Does Stoma Change Shape With Time? Is This Normal?

 Ostomy patients have several questions and doubts about stoma, its care, and its appearance. They also feel changes in the opening with the time. The changed look of the stoma can daunt the ostomates. The fluctuation in the size and shape of the opening can occur in the new fabricated and old stoma. The reasons for these alterations are multiple. Therefore, we shall discuss a few of them to give you some knowledge about the change in the stoma.

Alteration in New Stoma

During the postoperative period, a stoma adopts changes in the size and shapes. It happens because of the edematous, swelling, and healing process. The swelling of the opening gets receded gradually. The abatement of edematous will take six to seven weeks. However, this is not the exact duration of recovery from the swelling. It may take a long or short time, depending on the other factors, like the age of the patient and type of ostomy. However, the ET nurse will measure the size of the stoma regularly. You will have to go for your post-operative sessions and discuss every single detail about your stoma. Moreover, the measurement of opening will help you in choosing and wear the right size of ostomy appliances. You should wear a larger flange, approximately three to four millimeters bigger than your opening's size. The accurate size of the stoma pouching system will impede irritation, bleeding, and blockage. Moreover, it will protect the skin around the hole of the abdomen.

Alteration in Established Stoma

In an established stoma, the primary cause of fluctuation in the shape and size is weight gain. Many ostomates do not perform any physical activity and sit idle all day, this makes them lazy and chubby. Due to the obtaining weight, the stoma expands and looks larger than before. Moreover, it can also contour the skin around the stoma. A roughly 10 pounds of weight gain can disturb the original size of your stoma. Moreover, constant weight loss or gain can alter the original appearance of the opening. Therefore, an ostomate who is realizing bulkiness in the body should go to the ET nurse for a re-evaluation of the exact size of the stoma. Moreover, it will also help you in choosing the new pouching system with an exact size and shape. 

Change of Stoma in Pregnant Women

The pregnant ladies also feel an alteration in the shape and size of the stoma. It is because of the weight gain. Thus, they also need a regular re-evaluation of the opening to know the accurate size and appropriate pouching system. After the second and third trimesters, a woman can see the visible changes in the appearance of the stoma. Therefore, you must be in regular contact with your ET nurse for a regular checkup and evaluation of the correct size.

The fluctuation of Stoma Due to Hernia

Many ostomates develop hernia around the stoma, especially in the case of colostomy. This makes the opening to become bigger. Until you do not treat the hernia, you realize the significant alteration in the size stoma. This also demands regular sessions with your ET nurse. It will help you to assess your hernia stage and condition, and re-evaluation of the size of the stoma and its pouching system.

Aging can Make Alteration in the Stoma

Aging is another significant factor that can cause alteration in the size and shape of the stoma. Due to the age, the body muscles lose strength, shape, and tone; therefore, it re-contour the stoma and the skin around it. This can prolapse and retract the opening. The fluctuations will be sheerly visible. It also requires regular sessions with the ET nurse. 

What Are Different Stoma Complications

The number of people with permanent or temporary stomas has hit the one million mark in the US. A stoma is a surgically created opening in the abdomen to allow fecal materials or urine to leave the body, bypassing the diseased section of the tract.

There is no sensory nerve in the stoma, meaning that you are not going to feel any pain in it. Yet complications can arise in it. A stoma will remain delicate as long as you have it, so you will need to follow necessary measures to ensure prevention against complications and infections that can arise in the stoma and the skin around it.

A healthy stoma is generally pink and moist. Immediately after surgery, the stoma will have swelling, which will subside in the next few weeks. Your nurse will teach you how to take care of your stoma and the skin around it. He or she will also tell you about the right pouching system that you may use.

In this article, we will discuss several stoma complications and the ways you can prevent those.

Parastomal hernia

This hernia occurs in the area around the stoma, usually in the peristomal skin. It happens due to the weakness of muscle tissues under the abdominal skin. The bowel or intestines push through the muscle tissues, forming a noticeable bulge in the peristomal skin area. It can surround the stoma from all sides, forming a circumferential hernia, or it might appear only in a particular area.

In many cases, the hernia is painful, and it might compromise the seal between the ostomy appliance’s skin barrier and the peristomal skin. In some cases, it may not cause any issue. Your doctor may recommend conservative therapy to treat the problem. An adjustment to the pouching system may also be beneficial.

You may want to use a hernia support belt to prevent parastomal hernia. Avoid using convex skin barriers if you have this hernia. If you irrigate your ostomy, you may want to discontinue it until you get rid of your hernia.

Trauma

Trauma in the stoma may occur due to an injury. Most typically, the cause of this trauma is a laceration. Lacerations can occur as a result of the use of clothes and appliances that interfere with the stoma. A too-small or misaligned opening in the flange can result in a laceration on the surface of the stoma.

Signs of trauma on the stoma include bleeding, stoma discoloration, and a visible cut. This complication resolves without any intervention, provided that you eliminate the root cause. For instance, you may need to be careful while creating an opening in the flange if the trauma is due to a wrongly configured skin barrier.

Stoma prolapse

The displacement of the stoma from its proper position can result in the stoma prolapse. It happens due to the intussusception of the proximal segment of the bowel, resulting in it sliding through the stoma’s orifice.

The most common reason for stoma prolapsing is the intra-abdominal pressure. A conservative approach to resolving this issue would be the healthcare provider’s priority. If that doesn’t work, the doctor may have to refer the case to the surgeon.