Stoma Complications

Originally published on: August 1st, 2021. Last modified on July 14th, 2022

Advertisement

From time to time stoma patients may experience stoma problems. The majority of these issues are not serious and can be resolved relatively quickly by adjusting part of your routine, swapping to a new product or altering your diet slightly. Some of the most common stoma complications are listed below. If you are experiencing any issues with your stoma, it is best to seek advice from your Stoma Nurse or Colorectal Nurse Specialist.

What are the Most Common Stoma Complications?

下面列出了一些常见的并发症。In this post we go into more detail on the following topics:

  • Skin Problems and Irritations
  • Stoma Leaks and how to avoid them
  • Bleeding – when to get help
  • Retracted or Prolapsed Stoma
  • Parastomal Hernia
  • Blockages or Bowel Obstruction

For each of these topics, we will also cover how to prevent these common stoma problems and importantly, what you should do if you experience them.


Stoma Skin Problems

Issues or problems with theskin around the stomais probably the most common complication for ostomates. Not only is having sore skin extremely uncomfortable for the patient but it can also compromise the attachment of the bag to the skin causing leaks and leading to further skin damage.

There are a number of reasons for peristomal skin irritations including:

Faecal contact with skin

For those with a colostomy, pancaking (where the output sticks to the top of the bag) can cause the bag to lift and the output to come into contact with the skin, which can cause sore, irritated skin.Ileostomy output is more acidic and corrosive as the enzymes are not being broken down by the colon. These enzymes can cause the skin to break down if it comes into contact. Therefore it is vital to make sure that this waste doesn’t come into contact with the skin.

Ill-fitting stoma appliance

重要的是要确保从你的造口袋上切出的洞安全地环绕着你的造口。大多数供应商将包括一个气孔测量指南和模板,为您准确地切割形状。这个洞应该紧贴在你的气孔周围,没有任何空隙。也要确保这个洞不要太小,这样就不会挖到气孔里,造成任何可能流血的割伤或擦伤。

你应该定期测量你的气孔的大小,以确保它没有增长或缩小的大小。体重的增加或减少会影响气孔的大小。如果晶圆片上有任何折痕、褶皱或缝隙,这些也需要填补,以避免泄漏。气孔糊可以用来填充这些空隙。

Skin irritation/allergies from products or the appliance

Occasionally you can experience an irritation of the skin, or allergic reaction to the wafer of the bag. This usually results in a rash under where the wafer was attached, itching and weeping of the skin. Your stoma nurse should be able to offer help in reducing the rash and recommending other products for you to try. Any skin irritations can affect the adherence of your stoma bag resulting in leaks.

Get Your FREE Just Can't Wait Card

FREE Just Can’t Wait Toilet Card

Access the Universally Recognised Digital Just Can’t Wait Toilet Card Online for FREE Order the original toilet access card from the Bladder and Bowel Community today. We use the universally acknowledged W.C. signage, giving you the…

Stoma Leakage

气孔渗漏通常是由于气孔袋没有安装正确或从袋意外迅速填充或输出变松。大多数的口瘘会偶尔发生泄漏,这没什么可担心的。如果袋子意外装满了,那可能是因为饮食的改变,胃部不适,甚至是神经和压力等因素会影响你的输出。

How to prevent Stoma Leakage

如果你遭受不断的泄漏,那么这是明智的,再次检查你的吻合口袋。确保晶圆上没有空隙,并且小孔紧贴气孔。如果你有一个平的或缩回的造口,然后告诉你的造口护士,看看凸形晶片是否适合你。只有当你的造口护士说这样做可能会对你的造口造成伤害时,你才可以使用凸晶片。


Stoma Bleeding

Stomas are very vascular with a lot of blood vessels near to the top, which can bleed very easily. If the bleeding is coming from around your stoma then it is likely that your bag has rubbed around the stoma and is most likely not any cause for concern. The same applies in the stoma bleeds around the edges whilst you are cleaning it.

What you should do if your Stoma is Bleeding

If the bleeding is coming from inside the stoma then it is important to contact your stoma nurse for advice as this could indicate intestinal bleeding. If you are concerned by any bleeding from your stoma then you should contact your stoma nurse.


Retraction/ Prolapse

Retracted Stoma

A stoma will normally protrude slightly above the skin level. The length of the protrusion will depend on whether you have a colostomy or ileostomy (ileostomies tend to protrude further out) and the size of your bowel.

