Problems you may experience with a stoma

Overcoming common stoma problems

Below you will find some common stoma problems which you may experience in your every day life, along with information on how to overcome these issues with your stoma:​

Other problems you may experience with a colostomy, ileostomy or a urostomy

Retraction

This occurs when the stoma is below skin level. There are various reasons for this:

• Difficulties with stoma formation
• Weight
• Shape of the abdomen

If you have a retracted stoma, you may need to try a range of stoma bags and additional products to find the most suitable for your stoma. Leakages are more likely, but the use of appropriate products will minimise this. Finding the ideal products may take some time, but your Stoma Care Nurse will be able to offer advice on what is best for you.

Stoma products to help you overcome retraction

Please see below the stoma which are available to help overcome stoma retraction:

Other problems you may experience with a colostomy, ileostomy or a urostomy

Granulomas

Granulomas are red lumps that can appear on and around the edge of the stoma. They can be tender and may develop at any time. Sometimes rubbing from the wafer or base plate can increase the risk of granulomas occurring. Bleeding can happen and may interfere with the stoma bag adhesion. The template should be checked to ensure a good fit but do not cut the template larger to accommodate the granulomas as this may allow them to grow larger.

Your Stoma Care Nurse may feel it is necessary to treat with a course of silver nitrate or you may be referred for surgical excision, although this is rare.
 

Ulcers

Ulcers can develop for a variety of reasons that may include medication, type of appliance and as a result of your original diagnosis. They can appear as broken, red, sore areas which may be painful. Ulcers are treatable and your Stoma Care Nurse can advise you following assessment.

Other problems you may experience with a colostomy, ileostomy or a urostomy

Stenosis

Stenosis results in the stoma becoming very small and tight. The output from the stoma will become ribbon-like or even liquid. Following assessment, your Stoma Care Nurse may use a dilator to insert into the stoma and will request you continue to do this at home. Your Stoma Care Nurse may also recommend you take laxatives to keep your stool soft enough to pass and to avoid constipation. You may need surgery to refashion your stoma.
 

Necrosis

This is extremely rare. Necrosis occurs if the blood supply to the stoma is restricted. Initially the stoma will become a darker red/purple and may even turn black, which is an indication that the blood supply is impaired. It may also feel cold and hard to touch. It is vital that you seek urgent medical attention.

Potential Colostomy Problems

Constipation

Constipation can occur for many reasons, such as reduced mobility, pain relief medication, and reduced fibre and fluid intake. It results in infrequent hard stools and may cause abdominal discomfort. It is resolved by increasing your fluid and fibre intake. If this does not work, your GP or Stoma Care Nurse may advise the appropriate use of laxatives.

Potential colostomy & ileostomy problems
 

Change in output

A change in output from your stoma could contribute to sore skin. If you experience loose stools, you may find it helpful to temporarily use a drainable bag or a high output bag to prevent frequent bag changes, which can result in sore skin.
 

Mucocutaneous separation

To form the stoma, the bowel will be stitched to the skin. Occasionally, following surgery the stitches and skin can separate. This can sometimes look unpleasant but, like any other wound, it will heal over time. It is important to contact your Stoma Care Nurse who can advise you on treatment to aid healing.

Potential urostomy problems
 

Change in urine

Any change in your urine could contribute to sore skin. Highly acidic or alkaline urine may affect the adhesion of your bag. This could be a sign of infection and you should consult your Stoma Care Nurse.
 

Phosphate deposits

This occurs when your urine is too alkaline and forms grey crusty deposits on your skin, and can result in sore skin and leakage. These deposits must be covered by your stoma bag and it is important not to cut the hole bigger. Treatment includes white vinegar soaks: either by dabbing the surrounding area with a cloth soaked in equal parts white vinegar and water, or spraying or covering the area with this same solution. Your Stoma Care Nurse will show you how to do this. You should also increase your fluid intake.
 

Infection

Urinary tract infections (UTIs) are common in people with urostomies, it affects the upper part of the urinary system: the ureters and kidneys.
 

Mucocutaneous separation

To form the stoma, the bowel will be stitched to the skin. Occasionally, following surgery the stitches and skin can separate. This can sometimes look unpleasant but, like any other wound, it will heal over time. It is important to contact your Stoma Care Nurse who can advise you on treatment to aid healing.