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.

Ostomy - Colostomy and Ileostomy

Ostomy is a surgical round opening in the abdomen of a patient who suffers from an infection, injury, blockage, cancer, inflammatory bowel disease, or any other chronic disease in the rectum, bladder, colon, or ileum (small intestine and large intestine). The opening works as a new organ in the belly of the person and excretes the waste material of the body, urine, formed stool, semi-formed, stool, and liquid stool (depends on the type of disease and ostomy). For every disease in a specific part of the intestine, there is a different kind of ostomy, like ileostomy is for the treatment of the ileum or small intestine, a colostomy is for the treatment of the colon or large intestine, and urostomy refers to the bladder. 

What is Colostomy?

A colostomy is the treatment of any infection, injury, blockage, or cancer in the colon, a part of the large intestine. The stoma or opening appears as a result of the colon or large intestine operation, called a colostomy. In this surgery, surgeons remove the infected or injured part of the colon, bring the end of the large intestine to the opening (stoma or a hole made in the abdomen of the patient), to collect the solid or formed stool in a pouch, stoma or ostomy pouch. 

Sometimes, the colostomy is reversible. It means doctors halt the anus to discharge the feces temporarily. After the healing of the disease or infection, they bring the colon back to their natural location, and the patient can eject the stool through the organic passage, anus. However, in some acute diseases like inflammatory bowel disease or colon cancer, it is permanent. A patient cannot exit the formed form of stool through their anal path. They can only use the stoma for the excretion purpose. 

What is Ileostomy?

This is the surgery of an infection, injury, blockage, cancer, bowel disorder, or any other chronic illness in the ileum, a part of the small intestine. Surgeons remove the infected section of the small intestine and bring a healthy portion to the abdomen. In the belly wall, doctors fabricate a round pit, called a stoma. The opening in the abdomen aims to collect the liquid stool or semi-formed stool in a bag called a stoma or ostomy pouch. It requires an entire system for the hole in the body. In this incision, surgeons do not remove the colon. The incision happens to give some rest to the large intestine and time for healing. Therefore, an ileostomy is usually a temporary procedure. After the recovering of the infected intestines, doctors close the stoma and bring the ileum back to the organic track. 

The stoma of the ileostomy discharges the liquid form of stool. Therefore, the patients feel comfortable with the drainable pouches. These are the stoma bags you can drain, empty, clean, and wear them back. You do not need to change a drainable pouch again and again. The movement of the bowel becomes unpredictable after the ileostomy; thus, wearing this pouching system provides coziness and convenience. You can empty it when you feel the discharge and change the entire pouching system twice a week. 

WOC Nurse

Every ostomate needs the assistance of a special stoma nurse, WOC, or ET nurse. They are professionals and experienced in the ostomy fields. They know every single information about stoma, care, and surgery. After the operation, a person goes through multiple changes in life, emotional, physical, and mental. Thus, they need appropriate guidance and support. Apart from families of the ostomates, a nurse plays a vital role in the recovery of the patient. Moreover, a WOC or ET nurse will guide you about the care of the opening. He/she will be your therapist, caretaker, dietician, guidance, and support.

In the hospital, you will find a nurse for you; however, once you go away from the clinic, you can find a nurse for you through hospitals, WOC clinics, and ostomy foundations.