Between 750,000 to 1 million people in the United States have medical ostomies: surgical openings in the abdomen to remove bodily waste that is otherwise trapped or blocked.
Stoma are common, and for many, they’re life-changing procedures with few downsides. Yet, like any medical intervention, ostomies carry some inherent risk of complications. In fact, studies indicate over a third of patients (35%) experience stoma or peristomal complications within 1 year of the initial ostomy surgery.
With this reference resource, learn to recognize and treat stoma problems in their earliest stages.
Recognizing Signs of Unhealthy Stoma (Appearance & Behavior)
Distinguishing between a healthy and unhealthy stoma appearance is key. In addition to visual signs, symptoms like odors, unusual exudate, blood, inflammation, or pain are important to stay alert for.
What Causes An Abnormal Stoma Color?
A stoma’s color can change for benign reasons, stemming from the predictable effects of certain diets or medications. It can also change hue for dangerous reasons, like an infection or reduced blood flow.
Orange, Tan, or Brown Stoma (Colonic Mucosa)
Melanosis coli is the most common culprit behind a tan or brown colon lining. It causes the colon’s mucous membrane to accumulate deposits of lipofuscin, a natural, oxidized lipid with yellow-brown pigment, typically as a medication side effect.
Bright Red Stoma
Vibrant red foods like beets, tomatoes, and strawberries can temporarily stain the colon, turning the normally healthy, pink stoma bright red. A stoma may also become red due to bleeding.
Blue Stoma & Purple Stoma Coloration
Ischemia and necrosis are the most common reasons an intestine or peristomal skin may appear blue or violet. These conditions stem from reduced blood flow, or complete circulation cutoff.
A dark purple colonic mucosa can also be a sign of phlebosclerotic colitis (PC).
Dark Brown Ostomy & Black Stoma
This is typically necrosis. The colon’s tissue is beginning to die. It’s a medical emergency.
Green Stoma Output Or Colonic Mucosa
A stoma may appear green if its output is bile-heavy, or if it’s passing green foods. The visible colon can also develop a green mucous membrane as an effect of antibiotics and specific types of colitis.
10 Common Stoma Problems: Signs & Solutions
These conditions cause problems for many stoma users. Fortunately, with some preparation, it’s possible to catch them early and mitigate treatment.
1. Infected Stoma & Peristomal Infection
“Infection, Definition:
The invasion of… [the]body tissues by disease-causing agents and their multiplication, as well as the reaction by the host to these organisms and/or toxins that the organisms produce.”
— National Institute of Health
An infected ostomy is the colonization of stoma tissue or surrounding skin by disease-causing pathogens.
Types of Ostomy Infections
Stoma infections are categorized by pathogen type. Most often, infections are caused by bacteria, viruses, or fungi.
Key Stoma Infection Signs
Infected stoma have recognizable symptoms. Signs of ostomy infection include:
- Swelling
- Inflammation
- Discoloration of colon tissue
- Yellow / pus discharge
- Near-stoma skin changes color
- Increased pain / burning
Treatment
Stoma and peristomal skin infections can be treated with antibiotics, antifungals, or antimicrobial substances like silver nitrate. An ostomy clinician can make an accurate diagnosis and prescribe a precise treatment designed to clear the infection at its source.
2. Parastomal Hernias
A parastomal hernia is a type of abdominal wall hernia. It’s an enlargement of the stoma opening, allowing the intestines or other abdominal organs to pass through the opening inappropriately.
Signs & Symptoms
The most visible sign of a parastomal hernia is a bulge within, on the edge of, or just outside the stoma.
Physical sensations (like the stoma is “dragging,”) physical pain, discomfort, or pressure near the stoma are crucial symptoms. Nausea and vomiting are likewise urgent signs.
Treatment
Parastomal hernias are typically treated with surgical intervention. Very small hernias can be treated with non-operative medical devices like support belts, though this is unusual.
3. Skin Irritation & Pressure Ulcers
Pressure ulcers are sores caused by long-term restricted blood flow to a specific point in the body. These sores stem from constant pressure or friction on a site—including friction from a medical device like an ostomy bag.
Signs & Symptoms
Peristomal skin irritation and pressure ulcers are forewarned by several symptoms. Note subdermal swelling, areas of skin warm or cool to the touch, tenderness or sensitivity, or acute pain.
Treatment
Skin irritation can typically be treated by simple cleansing and the application of skin protectants. Pressure ulcers may require more complex treatment, including disinfection, biofilm debridement, and dressings that promote wound healing.
Read Pressure Ulcers: Treatment and Prevention, a Medical Monks resource, for more information.
4. Stoma Prolapse
The medical journal Annals of Coloproctology defines intestinal stoma prolapse as “an expansion of the intestine from the stoma.” Up to 25% of ostomy patients experience prolapse as stoma complications.
Signs & Symptoms
The primary stoma prolapse symptom is the intestine visibly protruding out past the stoma opening.
Types & Treatment
Stoma prolapse is categorized by severity, on a grade scale of 1-4. There are effective surgical treatments and non-surgical reduction methods. Explore our guide to stoma prolapse to learn more.
Curated Ostomy Care & Treatment Supplies
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The MEDICAL MONKS STAFF brings to the table decades of combined knowledge and experience in the medical products industry.
Edited for content by JORDAN GAYSO.
