stomal stricture – where the stoma becomes scarred and narrowed; further surgery may be needed to correct it if there's a risk of blockage.
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.
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.
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.
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.
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.
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.
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].
Mucus-discharge can often be more productive in the first few weeks and months, following surgery and then the amount slowly reduces. However, an increase in mucus can be a sign of a urine infection, so it may be beneficial to speak with your Stoma Care Nurse or GP.
In a systematic review of the literature,11 the analyzed articles mentioned alterations related to the colostomy: sexual problems, depression, constipation, intestinal gases, dissatisfaction with one's physical appearance, difficulties when traveling, changes in the wardrobe, fatigue, and concern with ostomy sounds.
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.
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.
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.
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).
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.
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.
You can drink alcohol. Alcohol can cause dehydration, so make sure to drink enough water. Remember to consult with your physician before using alcoholic beverages as alcohol may not mix well with your medication.
Generally, you can fly with a stoma bag without worries. However, it is recommended to wait about 4 to 6 weeks after your ostomy surgery. Remember to carry your essential supplies and a set of clothes in your hand luggage to be prepared for any leakages or changes.
Having an ileostomy makes it harder to stay hydrated. If you notice signs of dehydration such as fatigue, dry mouth or lots of poo coming out of your stoma, speak to your stoma nurse or another healthcare professional to get advice.