Stabbing pain near your stoma can signal issues like skin irritation, trapped gas, scar tissue (adhesions), constipation, or even serious problems like a blockage, hernia (parastomal), or infection, so you should contact your stoma nurse or doctor immediately for proper diagnosis and care, especially if it's severe or accompanied by vomiting or fever.
My Stoma is Painful to Touch
Discomfort is often due to issues with the surrounding skin or tissue. Common causes include irritation, parastomal hernias, granulomas, or trauma to the area. Sometimes, complications like bowel obstruction or scar tissue can also be painful.
What is Proctalgia? Just as spasms of neck muscles cause headaches, spasms of the pelvic muscles causes proctalgia. Proctalgia is pain due to a spasm of the pelvic floor muscles, the muscles of the anal sphincter, or the muscles of the rectum. This causes severe stabbing pain like a knife sticking into the rectum.
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.
If you think you have a parastomal hernia, you can assess for the following symptoms or problems:
Inguinal hernia symptoms include: A bulge in the area on either side of the pubic bone, which becomes more obvious when upright, especially when coughing or straining. A burning or aching sensation at the bulge. Pain, discomfort or pressure in the groin, especially when bending over, coughing or lifting.
The stool may have a strong odor. The stoma or the skin around the stoma may swell. If the blockage remains, the flow of stool will stop totally. Then you'll have increased pain, often leading to an upset stomach (nausea) and vomiting.
It can feel like a dull ache around the stoma area, or can create a pulling sensation. The swelling can increase as the hernia gets worse, making the stoma more difficult to use, as well as making it harder to hide beneath clothing, which can be embarrassing.
A mucous fistula attaches a disconnected part of your intestine to a surgically created small opening in the skin on your belly (stoma). This connection helps people with certain bowel diseases pass mucous (intestinal secretions) out of the stoma instead of the anus.
As the obstruction gets worse, your symptoms may happen more often and become more severe. You may have frequent vomiting, extreme bloating, and intense abdominal pain. These are signs of a complete obstruction, in which stool and gas are mostly or totally blocked from leaving the body.
Shooting pains occur when medical conditions disrupt nerves transmitting sensations to the brain. Common culprits include: Pinched nerves (e.g., sciatica, carpal tunnel syndrome, or herniated disks). Muscle spasms pressing on nerve pathways.
If the pain is sudden, severe or does not ease within 30 minutes, seek emergency medical care. Sudden abdominal pain is often an indicator of serious intra-abdominal disease, such as a perforated ulcer or a ruptured abdominal aneurysm, although it could also result from a benign disease, such as gallstones.
Although everyone's symptoms vary, the pain tends to affect the lower left side of the abdomen and is sharp and stabbing, rather than dull and achy.
Having a bath may ease the abdominal pain. Drawing your knees up to your chest and rocking from side to side can also help move the food blockage. Try walking around and massaging your tummy. You will find your abdomen becomes swollen and hard if left unresolved blockage can cause intense pain, nausea and vomiting.
If you have an ileostomy you will most likely be wearing a drainable pouch, which you can empty throughout the day and change your pouch every 2-3 days or however long you feel your wafer can last.
Some common signs of an infected stoma may include:
Types of enterovesical fistula including a “colovesical fistula” mean that stool, pus or blood can seep from the fistula opening. Early signs are swelling or a lump in the anal area, as well as pain or irritation that worsens when you sit down, move around, pass stool or cough.
Surgical diversion of the intestinal tract, including ileostomy and colostomy, does not preclude the ability to perform any gainful activity if you are able to maintain adequate nutrition and function of the stoma. However, if you are not able to maintain adequate nutrition, we will evaluate your impairment under 5.08.
Complications of an ileostomy
Five key warning signs of a hernia include a visible bulge or lump, a feeling of pressure, heaviness, or aching, pain that worsens with activity like coughing or lifting, digestive issues such as bloating or constipation, and signs of strangulation like severe pain, discoloration, fever, nausea, or vomiting, which require immediate emergency care.
It is usually easy to recognize an parastomal hernia. You may notice a bulge under the skin next to the stoma. It may be difficult to get your stoma appliance to fit and function properly. You may feel pain when you lift heavy objects, cough, strain, or during prolonged standing or sitting.
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.
Symptoms of intestinal obstruction are:
The 3-6-9 rule is a guideline for interpreting abdominal X-rays to detect bowel obstruction, stating normal upper limits are 3 cm for the small bowel, 6 cm for the large bowel (colon), and 9 cm for the cecum; diameters exceeding these suggest dilation, a key sign of obstruction, with larger measurements increasing the risk of rupture (e.g., >6cm small bowel, >9cm cecum).
Stenosis is when the opening of the stoma, or just inside the stoma becomes narrow or constricted. Hints and tips. This is sometimes known as a stricture and can occur at any time after your surgery. Stenosis can occur if you have a colostomy, ileostomy or urostomy.