If the stoma does not protrude above the skin, the stool may get under the pouch seal and cause leakage. A convex pouching system can provide some pressure around the stoma to force output to get into the pouch and not under the skin barrier seal.
To treat irritated skin around the stoma you can use stoma 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).
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.
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.
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.
It is also important that you dry your skin thoroughly before applying your stoma bag. If the skin is too moist then this can also cause stoma bag leakages. Leaks can also occur if the stoma protrusion has altered. It may mean you need to have an alternative product to help prevent leaks such as a convex product.
Most issues around stoma leakages bag can be resolved relatively quickly by making slight adjustments, swapping to a new product or even altering your diet slightly.
Certain foods may make your stoma output more liquid especially if eaten in large quantities e.g. fibrous foods (wholemeal bread, wholegrain cereals, pulses, leafy green vegetables, raw vegetables, sweet corn, fruits and nuts), spicy foods, alcohol, drinks containing caffeine (e.g. coffee, tea, cola), fruit juices and ...
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.
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.
You may wish to apply a skin barrier cream to the sore skin before applying your stoma pouch. This will help soothe any irritated skin. iLex is an extremely popular cream that many ostomates swear by.
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.
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.
A prolapse can occur in any stoma type but is more common in loop stomas. There are many causes, the most common are: An over sized hole made in the abdominal wall at surgery. Increased abdominal pressure due to tumour, pregnancy, coughing and sneezing.
What does this mean? If your stoma output is loose and watery for more than 24 hours nutrients, electrolytes (eg. Salt) and fluid are not absorbed properly.
If your stoma bag does not fit snugly around your stoma, it can cause leaks which affect adhesion and harm the skin, which in turn makes it harder to get a good seal. Re-measure your stoma using the backing paper of the adhesive as a guide. You may want to stand in front of a mirror to do this.
Keeping hydrated is an important aspect of living with a stoma. For many people it is just making sure you are drinking plenty throughout the day. You should try to drink 6-8 glasses of water each day along with any other drinks such as tea or coffee.
It involves washing out your colon with water either every day or every other day. To do this, you gently insert a small device into your stoma and attach it to a bag full of water. You slowly move water into your colon so it washes it out.
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.
It's always a good idea to empty or change your stoma bag before you go to bed as it will help to prevent your bag from filling up too much overnight and disturbing your sleep. A full stoma bag is always at risk of leaking and that's not something you want to experience during the night.