Having diarrhoea will often mean that the stoma bag needs to be changed much more regularly than usual. This can mean that you go through supplies much quicker and also lead to irritation of the peristomal skin.
A colostomy may make you more prone to constipation or diarrhea. It's important to get enough fiber in your diet and drink plenty of water to prevent these problems. Some people experience a small amount of stool leakage between irrigations.
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.
Irritant contact dermatitis is the most common peristomal skin complication. Although attention to proper fit occurs during the inpatient setting, patients need to be refitted postoperatively as stomal swelling decreases.
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.
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.
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.
Speak to your stoma nurse if you have cramps, feel nauseous or notice swelling around your stoma. They may recommend avoiding solid foods, massaging your tummy or having a hot bath. In more serious cases, your bowel could burst (rupture), and you may need further surgery.
If your diarrhea fails to improve and resolve completely, you can be at risk of complications (dehydration, electrolyte imbalance, kidney failure and organ damage). Call your healthcare provider if you have diarrhea that fails to get better or go away, or if you experience symptoms of dehydration.
Loperamide (Gastro-Stop) capsules can be used to further slow ileostomy output. If you see unopened capsules in your stoma output, try opening the capsules and taking the granules with food or fluid.
Certain foods may make your stoma output more liquid especially if eaten in large quantities e.g. fibrous foods (wholemeal bread, wholegrain cereals, pulses, leafy green vegetables, raw vegetables, sweet corn, fruits and nuts), spicy foods, alcohol, drinks containing caffeine (e.g. coffee, tea, cola), fruit juices and ...
Loperamide may be used for long-lasting diarrhoea and by people who have a colostomy (stoma) if their doctor prescribes it.
You will know when you have a blockage as your bag will be empty when usually it is filling up. Another symptom of a blocked stoma, in addition to your output slowing down, is stomach-ache. You may start to feel waves of cramping and abdominal pain, which may worsen if the symptoms you experience are unresolved.
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.
After ileoanal pouch surgery is complete, the temporary stoma is closed. Stool and gas will leave your body through your anus, as they did before surgery. At first, you will have more frequent bowel movements, up to 15 per day. You may have mild bowel control problems and may need to wake up from sleep to pass stool.
If the stoma is only temporary, a subsequent operation will be needed to reattach the bowel so faeces can once again be passed through the anus. If permanent, the stoma is checked some three weeks later (or when the swelling has subsided) to make sure it has an appropriate diameter. The bags must be changed frequently.
It's always a good idea to empty or change your stoma bag before you go to bed as it will help to prevent your bag from filling up too much overnight and disturbing your sleep. A full stoma bag is always at risk of leaking and that's not something you want to experience during the night.
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.
Use the palm of your hand to apply gentle pressure to the stoma, very gently pushing it back into its usual position. 2. Another alternative is to apply a cold compress to the stoma with your pouch on. Then try to reduce the stoma again using the palm of your hand.
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. Massage the abdominal area and the area around your stoma. Most food blockages occur just below the stoma and this may help dislodge the blockage.