Like those in our gut, skin micro-organisms have essential roles in protecting against invading pathogens. These micro-organisms can easily multiply when you have a stoma because the area is warm, humid and soiled. They may colonise the stoma without causing any major issues.
The skin around a stoma may become inflamed (red, swollen, painful) because the stoma is leaking, because of an underlying skin disease, or because of infection. Papules (small bumps) and nodules (large ones) can develop due to ongoing irritation, granulation tissue, viral warts, cancer or Crohn disease.
The first sign of a stoma infection may be a pus-like discharge, unusual swelling, increasing redness, or color changes. Some may notice an abscess or an ulcer. A Wound, Ostomy, and Continence Nurse (WOCN) or your doctor will be the best source for medical advice on this issue.
Inflammatory or infectious conditions affecting the skin around an intestinal stoma are common and may be a source of considerable aggravation to patients. Recognition and prompt appropriate treatment of these conditions improves their quality of life.
It's especially important to keep the skin around your stoma—called peristomal skin—clean and healthy. This helps avoid irritation, infection and potential complications.
Infections around a stoma are rare, but can happen for various reasons so it is essential to have a good skin care regime in order to maintain healthy skin.
Skin irritation
This is the most frequently observed complication with all stoma types [2, 7, 12].
Many people enjoy leaving their skin uncovered for 15 to 30 minutes after taking their pouching system off. This is called a skin break. Taking a skin break can help with irritation or keep it from happening. You can decide if you want to take a skin break.
Stool irritation, product sensitivity and yeast are certainly the more common reasons for redness around the stoma.
Signs of Skin Problems Around a Stoma
The skin around the stoma appears infected and/or is red and "angry" in appearance. There is a pus-like discharge. The skin color suddenly changes. The skin is irritated by the stoma appliance, causing redness, chafing, or a raw or "burned" appearance.
Large areas of skin that are red, sore, and weeping (always wet) will keep you from getting a good seal around your stoma. It's important to treat minor irritations right away. If you have a large irritated area, or one that's getting larger despite special care, contact your doctor or ostomy nurse.
The easiest way to clean your stoma site is to gently wash it with warm water using the dry wipes provided and then pat dry thoroughly using a clean dry wipe. Avoid using paper towels as these can get stuck to the stoma, always use dry cotton wipes.
Common complications include poor stoma siting, high output, skin irritation, ischemia, retraction, parastomal hernia (PH), and prolapse. Surgeons should be cognizant of these complications before, during, and after stoma creation, and adequate measures should be taken to avoid them.
A rash around the stoma that is red, or red with bumps – this may be due to a skin infection or sensitivity, or even leakage. Wart-like, pimple-like or blister-like bumps under the skin barrier – this type of irritation can happen any time, even if you've used the same product for months or years.
Air from the stoma causes the bag to expand and detach from the skin (ballooning) Ballooning occurs when air from the stoma inflates the bag and cannot escape through the filter. The resulting air pressure can cause the adhesive to detach from the skin.
The BBC Radio 1 presenter had a stoma bag, which she refers to as Audrey, fitted last October after being diagnosed with bowel cancer. The operation diverts one end of the colon, which is part of the bowel, through an opening in the abdomen called a stoma.
Clean around the stoma with warm water and a soft washcloth each time you change the pouch. Water does not harm the stoma. You can even take a bath or shower without your pouch if you choose: There are no nerves in the stoma, so there is no feeling.
You can bathe and shower as normal with your stoma and, unless you have been specifically advised otherwise, you can do so with the stoma bag on or off. It won't fall off in the water if you choose to keep it on and if you bathe with the stoma bag off, soap rinsing over the stoma isn't a problem.
If possible, take a short walk or just walk slowly around your house, as long as it's not too painful. Try several different body positions, such as a knee-chest position, or lie on the side of your stoma with knees bent, as it might help move the blockage forward.
When the large bowel has been removed the small bowel must adapt to absorb more fluid, which it is not as effective at doing (this will improve over time). This means output from your stoma can increase.
Living with a stoma is a challenging situation for various reasons including uncontrolled gas passage through it, odor, diarrhea, and leakage around the stoma or appliance. It would take several months for the patients to adjust to this difficult time.
A colostomy is an operation to create an opening (stoma) of the large bowel (colon) onto the surface of the tummy (abdomen). Your poo no longer passes out of your body through your back passage. Instead, it passes out through the stoma. You wear a bag that sticks onto the skin over the stoma to collect your poo.
Results: The mean score for the overall quality of life for stomata was 7.42 ± 0.53. Around 70% of patients have adjusted their dietary style due to stoma.