Following the Ostomy, most of the patients complain about their stoma. There various issues related to the stoma. Most of these issues are not life-threatening and they can be cured by good take care and alterations in life. In this article, we will discuss some most common stomal issues.
Skin Problems around the stoma or Peristomal Skin Problems
Most of the ostomates complain about peristomal skin issues. Sore skin around the stoma not only leads to irritation but also causes difficulty in adhesion. It can also cause leaking which leads to an infection.
Waste leakage
Most people complain about pancaking. Pancaking is a term used when the waste accumulates at the top of the bag. This can cause uplifting of the bag and the waste come in contact with the skin. This can cause itching, soreness, and skin irritation. The waste produced as a result of ileostomy is very acidic; this is because the enzymes are not broken completely in the colon. These unbroken enzymes cause skin breakdowns if they touch the skin.
Adhesion Problems
Make sure that the incision or the cut on your stoma bag is the same size as your stoma. Most of the brands provide the stoma measurement guide that will help you to cut the exact shape. The incision or hole must attach to your skin properly. There should be no gaps. Ensure that your cat is not too small, or not too big that it snug into the stoma and cause bleeding,
You must measure your stomal size regularly. Gain and loss in your weight can also affect the stomal size. If you notice any kind of creases, folds, or gaps in your pouch, you must fill them to avoid any leakage. A stoma paste can be a very good option.
Skin allergies and irritation
Sometimes patients with stoma complain about irritation and allergic reaction near the pouch. This can cause rash under the pouch and leads to itching with the weeping skin. You can consult with your Ostomy nurse in this regard. Any kind of skin discomfort can affect the adhesion property of the Ostomy bag and cause leakage.
Stomal leakage can be due to the following reasons:
Improper adhesion of the pouch
Very fast and frequent bag filling
Loose output
Leaking Stoma
Most of the patients with Ostomy face leakage, but it not a thing to worry about until it becomes continuous. If your bag is filling quickly this means there is an issue in your diet or nerves, even stress can disturb your bowel movements.
How can you avoid stomal leakage?
If there is a continuous leakage then you must ensure that pouch has been fitted properly. Make completely sure that there are no creases or folds and the skin barrier fits properly around your stoma. In case if your stoma is flattened you can consult your doctor before using a convex flange. You will only be allowed to use a convex wafer if your Ostomy nurse or doctor allows you otherwise it may hurt the stoma.
Bleeding stoma
There are a lot of vessels especially blood vessels around the top of the stoma. These blood vessels are very fragile and can bleed easily. If you observe bleeding nearby the stoma that means your pouch has rubbed roughly against your stoma and this is nothing to worry about. The same is the case when you notice any bleeding around the edges.
How can you prevent stomal bleeding?
If you notice any internal bleeding or bleeding from inside of the stoma then you should contact your doctor without wasting any time. This can be due to intestinal bleeding. You can also consult with an Ostomy nurse in case of bleeding.
Retraction or Prolapsed
Mostly there is a stomal protrusion above the skin level. The length of the protrusion varies with the colostomy or ileostomy and the measurement of the bowel.
A retraction is a condition when the stoma gets flattened and is below the skin level. This retraction can cause issues such as sore skin and irritation.
Solution
This issue can be resolved by using a convex wafer that will aid in pushing the stoma upward. You can also use an Ostomy belt. And stoma paste is another good option. If there is something serious surgeon may consider remaking the stoma for you.
Prolapsed Stoma
A prolapse is a condition when there is an abnormal growth of the stoma that results in extreme elongation. This length can cause abrasion or infection. Most of the prolapse occurs after the colostomy. Other reasons include:
Rapid weight gain
Weak abdominal wall and muscles
Pregnancy
Surgical technique
Pressure caused in the bowel due to severe coughing
How to avoid prolapsed stoma?
You must observe your stomal size and color closely because if there is prolonged prolapse it can affect the blood supply to the stoma. It may also become difficult to pass out feces if there is an infection as a result of prolapse. If you observe that your stoma is pale in color than usual, then contact your healthcare center.
Peristomal Hernia
A peristomal hernia is a condition when the loops of your intestine lump through the feeble abdominal muscles and get behind the stoma. You can easily tell whether a hernia is present or through the hump or the bulge behind the stoma. Over time, this bulge will become bigger. Your bowel movements will become unpredictable and it can also cause diarrhea and constipation.
Major Symptoms:
In case of a large hernia, you might experience pain or dragging when the stoma becomes active.
Your skin might become sensitive, thinner and even break down while changing the bag.
You may observe ineffective irrigation
In case of severe hernia, the bowel becomes entangled and causes severe pain along with vomiting. In this regard, you must see your doctor immediately.
Solution
You can aid your peristomal hernia by using a stoma belt and specially designed underwear. Almost 70% of the patients with an Ostomy have chances to develop a hernia. But some precautions help to prevent this condition. You should not lift heavy weight not more than a kettle full of water, always hold your muscles (abdominal) when coughing and sneezing, wear support while doing exercise or heavy physical activities. Also, avoid gaining weight rapidly.
Stomal Blockage or obstruction:
Some people with older age complain about bowel obstruction. Bowel blockage or obstruction can be partial or complete. This can be due to some foods that are not digested completely. This condition can also occur as a result of any injury to the stoma that does not allow the feces to pass out.
Symptoms:
Severe abdominal pain
Nausea or vomiting
Bulging hard abdomen
Solution
Some tips will help you to reduce the risk of these obstructions;
Stop eating solid food
Increase fluid intake
Taking warm fluids such as tea
Draw your knees to your chest and move side to side to remove any food blockage
In case of severe pain and frequent vomiting see your doctor without wasting any time.
