Breaking the Silence: Support and Strength for South Asian Patients with a Stoma

13 August, 2026

For some people in South Asian communities, living with a stoma can feel especially hard. Alongside the surgery itself, there may be silence, shame, worry, and fear of being seen differently. Stoma Care Nurse, Nelam Kumari, brings both her professional experience and personal knowledge to raise awareness of these communities.

By Nelam Kumari, Clinical Educator, Convatec Ltd

While this article is written mainly for patients, families and the general public, it may also help nurses and other healthcare professionals better understand the cultural, emotional and practical needs of South Asian patients living with a stoma.

Having a stoma can affect body image, confidence, relationships, and daily life as well as physical recovery. Many people worry about leakage, smell, clothing, socialising and intimacy, especially in the first months after surgery. For some South Asian patients, this can feel harder because bowel problems and stoma surgery may be linked to shame, silence or fear of judgement.

South Asian communities are diverse, with different languages, religions, family roles and beliefs. Not everyone will feel the same. Even so, studies suggest that stigma, language needs, family expectations and faith can affect how some South Asian patients ask for help and adjust after treatment.

Silence, stigma and bowel health

In some families and communities, bowel symptoms, cancer and stoma surgery may be seen as private, taboo or shameful topics. Some patients worry that a stoma will make them seem unclean, weak or different, and may fear pity, gossip or judgement. For younger patients, there may also be worries about marriage and relationships. When these fears stay unspoken, people may delay asking for help and carry distress on their own.

“In my culture, we don’t talk about these things. I felt I had to deal with it on my own.”

If this feels familiar, please know that you are not alone. Stoma problems are medical problems, not something to hide. Asking for help early can prevent skin problems, improve confidence and reduce isolation. It can also ease the emotional burden of feeling that you have to manage everything in silence. Writing questions down before an appointment, asking for a longer review, or requesting time alone with your stoma nurse can make it easier to talk honestly if family or community expectations feel hard to navigate.

Faith, cleanliness and worship

For many South Asian patients, faith is part of daily life. A stoma may raise questions about cleanliness, prayer, fasting, worship and pilgrimage. Some Muslim patients worry about ritual purity and leakage, even though faith guidance often supports prayer and attendance with a stoma. Similar concerns can also affect Hindu and Sikh patients, although experiences differ from person to person.

“I didn’t know whether fasting during Ramadan was allowed or safe for me anymore.”

“I worried constantly about smell or leakage at the temple, so I stopped going for long periods.”

These worries matter and deserve to be discussed. If you want to fast, travel on pilgrimage or return to worship, ask your stoma nurse or doctor for advice. You can also ask for written information in your preferred language or speak with a trusted faith leader who understands health issues.

Modesty, gender and asking for help

A stoma involves intimate care, and for some South Asian patients this can feel especially sensitive. Modesty may be closely tied to dignity and family expectations. Some women may feel uncomfortable talking about their stoma or intimacy with male professionals. Some men may feel pressure to stay strong and not show vulnerability. Research shows that embarrassment and fear of judgement can stop people asking for help, even when problems can be treated.

You can ask for a clinician of the same gender where possible, request an interpreter, or ask to speak without family present. Good care should protect your dignity and give you choices, not make assumptions about what matters to you.

Family, marriage and relationships

Family can be a great source of love and support after surgery. But some patients worry about being a burden, affecting marriage prospects or bringing shame to the family. Some may also fear that relatives or in-laws will see them differently. Studies suggest that family beliefs, misunderstanding and stigma can affect how people cope and whether they ask for help.

If your family is very involved, that can be helpful. But your wishes still matter most. Healthcare professionals should ask who you want in the room, what you want shared with relatives, and whether there is anything you would rather discuss in private.

Body image, intimacy and confidence

Many people worry about how they look after stoma surgery, whether they will still feel attractive, and what might happen during intimacy. Studies show that body image concerns, sexual worries, and fear of leakage can affect confidence and quality of life. For some patients, the hardest part is feeling too embarrassed to ask what is still possible.

“I didn’t know what I could or couldn’t do, and I was too embarrassed to ask.”

“I thought having my rectum removed meant I could never have sex again, but I was too embarrassed to ask, and nobody ever made me feel it was okay to talk about.”

These are important questions. They are not embarrassing, and you deserve clear answers. If intimacy feels difficult, ask your stoma nurse, consultant or GP for support. Practical advice, reassurance, counselling, and specialist help can all make a difference.

LGBT+ South Asian patients: being seen and supported

Some South Asian patients also identify as lesbian, gay, bisexual, trans or queer. They may face extra pressures around identity, family expectations and being open about relationships, and a stoma can make these conversations even harder. Research shows that patients want healthcare professionals to avoid assumptions and make it clear that different identities and relationships can be discussed safely.

“I was worried about the stoma, but I was also worried about whether I could be honest about who I am.”

If this applies to you, you deserve care that is respectful, private and inclusive. You should not have to choose between cultural identity, faith, family belonging and being honest about your relationships or gender identity. Healthcare professionals should use open language and avoid making assumptions about who you are.

What can help?

Evidence suggests that education, person-centred follow-up and peer support can improve confidence, self-management and quality of life for people living with a stoma. The following steps may help:

For patients

• Write down questions before appointments, especially about prayer, fasting, diet, travel, clothing, intimacy, or skin problems.
• Ask for private time with your nurse if you do not want to speak in front of family.
• Ask for the same-gender clinician or interpreter if that would make discussion easier.
• Use trusted support groups, helplines, or online support if talking face to face feels difficult at first. (See the support section below for more on this).

For families

• Try to listen without shame or blame.
• Remember that a stoma is a medical treatment, not a sign that a person is unclean or less able to live a full life.
• Offer practical support while still respecting privacy and independence.

For healthcare professionals

• Do not assume that all South Asian patients believe the same things; ask what matters to the individual.
• Use permission-based language to open sensitive conversations about faith, body image, and intimacy.
• Offer privacy, language support and follow-up over time, as needs often change after discharge.
• Signpost patients to reputable charities, peer support and specialist psychological or sexual wellbeing support when needed.

Where to get support

You do not have to deal with this on your own. Support is available. Some people prefer a helpline. Others prefer a patient group, a nurse or a trusted online service.

• Colostomy UK offers various services to anyone living with any kind of stoma and which includes their stoma helpline.
• Ileostomy Association supports people living with an ileostomy or internal pouch.
• Urostomy Association offers information and support for people with a urostomy.
• Macmillan Cancer Support can help if your stoma is linked to cancer.
• Convatec me+ offers free stoma support, advice and lifestyle information.

Your stoma nurse, GP or hospital team can also tell you about local support, including groups, interpreters and specialist services in your area. You are not alone, and support is available.

References for this article are available upon request. Please contact the editor at editor@colostomyuk.org.uk if needed.

This is a non-sponsored article, written in collaboration between Convatec Ltd and Colostomy UK.

Support From Colostomy UK

We offer a wide range of support for people living with a colostomy, including our free Stoma Helpline, live chat support, and opportunities to connect with others through local and online groups. We also provide trusted information and resources to offer practical advice, reassurance, and the confidence to live well with a stoma: colostomyuk.org/support