Some common complications of stoma include poor siting, parastomal hernia (PH), prolapse, retraction, ischemia/necrosis, peristomal dermatologic problems, mucocutaneous separation, and pyoderma gangrenosum. Each will be discussed separately in further detail.
Common early complications include leakage and skin irritations, high output resulting in fluid and electrolyte imbalances, or stoma necrosis; late complications include parastomal hernia, stoma prolapse, and stoma stenosis [7].
Issues or problems with the skin around the stoma is 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.
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.
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.
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.
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.
Get medical help right away if: Your stoma has turned purple, brown, black, or dark red. Your stoma won't stop bleeding. You haven't pooped into the pouch for several hours and you have nausea, belly pain, or you're vomiting.
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.
Complications of ileostomy and colostomy may include stoma or skin complications, dehydration, problems absorbing nutrients, and intestinal obstruction.
A partial blockage usually displays itself through cramping abdominal pain, watery output with a foul odour, and possible abdominal distension and swelling of the stoma followed by nausea and vomiting.
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.
Early complications include inappropriate location, skin excoriation, leakage, stoma retraction, dehydration and stoma necrosis. The late complications include parastomal hernia, stomal prolapse, stenosis, and peristomal dermatitis.
What causes a stoma blockage? A stoma blockage can be caused by damage to the bowel, such as adhesions and scar tissue, that prevent waste from passing through. But by far the biggest cause of an obstruction is indigestible food. The good news is that blockages caused by food are preventable.
If the stoma does not protrude above the skin, the stool may get under the pouch seal and cause leakage. A convex pouching system can provide some pressure around the stoma to force output to get into the pouch and not under the skin barrier seal.
Lifting weights can put a strain on your healing tissues after your surgery. If you want to resume weight lifting, talk to your doctor or ostomy nurse about a binder or hernia prevention belt to support your abdomen while you lift. Sit-ups and crunches can be uncomfortable with an ostomy bag, also called a stoma bag.
Drink sports drinks (such as Gatorade or Powerade) and oral rehydration solutions (such as Pedialyte). These drinks will help replace your fluid loss quickly, especially if your ostomy output is high. A high output is more than 1000 milliliters (about 34 ounces) per day.
In general, if you have a colostomy you will change your closed bag one to two times a day and if you have an ileostomy or a urostomy, you will need to empty your bag several times a day and change your bag every three to five days depending on the wear.
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.
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.
Occasionally most people with a stoma will experience some minor issues which may cause discomfort such as leaks and sore skin, granulomas, retracted stomas, constipation, hernias, or prolapsed stomas.
Red or sore skin around your stoma is usually caused by leakage from your pouch and the output from your stoma getting underneath the appliance and onto your skin. It is important to regularly evaluate the skin around your stoma.
To treat irritated skin around the stoma you can use stoma powder under the ostomy appliance. The powder is available from a medical surgical supplier. If skin has a red, raised, itchy pimply rash: If you have a rash this may indicate a yeast infection and you may use an antifungal powder (2% Miconazole).