The most common early complications of stoma creation include improper siting, vascular compromise, retraction, peristomal skin irritation, peristomal infection/abscess/fistula, acute parastomal herniation, and early postoperative bowel obstruction.
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.
Complications of ileostomy and colostomy may include stoma or skin complications, dehydration, problems absorbing nutrients, and intestinal obstruction.
Early complications include stomal ischemia/necrosis, retraction, mucocutaneous separation, and parastomal abscess.
bloating and swelling in your tummy. tummy cramps. a swollen stoma. nausea or vomiting, or both.
Signs of Stoma Problems
The stoma is no longer beefy red or pink but pale in appearance. The stoma is no longer moist in appearance but seems dry. Your stoma turns dark red, purple, or even black in color. Your stool from the stoma is always watery or diarrhea.
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.
When the skin becomes infected it can start to look inflamed and the infection tends to cause some swelling around your stoma. The skin colour often changes from a healthy pink/reddish colour, to pale, bluish purple or even black. If there is any discharge of blood or pus this is often a definitive sign of infection.
If the skin around the stoma does not appear to be similar to the skin on rest of your abdomen, it is likely that you have a skin issue that needs to be addressed. The skin barrier should protect your skin. If the skin is irritated (red, moist, or sore to the touch), the pouch seal can fail and leakage.
It occurs when the blood supply to/ from the stoma is impaired or interrupted, resulting in partial or complete stoma tissue death. As blood flow and tissue perfusion are essential for stoma health, deficient blood flow to the stoma will lead to necrosis.
Taking a Skin Break
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.
Ileostomy complications cause laceration from clotting, mucocutaneous suppuration, stoma separation from the skin, and peritonitis. Stoma necrosis can occur due to strangulation and low blood flow from the surgical procedure.
Symptomatic or progressive stoma prolapse requires surgical repair, through laparotomy or laparoscopy approach. Strangulation of the intestine may lead to edema and necrosis and require emergency surgery.
Stoma necrosis presents as a stoma that appears either ischemic (dark red, purplish tint or cyanotic hue discoloration), or necrotic brown or black. The stoma may be flaccid or hard and dry. Necrosis may be circumferential or scattered on the mucosa and may be superficial or deep.
A bulge in the skin around your stoma. Skin color changes from normal pink or red to pale, bluish purple, or black. 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.
If there is no output from your stoma, and you are not nauseated or vomiting, stop eating solid food and only consume liquids such as juices, warm broth or tea. Take a warm bath or shower to relax the abdominal muscles. A heating pad placed on a low setting may be helpful to relax the abdominal muscles.
If the bleeding is minor and you notice spots on the wipes as you clean, the bleeding may be coming from the edges of the stoma. The stoma is incredibly vascular and can easily bleed if knocked or caught by the edges of the stoma appliance.
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.
You can bathe or shower with or without wearing your pouching system. Normal exposure to air or water will not harm or enter your stoma. If you're showering without your pouch, remove the skin barrier too. Try to create a routine that coincides with when you're due for a pouch change.