A retraction of the stoma is when the stoma lays flat to the skin or below skin surface level.This retraction can become problematic as it can affect the fit of your stoma bag and cause leaks, which can lead to sore and broken skin.

How to manage a retracted Stoma

This can be rectified by using a stoma bag with a convex wafer to push the stoma forward, an ostomy belt to help support the stoma and/or barrier rings or a barrier paste to help keep the output off the skin. In extreme cases, your surgeon may suggest re-siting your stoma for your comfort.

Prolapsed stoma

A prolapse is when the stoma extends to an abnormal length and if left untreated are more susceptible to abrasions or infection. Prolapses are more common in loop colostomies and there are several reasons why a prolapse may occur including a weak abdominal wall, rapid weight gain, pregnancy, surgical technique (such as a large incision in the abdominal wall, where the bowel was bought through to the surface) or a sudden pressure in the abdomen caused by coughing fit.

How to manage a Prolapsed Stoma

It is important to monitor a prolapsed stoma for changes in size and colour as the blood supply to the stoma could become compromised. A prolapsed stoma could also become obstructed making it impossible for faeces to pass through.重要的是寻求医疗建议,如果你的造口变得阻塞或如果造口看起来比平常苍白。你可能还需要改变你的气孔袋,以包括扩大的气孔的大小。如果出现问题,你的外科医生可能会决定重新定位你的造口。


Parastomal Hernias

What is a Parastomal Hernia?

造口旁疝是指肠袢通过造口后薄弱的腹肌膨出。你通常可以通过在气孔后面形成的明显的隆起或肿块来判断是否有疝气。随着时间的推移,它的大小会增加。疝可导致造口输出量变得不可预测,并引起交替腹泻和便秘。

随着疝的增长,它会导致造口缩回或引起造口袋的粘附问题。

Parastomal Hernia Symptoms

  • If your hernia is large, you may experience a dull ache or dragging sensation particularly after the stoma has been active.
  • 你的皮肤可能会开始感觉变薄和拉伸,当你把包拿出来的时候可能更容易撕裂。
  • You may find irrigation difficult or less effect as the water will struggle to get through the collapsed loops of bowel.
  • 在极端情况下,肠袢可能被绞窄和阻塞,引起极度疼痛和呕吐。在这种情况下寻求紧急医疗护理是很重要的。

How to Reduce Risk of Parastomal Hernias

Stoma belts

You can help support your stoma by wearing a stoma belt and specialist support underwear that comes in different support strengths. It is thought that around 70% of ostomates develop a hernia but there are a couple of things you can do to prevent them including not lifting anything heavier than a kettle in the first three months post surgery, holding your abdominal muscles when coughing or sneezing, wearing light support from the start and definitely wearing support during exercise and not gaining rapid amounts of weight.


Blockages/ Bowel Obstructions with a Stoma

Due to the mature of the surgery some people may experience partial or complete bowel blockages/obstruction with a stoma. These can be caused by certain foods that the bowel may find difficult to digest or could be caused by adhesions and scar tissues within the bowel that can prevent faecal waste from passing through.

Symptoms of a bowel obstruction include:

  • Acute abdominal pain
  • No output or extremely watery output
  • Nausea or vomiting
  • A swollen, hard abdomen

How to relievea bowel obstruction

There are some self help tips that you can follow including stop eating solids, increase fluid intake, drinking a warm drink such as tea can help stimulate the bowel to move as can having a warm bath and can help to ease abdominal pain. Drawing your knees to your chest and rocking from side to side can also help to move a food blockage. If you have extreme abdominal pain and you are vomiting then seek emergency medical attention to resolve the obstruction and to avoid perforation of the bowel.

THE INFORMATION ON THIS PAGE IS A GUIDE ONLY. IT IS IMPORTANT THAT YOU SPEAK TO YOUR GP OR A QUALIFIED HEALTH PROFESSIONAL ABOUT YOUR CONDITION.
Advertisement
Bladder & Bowel Home Delivery
Home Delivery Call FREE

Home Delivery Service

Bladder & Bowel Home Delivery service provides all of your urology, ostomy, wound care and prescription medication delivered right to your front door. With FREE Just Can’t Wait Card, Radar Key and Complimentary Items.