rectum

2. Fashioning the ileum into a reservoir shape

3. Attaching the new pouch to the anal canal

4. Temporary loop ileostomy (often reversed after healing)

Whether termed an ileal pouch, internal pouch, or by its specific shape (J, S, W), the ipouch represents a transformative option for patients undergoing restorative proctocolectomy. Maintenance of pouch health and open communication with your surgical team and pouch nurse specialist are key to long-term success.

An Advanced Nurse Practitioner (ANP) in the UK is a highly trained and experienced registered nurse who works at an advanced clinical level, often independently, across a wide range of healthcare settings.

Here’s a breakdown of what defines the role:

🩺 Core Responsibilities

- Assess, diagnose, treat, and manage patients with undifferentiated and undiagnosed conditions

- Prescribe medications, including some controlled drugs, if qualified as an Independent Prescriber

- Order and interpret investigations, such as blood tests or imaging

- Refer patients to specialists or secondary care

- Provide health promotion and disease prevention advice

- Sign fit notes and conduct home visits when needed

🎓 Qualifications & Training

- Must be a Registered Nurse with the Nursing and Midwifery Council (NMC)

- Typically educated to Master’s level (Level 7) in clinical practice

- Must complete an Independent Prescribing qualification

- Expected to demonstrate competence across the four pillars of advanced practice:

- Clinical practice

- Leadership and management

- Education

- Research

🧠 Scope of Practice

- ANPs work autonomously but within defined boundaries set by their employer

- They often serve as first contact clinicians, managing patients without prior assessment by a GP

- Their role is especially valuable in primary care, helping to address GP shortages and streamline services

💼 Work Settings

- GP surgeries

- Hospitals (acute and emergency care)

- Community health teams

- Walk-in centres and urgent care hubs

A Stoma Nurse Specialist in the UK is a highly skilled clinical nurse who provides expert care and support to patients living with a stoma, whether it's a colostomy, ileostomy, urostomy or, in some cases, enteric fistula. Their role is both practical and deeply personal, helping patients adjust physically and emotionally to life after stoma surgery.

🩺 Core Responsibilities

- Pre-operative care: Educating patients, marking stoma sites, and preparing them for surgery

- Post-operative support: Teaching self-care techniques, managing complications, and ensuring safe discharge

- Long-term care: Monitoring stoma health, preventing issues like hernias or skin breakdown, and offering psychosocial support

- Product guidance: Advising on stoma appliances and accessories tailored to individual needs

- Multidisciplinary collaboration: Working closely with surgeons, oncologists, dietitians, and community teams

🎓 Qualifications & Expertise

- Registered Nurse with specialist training in stoma care

- Often holds additional qualifications in wound care, colorectal nursing, or oncology

- May be a member of professional bodies like the Association of Stoma Care Nurses UK

🧠 Why Their Role Matters

- A stoma is life-changing, physically, emotionally, and socially. Stoma Nurse Specialists help patients regain confidence, independence, and dignity

- They reduce hospital readmissions by managing complications early

- Their holistic approach improves quality of life and supports long-term rehabilitation

A Pouch Nurse Specialist in the UK is a clinical expert who supports patients living with or preparing for an ileoanal pouch, a surgically created internal reservoir made from the small intestine, following removal of the colon due to conditions like ulcerative colitis, bowel cancer or familial adenomatous polyposis (FAP).

🩺 What They Do

- Pre-operative counselling: Educating patients about pouch surgery, expectations, and recovery

- Post-operative care: Monitoring healing, managing complications (e.g. pouchitis, strictures), and guiding rehabilitation

- Long-term support: Helping patients adjust to lifestyle changes, bowel frequency, hydration, and diet

- Multidisciplinary collaboration: Working with colorectal surgeons, gastroenterologists, dietitians, and psychologists

🎓 Qualifications & Expertise

- Registered Nurse with specialist training in IBD and colorectal surgery

- May be involved in research, education, and peer support programmes for pouch patients

💬 Why Their Role Matters

- Living with a ipouch can be physically and emotionally demanding, pouch nurses provide continuity of care and empower patients to regain control

- They help reduce hospital readmissions by managing issues early and offering tailored advice

- Their holistic approach improves quality of life, especially for patients navigating complex IBD journeys

Specialist nursing care is centered around the needs of those with digestive and urology needs, including those requiring stoma care, internal pouch care, wound care and continence care.

