Stoma surgery: How the colorectal procedure is the best thing that ever happened to me 

Following years of painful flare-ups and medication for ulcerative colitis, Ashley Hoyne underwent stoma surgery and hasn’t looked back since

Ashley Hoyne: 'I don’t feel that [the stoma bag] had a major impact on my mental health from an image point of view, I think because it gave me such relief. I look at it as such a gift.' Picture: Ferdia Mooney.

Ashley Hoyne was a typical student enjoying college life while studying to be a nurse at the University of Limerick (UL) when she began to experience serious gut issues and pain.

“I suffered with gut issues [as a child] — usually constipation and things like that,” she says. “But when I got to college, it started getting a bit more serious; more abdominal pain, very crampy, a lot of urgency running to the bathroom.”

One day she found blood in the toilet bowl and realised there was “something wrong”.

After a trip to her GP, Hoyne was referred for a colonoscopy and, aged just 20 and in her second year at UL, was later diagnosed with ulcerative colitis. The autoimmune condition causes the immune system to attack the lining of the large intestine.

“It mistakenly identifies the bowel as a foreign body, resulting in inflammation, bleeding, mucus, and ulcers on the bowel. As you can imagine, that’s very painful when stool passes through it,” she says.

The diagnosis was the start of a seven-year journey with medication. “I was on so many oral medications, rectal medications, but none of them worked.”

Her doctors then prescribed Infliximab, delivered by IV, but the treatment had limited success. Hoyne says: “It never really worked 100%. Maybe it worked 60-70%. I would always end up in a flare-up.”

The medicines also came with side effects, including infertility and an increased risk of cancer, she says. With the approval of her consultant, Hoyne opted to take a break from the medication and moved to Dubai, where her then-boyfriend was living. 

However, in a few short weeks, she found herself having difficulty.

“Around the two-month mark, I knew I would be in trouble. My health insurance still hadn’t come in. I was losing a lot of weight; I was running to the toilet; I was wearing nappies to work; I was wearing nappies in the car with my boyfriend, soiling myself every day going to work, and I definitely pushed myself too hard. At this stage, I shouldn’t have even been going to work. I should have been in hospital getting treatment, but I was a bit too stubborn,” she admits.

Having been convinced by her mum to return to Ireland and, after a stint in A&E, her consultant told her that her options were to try a drug with a high risk of adverse side effects or undergo stoma surgery, which would enhance her quality of life. She opted for the surgery.

A new lease of life

Carlow native Brid O’Neill, a colorectal clinical nurse specialist in St Vincent’s Hospital, Dublin, sees a range of patients with different gut issues who undergo stoma surgery.

“[Around] 65% of clientele present for cancer reasons. Then we have inflammatory bowel [conditions] like ulcerative colitis or Crohn’s disease, which would be maybe 25-30%. There are other reasons as well —someone might have a disease or trauma from childbirth,” she says.

Symptoms can vary, with diarrhoea, fever, and weight loss being the main red flags.

“The main symptoms presenting for bowel cancer would be a change in bowel habit, passing blood, weight loss, and anaemia sometimes as well — where their blood count is low because they’re bleeding inside and they don’t know about it.”

O’Neill explains that surgery can take two to three hours, depending on the case, but the stoma bag gives them a new lease of life. “They now have their energy back. They are back in control of their body, rather than the body being in control of them.”

Ashley Hoyne, shot by Ferdia Mooney.

Hoyne can attest to that — she has been living with a stoma bag since November 2022.

“I don’t feel that [the stoma bag] had a major impact on my mental health from an image point of view, I think because it gave me such relief. I look at it as such a gift.”

As for self-image? That’s another aspect she has taken in her stride. Now 28 and working in occupational health with Pfizer, she also finds time to work with Zebedee Talent, a British-based inclusive acting and modelling agency.

The call-out from the agency came at a good time, she says. “I was at a stage where the stoma was very new, and I was trying to accept it myself. I said, ‘That might be a good way to help your confidence.’”

She recently worked as a live fitter in a campaign by Primark and Victoria Jenkins’s brand Unhidden, which is developing a line to meet the needs of the disabled and chronically sick communities.

Primark says the launch aims to “make adaptive fashion more affordable and easier to buy on the high street”.

Hoyne says: “It’s things like this that really make the experience [of having a stoma] positive. I honestly wouldn’t change it for the world — it’s been the best thing that’s ever happened to me.”

Did you know?

There are various terms in colorectal medicine. Here, O’Neill breaks down some of the information.

Stoma: Any surgically created opening along the abdomen surface. Waste and urine leave through this opening, not the urethra or anus.

Ileostomy: A stoma fitted along the small intestine or bowel (the ileum). The ileum is where you pick up the nutrition from food. 

“There’s a lot more work to [an ileostomy], O’Neill says. “Diet would be affected, and they’re emptying the bag more often, getting up at night time to empty the bag.”

Colostomy: A stoma fitted along the large intestine/bowel (the colon). Passing into the colostomy bag is more habitual. 

“Once a day, twice a day, every second day — whatever your ‘normal’ habit is. And there is no effect to your diet, and they’re generally ‘easier’ to manage,” says O’Neill. 

The contents of the bag(s) are emptied into the toilet, and the bag is changed every two to three days.

Some stomas are temporary. O’Neill adds: “If you had low-rectal cancer and a diseased part of the bowel pipe was removed, you’d be given a temporary stoma to protect the joinings downstream. We don’t want a leak on the pipe.”

• Stoma bags are covered under the drug payment scheme and medical cards. Advances in stoma bags include improved filters, better materials, and different colours.
• Crohn’s & Colitis Ireland supports those living with the conditions