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.
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.
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.
Call your doctor or nurse advice line now or seek immediate medical care if: You have pain that does not get better after you take your pain medicine. You have signs of infection, such as: Increased pain, swelling, warmth, or redness.
To treat affected skin around the stoma you can use Stomahesive 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).
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.
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.
Skin Irritation
This is usually due to leakage from the ostomy device. This is when output from the stoma seeps under the adhesive part of the wafer and output is now touching the skin. This can be painful as well as damaging to your skin and your ostomy device.
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.
A healthy stoma is pinkish-red and moist. Your stoma should stick out slightly from your skin. It is normal to see a little mucus. Spots of blood or a small amount of bleeding from your stoma is also normal.
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.
Skin irritation around your stoma is usually caused by leakage from your ostomy pouch and the output from your stoma getting underneath the adhesive and onto your skin. It is uncomfortable and can stop your pouch from working well.
Most commonly with an ileostomy, redness to the skin around the stoma, accompanied by burning and itching, is the result of stool having direct contact with the skin. Stool from an ileostomy is corrosive and can cause damage to the skin within a short period of time.
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.
Spontaneous stoma closure is a rare and interesting event. The exact etiology for spontaneous closure remains unknown, but it may be hypothesized to result from slow retraction of the stoma, added to the concept of a tendency towards spontaneous closure of enterocutaneous fistula.
Prolapsed stoma is when a piece of your intestine pushes out through the stoma, or opening, in your belly. It's a possible complication of colostomy or ileostomy surgery. A prolapsed stoma may look scary, but it's usually nothing serious. Let your surgeon or ostomy care nurse know if it happens.
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.
Change your pouch every 5 to 8 days. If you have itching or leakage, change it right away. If you have a pouch system made of 2 pieces (a pouch and a wafer) you can use 2 different pouches during the week. Wash and rinse the pouch not being used, and let it dry well.
Use only plain, lukewarm water and dry wipes for cleaning your stoma (if you must use wet wipes, then make sure they are free from lanolin and fragrance as the skin around your stoma can be very sensitive).
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.
It's especially important to keep the skin around your stoma—called peristomal skin—clean and healthy. This helps avoid irritation, infection and potential complications. You'll need to clean around your stoma whenever you change your pouch. The key is to be gentle.
Aside from physical impact (a hard fall, etc.) your bag bursts because of excessive gas accumulation.