What is a Prolapsed Stoma?
A prolapsed stoma occurs when a small section of the intestine pushes through the stomal opening in the skin. This may happen in individuals who had a colostomy or ileostomy. The amount of protruding intestine can vary from 2-3 cm to more than 10 cm.
Although a prolapsed stoma can be alarming when it happens, it is usually not serious and can be managed by visiting your healthcare provider. Learn more about the causes and treatments for a prolapsed stoma below.
Causes
The stoma may prolapse if the muscles supporting it are weak. It can also happen due to excessive straining on the abdominal muscle, such as through heavy lifting. Other causes include constipation, obesity, or coughing and sneezing too hard. Individuals who have had their stoma prolapsed once are also more likely to experience a prolapse again if there is excessive abdominal pressure.
Management and Symptoms
Symptoms of Prolapsed Stoma
The most obvious symptom of a prolapsed stoma is when you see the intestine protruding through the stoma. The stoma will be longer than usual, sometimes with swelling. Some individuals might only notice it when they are standing, and it may disappear when they are lying down.
A prolapse decreases blood supply to the stoma, causing it to turn dark red, purple, or pink. It may also feel cool to the touch. You may experience skin irritation as well as sores on its surface that appear like yellow or white patches. If the stoma is blocked, the stool will not be able to properly empty into the pouch.
Treatments for Prolapsed Stoma
The stoma prolapse treatment recommended by your healthcare provider depends on your situation, including:
Non-surgical treatment
If your prolapsed stoma does not cause complications, such as bowel obstruction or strangulation (cut off blood supply to the rest of your intestines), your healthcare provider may recommend non-surgical treatments. This includes gently pressing on the exposed intestine to help it move back into your belly. They may also use a cold compress or pour table sugar on it to reduce swelling and help the intestine move back in place. Your provider may also teach you how to do these treatments on your own in case of another prolapse.
Surgical treatment
If your provider notices that your prolapsed stoma causes complications, they may perform surgery to remove the prolapsed section of the intestine. They will then attach a new section to replace it and redo the stoma site.
Managing Prolapsed Stoma
When you experience a prolapsed stoma while you are at home or away from your healthcare centre, you can try lying flat with your head back. Do not look at your abdominal area to prevent straining your abdominal muscles. Try your best to relax, and apply continuous gentle pressure with your hands to help the intestine slide back into your body.
Since the stoma tissue is very delicate and easy to injure, a prolapsed stoma can easily get irritated or bleed when rubbing against the pouch opening. Avoid pinching the stoma between the flange, or the plastic piece that fits into the ostomy pouch. Wearing loose-fitting clothes, especially around the waist, can prevent rubbing.
While some cases of prolapsed stoma can subside on their own, it is best to let your healthcare provider know if you have it. Your provider will assess your condition and advise how you should look after the stoma, helping reduce the swelling and prevent it from prolapsing again.
You may also be advised to get stoma care products that help you conveniently manage your stoma at home, such as:
Stoma bags
Stoma bags or ostomy pouches help collect waste. They are commonly found in two different types which you can choose from to suit your needs. The first is a one-piece system bag, where the pouch and skin barrier come pre-attached in one piece. The second is a two-piece system, where the pouch and barrier are separated so you do not have to remove the whole system when changing your pouch.
In some cases of prolapsed stoma, you may need to get a bigger stoma bag with a larger opening, or choose a flexible pouch as it can expand in size. You may also be advised to empty your stoma bag more often.
Skin barriers
Skin barriers, also called wafers or flanges, are available in different styles and sizes. If you are unsure which skin barrier to choose, your healthcare provider can provide recommendations.
Cleaning supplies
Make sure to clean the skin around the stoma regularly to reduce the risk of infection. You can use stoma cleaning products such as skin barrier wipes and adhesive remover wipes.
Support belt
Ask your healthcare provider whether you need a support belt or hernia belt to hold the stoma in place and protect it from another prolapse. Support belts are garments to hold the stoma in place and protect it. They also help make the stoma bag appear more discreet, while drawing in and helping support the weight of bulges to feel more secure in the core.
Do You or a Loved One Need Stoma Prolapse Treatment?
Sozo Wound & Stoma Care provides stoma care in Singapore to help manage stoma prolapse. Get in touch with us and let us assist you with our stoma care services!