A prolapsed stoma looks like the intestine telescopes out, making the stoma significantly longer (from 2cm to over 10cm) and protruding further from the body than usual, appearing as a reddish/pink, sometimes swollen, tube or bulge, which can cause pouching issues but is usually manageable if healthy, though discolouration (dusky/purple) needs urgent care. You can find images on medical sites like AccessMedicine, National Institutes of Health (NIH), and ostomy support sites like Colostomy UK and Salts Healthcare by searching "prolapsed stoma pictures" on Google Images or PubMed Central.
What are the symptoms of a prolapsed stoma? The most obvious symptom is that you see your intestine push out through the stoma and the stoma gets longer. The amount of intestine can vary between 2 centimeters (about 1 inch) to 10 cm (more than 4 inches). A prolapsed stoma may hurt and irritate your skin.
When your stoma is formed, the end of your intestine is brought out through an opening in the abdominal wall. This can weaken the muscle of the wall, allowing the bowel to push forward and form a bulge. The size of the bulge varies from person to person, but when a bulge first appears it is often the size of a lime.
If your stoma prolapses, it can often become more swollen in addition to longer in size. It is a good idea to try and cut the aperture size larger to incorporate this, which will also help to prevent leaks, sore skin and ulceration from the aperture being too tight.
Depending on the severity of the prolapse, a referral can be made to the Surgeon for review, but is often not deemed as urgent, unless the prolapsed stoma changes to a very dark/dusky colour, stops functioning or causes pain. Pain may suggest bowel strangulation which is treated as an emergency.
Surgical correction consists of cutting away the excess bowel and removing it and re- suturing the stoma to the abdominal wall. Alternatively, the stoma may be re-sited and if previously a loop stoma, an end stoma constructed.
See a GP if:
you have a lump in or around your vagina. you have any other symptoms of pelvic organ prolapse.
What do I do if my stoma prolapses?
Vaginal prolapse surgery is a major surgery with serious risks and potential complications. You may have less invasive treatment options depending on your circumstances. Consider getting a second opinion about all of your treatment choices before having vaginal prolapse surgery.
Stoma prolapse is reported to occur in 8.1% to 25.6% of children [15], 2% to 3% of ileostomy patients, 2% to 10% of colostomy patients [16-20], and up to 30% of transverse colostomy patients [21, 22].
A stoma hernia resembles a bulge or a lump. Many people describe it a looking like a “golf ball” or a “grapefruit” behind their stoma. Having a hernia can cause your stoma to look more pronounced and potentially change shape, it may also appear larger or flatter than it did before the hernia.
you have lots of blood coming from your stoma, or in your stoma bag. you have signs of dehydration. poo has not come out of your stoma for much longer than is normal for you, or you feel uncomfortable. you have severe tummy pain.
Despite the prolapse, your colostomy should continue to be a healthy pink/red colour. and it should function in the usual manner. If things alter in any way and becomes darker it is important that you seek urgent medical advice.
If you have rectal prolapse, you may notice a reddish lump that comes out of the anus, often while straining during a bowel movement. The lump may slip back inside the anus, or it may continue to be seen. Other symptoms may include: You cannot control your bowel movements, known as fecal incontinence.
How to prevent a stoma prolapse
Stoma prolapse is a full-thickness protrusion of the bowel through a stoma [1], and parastomal hernia is defined as an incisional hernia associated with an abdominal wall stoma [2]. Both of these are common late complications after stoma formation [3].
If you are using a closed bag, you may be changing it 1-3 times a day, it varies from person to person. For those with a drainable bag, particularly with a urostomy or ileostomy, you may be changing it daily or even every other day.
Colostomies should typically protrude 1.5 to 2.5 cm and stomas of the small bowel should evert 2.5 to 3.5 cm. Stomas that do not evert at least 1 cm above the skin surface 48 hours after surgery have a 35% chance of causing problems.
Do not do activities that put pressure on your pelvic muscles. This includes heavy lifting and straining. Try exercises to tighten and strengthen your pelvic muscles. These are called Kegel exercises.
Common granulated sugar is the main used substance, working as a dehydrating substance due to its high osmolarity when compared to the exposed mucosa. Therefore, mural edema is absorbed, allowing the bowel to return to its usual size spontaneously or at least allowing manual reduction [4,10].
A prolapsed stoma occurs when the bowel protrudes (extends), resulting in a visible increase in the length of the stoma (usually over 2cm longer than when initially formed). A weakness in the abdominal wall around the stoma.
According to the Association for Pelvic Organ Prolapse, over 50% of women over 50 have some form of this disorder. The most common disorders that pelvic organ prolapse is mistakenly diagnosed as include urinary and fecal incontinence, constipation, and irritable bowel disease.
Beyond the physical discomfort and health implications, untreated pelvic prolapse can lead to a diminished quality of life. It might reduce the joy in activities you once loved, from simple things like a long walk to more strenuous activities like dancing or aerobics..
Early signs of pelvic organ prolapse include a feeling of pelvic pressure or heaviness, a bulge at the vaginal opening, difficulty emptying your bladder or bowels, urinary leakage, and discomfort during sex, often worsening with activity and improving with rest. You might also notice recurrent UTIs, a weak urine stream, or feeling like your tampon isn't staying in place.