Living with a stoma is manageable with the support of your doctor, family, and friends. However, many people may experience stoma problems within the first five years after stoma formation. Thankfully, managing these complications is still possible.
Common Stoma Problems You May Face
Your doctor will notify you of the potential complications you may face with your stoma. Some of the more common ones include:
- Sudden leakage
- Sudden bleeding
- Pancaking or ballooning
- Skin irritation
- Blockage in the stoma
- Retracted or prolapsed stoma
- Hernias
Managing Stoma Complications
Leaking
Leakage can occur due to a poorly fitted stoma bag or even weight loss, which can influence your stoma’s size and affect the bag’s placement. Leaks can occasionally occur, especially when the stoma’s size changes in the first few months after surgery. You should regularly check that your stoma bag is correctly positioned to reduce this risk.
Ensure that the stoma bag’s opening (the flange) fits snugly around the stoma and that there are no gaps between your skin and the flange. Consider using a convex wafer if you have a flat or retracted stoma, which can lead to leakage.
Pancaking
Pancaking occurs when your stoma’s output becomes stuck at the top of the bag and does not flow into the bag. This is because the stoma bag’s internal layers stick together, preventing the output from settling to the bottom. It could cause a blockage in the bag filter (allowing gas to escape from the bag), skin irritation if the output comes into contact with your skin, or even force the bag off your body.
You can blow into the bag before applying it to your stoma to force both internal sides of the bag apart, and then apply the filter cover to retain some air inside the bag. When the stoma functions normally, you can then remove the filter cover to ensure the output reaches the bottom of the bag.
Alternatively, place a small, rolled-up tissue into the bag to keep the sides apart. You could also add baby oil or liquid soap to help the output slide to the bottom of the bag.
Ballooning
Ballooning occurs when the stoma bag inflates due to air introduced into it. This air may be flatulence, in which gas is expelled from the colon through the stoma and collects in the bag. It may also occur when the bag’s filter gets wet or is blocked by stoma output.
Some stoma appliances do have an integral filter that you can use to release this air and neutralise any unpleasant odours. Use a sticky patch to prevent the filter from getting wet.
You may also need to modify your diet to reduce wind in your digestive tract. These include carbonated drinks, spicy foods, and certain vegetables, such as peas and beans. Eat regular meals to reduce this wind build-up, and avoid drinking while eating to prevent air from being swallowed along with your food.
Skin Issues
You may also experience skin problems due to:
- Poorly fitted stoma bags
- Stoma output in contact with your skin
- Skin or stoma injury or trauma
- Skin allergies when using a stoma product
If your skin feels sore or appears red or broken, double-check that your stoma bag snugly fits around your stoma. An ill-fitting stoma bag can cause skin irritation or damage. Look for signs of output on your skin as well, as that will indicate a leak. Check your stoma bag’s condition as well, and replace it immediately if it is damaged.
Look out for signs of damage to the stoma as well. Notify your doctor immediately if your stoma’s condition seems concerning.
Bleeding
The stoma contains plenty of blood vessels, so some minor bleeding can happen. It may also occur when the stoma bag rubs against the stoma. Gently cleaning your stoma with a clean, dry pad will help reduce bleeding, but if it persists or if you notice blood in your stoma bag, contact your doctor immediately.
Retraction
A retraction is where the stoma lies flat or below the skin’s surface. It can make it difficult to fit your stoma bag, increasing the risk of leaks and sore skin. Managing a retracted stoma may require a convex wafer to push the stoma forward, or using other stoma products to support it and ensure a proper fit. If necessary, surgically repositioning the stoma may help maintain your comfort.
Prolapse
A prolapse occurs when the stoma extends in length due to increased intra-abdominal pressure, thereby increasing the risk of infection or injury. The stoma can still function normally, but if it changes colour, contact your doctor immediately. You may need to adjust your stoma bag to accommodate the stoma and prevent complications, such as output blockages. Additional cuts of at least 5 mm to your stoma template can ensure your stoma bag fits snugly without causing abrasions.
Blockage
A bowel obstruction can slow or block the passage of stool through your stoma. A blockage can result from certain foods that are difficult to digest or scar tissue in the bowel, and you may experience symptoms such as:
- Abdominal pain
- Stoma swelling
- Nausea or vomiting
- Reduced urine output
You may need to reduce solid foods and increase fluid intake to stimulate bowel movement. Warm baths can also help ease abdominal pain, while short walks can stimulate blood flow to your bowel, facilitating bowel movements. You may also try gentle massages around the stoma or your abdominal area to dislodge the blockage. If your abdominal pain or vomiting persists, seek medical attention immediately.
Receive Stoma Care with SOZO Wound Care
Managing a stoma can be worrying, but rest assured that SOZO Wound Care’s specialists are here to help. Contact us today to learn how we can provide stoma care for you or your loved one.