Complications of ileostomy and colostomy may include stoma or skin complications, dehydration, problems absorbing nutrients, and intestinal obstruction.
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].
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.
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.
Bowel obstructions can occur in both the small and large intestine – meaning that people with ileostomies as well as colostomies can experience an obstruction. Blockages in the large intestine usually occur gradually while blockages in the small intestine can happen fairly fast.
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. The skin around your stoma should look similar to the skin on the rest of your body.
The studies revealed the average age of a person with a colostomy to be 70.6 years, an ileostomy 67.8 years, and a urostomy 66.6 years.
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.
A colostomy is an operation to divert 1 end of the colon (part of the bowel) through an opening in the tummy. The opening is called a stoma. A pouch can be placed over the stoma to collect your poo (stools). A colostomy can be permanent or temporary.
Air from the stoma causes the bag to expand and detach from the skin (ballooning) Ballooning occurs when air from the stoma inflates the bag and cannot escape through the filter. The resulting air pressure can cause the adhesive to detach from the skin.
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.
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.
The easiest way to clean your stoma site is to gently wash it with warm water using the dry wipes provided and then pat dry thoroughly using a clean dry wipe. Avoid using paper towels as these can get stuck to the stoma, always use dry cotton wipes.
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.
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.
One major issue to watch out for with a stoma is the laxative effect of some chocolates. The caffeine and fibre within the chocolate can increase the rate of motility (which is the contraction of the muscles in the digestive tract that encourage bowel movements).
Avoid applying products that contain alcohol as they can cause dry skin. Do not use skin products made with oil. They will make it difficult for the pouch to stay attached. If you have hair on the skin surrounding the ostomy, you may need to keep it shaved so the pouch will stick.
Just take it slow and don't expect to be able to go straight back into your normal routine. It takes around 8 weeks to feel fully recovered from stoma surgery. You may also feel quite emotional and maybe a little bit overwhelmed. Having stoma surgery is a big change physically and emotionally.
If you allow it to get too full, the weight of the stool may pull the pouch away from the skin. A person with an ileostomy will need to empty the pouch about five or six times in a 24-hour period. If you have a colostomy, you will need to empty the pouch two or three times in a 24-hour period.