Great information! This is quite possible why I have had so many issues with my stoma.

When did you have your surgery and was it planned?

Great article, I'm sure it will benefit those who are fortunate enough to find it before they have the surgery. I didn't know about this but part of my health care team was a Stoma Nurse and she did all of the above. I feel like she must have read your article. :o) If you are going for surgery and feel uncomfortable discussing this with your health care team, print out this article and take it with you.

16 years ago I had my permanent ileostomy going in on March 15th for revisions my bag has never fit correctly I go through 5 bags and night how should I have them mark it no one has even offered me two pre- Mark me

You need to speak with a stoma nurse and ask them to make sure that your stoma site is marked. It's possible that they are waiting until the morning of your surgery to mark the site, but I would confirm that with them. Best of luck with your revision!

I had my stoma site marked and the nurse was very meticulous. One year on and I ve had hardly any problems with leaks and my bag sits neatly under my knicker line!!

Exactly the way it should be! Glad to hear that!

I had my site marked with three possibilities. I preferred one of them but the surgeon used another. I have no issues with my stoma but the placing of it is parallel to my navel and I have great trouble with pant waistlines. I don't like the feeling of the waistline under my bag so I have gradually changed my wardrobe to maternity pants. They are not ideal but much better than ordinary waistlines. Even the so called high waisted jeans are not high enough and want to sit right across my stoma. Last week I had a parastomal hernia removed, very painful still, and I asked the surgeon if he could reposition the stoma but he said no. Any lower and it would interfere with my hip and higher would be on a rib.

I did have mine marked (colostomy) before the operation. And 9 years on all is good. Maybe I was lucky, as I did not know that I should have the position marked before the operation. The right nurse on the right day ?? In NZ I am told this is standard procedure. Good article as I am sure a lot of people do not know about this. Thanks.

That's great! Many people today, even those living in Europe or North America still encounter instances where they aren't marked and don't know that they have a right to be.

Some countries do lag behind others, but many hospitals simply don't have stoma nurses available and it can compromise patient care and their quality of life.

Hi Eric,

Great article. This is valuable information for anyone going for surgery and I like that you include references.
As an ostomy nurse it is very important to be very thorough in doing the pre-op marking. Some additional factors that we consider is the person's ability to see the stoma to make pouch application and removal easier. So a person with a larger abdominal circumference may need to have the stoma site marked above the line of the navel. Placing a mark in this area is also common for a person who is wheelchair confined to make pouch management easier.
We may also place a one piece pouch or the flange of a two piece appliance as a guide on the abdomen to get a sense of the best place to mark. In some cases we may ask a person to wear a pouch prior to surgery for a couple of days to see if that location would be comfortable for them.
Another factor I take into account is if the surgical consent states an ostomy may be a possibility. For example, when the diagnosis is cancer or Crohn's disease I may need to mark two locations for either an ileostomy or colostomy. During the course of an operation a surgeon may plan to do one type of ostomy but out of necessity needs to create a different type. In cases where we are concerned that the best possible site may be problematic for management, we will contact the surgeon to let them know.

I love that you can be so thorough! I wish every patient had the opportunity to work with a stoma nurse (or hospital) that can put that much focus on site marking!

Well I had a loop ileostomy and now have a permanent ileostomy. For my permanent ileostomy my surgeon did mark me but it ended up being next to my belly button. Unfortunately for me my belly looks weird due to having major surgeries. So I feel my surgeon did what she could when it comes to stoma placement. My old surgeon didn't even give me the choice of stoma placement for my loop ileostomy. She said she might be able to remove my colon and hook up j pouch in 1 step but it turned out to be a 2 step surgery. My loop ileostomy was placed in a bad spot. It was lower than my permanent one and I hated it. I had so many leaks but with my permanent ileostomy I haven't had many leaks.My old surgeon got sued for malpractice but she moved away. Luckily I have a really good surgeon and now have a colorectal surgeon.

Hi Erica, I'm sorry to hear that you had such an incompetent surgeon the first time around! When your other surgeon marked you, did she have you sit, lay down, bent, etc. or was it a quick marking?

First (2003) ostomy wasn't marked as i was unconscious. Second (2006) went in for a reversal but came out with ostomy on same site as previous. My third (2011) was very marked, byhw stomas nurse. my surgery date was all messed up so I had to keep drawing it on for a few days. (was inpatient for three months prior) she made me all all sorts of stretching and moving. She marked several places, I preferred one so it was easier for me to wear costumes (cosplayer and also hoped to return to the dojo), my surgeon is ace face and went with the site I wanted, even though he was not overly happy with the choice. Had no issues and awesome but now because my body has changed slightly it's really not a good place. I have to put up with it though as moving is too risky. Havent a lot of issues further up my 1.2m of intestines so maybe they will move is moe surgery anyway.

It really does make a massive difference!!!

Yes i had my stoma site marked by a trained stoma nurse. I have a permanent illeostomy and at the it leaked alot but my stoma nurse changed my bags and the ring seals and mine hardly ever gives me any bother. I really think she done a great job and have to commend the surgeons for doing a great job😁

I had my stomach marked 15 minutes before surgery only in a sitting position and took about 3 minutes to mark. My stoma is located about 1 inch above my bellybutton and right in line with my belt. This also makes it difficult to hide my bag. I believe my doctor rushed me into the wrong divergence as the other two options are 8 hour surgeries instead of the 4 hour one that he did. The insurance pays him the same amount regardless of which surgery is done. I do have a fold which I am sure "jumped" out at him during my first appointment. I believe at that time he should have told me that one of the other choices may be better. I should mention that my doctor has done over 1,000 of these surgeries. Another urologist has suggested to me that a law suit would be one of my options at this point. This totally unsolicited comment by him really surprised me. Your comments on the above points are appreciated.

Hi Bill,

I really can't offer legal advice, but if you trust what your urologist has said and believe that this rushed stoma site marking has lead to a decreased quality of life, then I would explore that option.

Did you have any pre-surgery appointments with a stoma nurse? A nurse would usually mark you after doing an assessment, but this could totally depend on your hospital and whether that option even exists.

When did you have your surgery?