If you are looking for a stoma nurse, pouch nurse, wound care nurse or a continence nurse for bowel and urinary support, the specialist nurses will be able to support you with all these expert care needs.

If you wish to be seen by a private Specialist Nurse, to support you with stoma care, pouch care, wound care or continence care, you may need to speak to your GP, Surgeon or Gastroenterologist/Urologist for a referral to a specialist nurse. Alternatively, you may do this through a self-referral. To access advice or book a consultation, use the email.

This will depend on your circumstances and type of consultation. However, the initial/first consultation typically lasts between 45 minutes to 60 minutes.

Out-of-hours support is available 365 days a year, including late nights and weekends, when your local specialist service is closed. To access advice or book a consultation, use the email.
A nurse will review your needs and call you or email you back as soon as possible, depending on the urgency of your request.

The Specialist Nurse will need some information, so please provide the information below when emailing/leaving a phone message:

• Full name • Date of birth • NHS Number • Email & telephone number • Registered GP practice email & contact details • Reason for appointment • Whether you need support with stoma care/ipouch care/wound care or continence care

You must provide basic information about your medical issue so that the dedicated nurse can determine how soon they need to contact you.

No, you will remain under your team’s care, if you wish to, and the private Specialist Nurse will continue to communicate with your GP and your team and inform them if there is a need for them to take action.

No, you are still entitled to free NHS care even if you choose to pay for private care.

To access more information on Private healthcare, visit the Private Healthcare Information Network’s website, click here.

A private Specialist Nurse is available to everyone, including NHS patients! They are offering to help everyone and will not turn away anyone.

Private Care - Self-pay

You can pay directly, allowing you to access high-quality care as quickly as possible. This will enable you to book a consultation with a Specialist Nurse without delays.

While a referral letter from your GP or Consultant is advisable to help the Specialist Nurse better understand your problem, it is not always required, as you will be asked to complete a registration form - Patient Passport, with all your relevant past medical history, medications, allergies, etc. ensuring that the Specialist Nurse does not miss important information about your health when providing advice.

The Specialist Nurse can provide further details, including estimates of future costs.

Private Medical Insurance

You will need to obtain a pre-authorisation number from your insurer first, confirming that they agree for you to be seen by a private Specialist Nurse. Alternatively, your insurer may ask you to self-pay, and then claim the expenses via their appropriate processes.

Most insurers cover care for short-term conditions, though this varies by insurer. The majority of care provided by private Specialist Nurses are covered by most health insurers, but you should check your policy and ideally contact your insurer to confirm eligibility before booking an appointment.

Your insurer may have limits or excess on your policy, which they can provide details of in your documentation or if you contact them directly.

If you have medical insurance, the process for most patients is as follows:

1. Obtain a referral letter from your GP or Consultant, whether NHS or private. This will help your insurer confirm that your care will be covered.

2. Contact your insurer to confirm your policy coverage and obtain a pre-authorisation number.

3. Book an appointment with a Specialist Nurse and provide the name of your insurance company, your membership or policy number, and your pre-authorisation code or claim reference number. These details allow the Nurse Specialist to liaise directly with your insurance company for payment, so you can focus on your ipouch and/or stoma care optimisation journey.

Installments Payment

If you cannot afford to pay for your consultation as a single upfront payment, your Specialist Nurse can discuss with you different options of 3-6 monthly instalments.

Financial Hardship

The private Specialist Nurse can offer a free-of-charge service to those in financial hardship. If you are facing financial difficulties, you can still receive the support you need, ensuring you receive the care you need. You can read more information on the dedicated Financial Hardship Page.