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.
Complications of ileostomy and colostomy may include stoma or skin complications, dehydration, problems absorbing nutrients, and intestinal obstruction.
Ileostomy complications cause laceration from clotting, mucocutaneous suppuration, stoma separation from the skin, and peritonitis. Stoma necrosis can occur due to strangulation and low blood flow from the surgical procedure.
Early complications include stomal ischemia/necrosis, retraction, mucocutaneous separation, and parastomal abscess.
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.
Major changes in the color of a stoma, including extreme paleness or extremely darkening, are signs that the tissues are not receiving enough blood. An extremely pale stoma means that the blood supply is poor. A purplish, or blackish color is an indication that tissues are dying (referred to as necrosis ).
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].
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.
Symptomatic or progressive stoma prolapse requires surgical repair, through laparotomy or laparoscopy approach. Strangulation of the intestine may lead to edema and necrosis and require emergency surgery.
If your blockage lasts any more than 8 hours with no movement, you should go to the hospital as it might need surgical intervention!
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.
This pain is often due to intercostal nerves caught in scar tissue or even stitched when the surgeon closes the site. This can lead to irritation and inflammation that produces a burning or stabbing sensation in the area of the colostomy site. Most people experience radiating pain from the abdominal wall to the side.
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.
Bacterial infections are the most common type of infections for those with a stoma. Any break in the peristomal skin caused by leakage, allergic contact dermatitis or other chronic skin conditions. increases the risk of infection.
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.
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.
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.
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 common type of blockage is called fecal impaction. This is when a large, hard mass of poop gets stuck in your digestive tract and can't get pushed out the usual way. But when your bowel is blocked by something other than hard stool, doctors call it a bowel obstruction.
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.
The muscles in the abdominal wall should create a snug fit around the stoma opening, so if the muscles in this area becomes weak, a hernia can form. Hernias are unfortunately quite common amongst those with a stoma and can develop gradually as the area stretches and weakens over time.