Patients who have undergone Ostomy experience many complications time to time. Most of these issues are not very severe and can be treated and resolved by simple changes in routine, switching to new Ostomy products, and making changes in diet. In this article, some of the most common stoma issues have been discussed. In case if you observe any stoma issue or change you must consult with your doctor immediately. An Ostomy nurse or health care expert can help you.
The most reported and common issues among Ostomy patients are mentioned below. In this article, each issue is discussed thoroughly.
- Skin discomfort and issues
- Stoma leaking and the treatment
- Bleeding and how to control it
- Retraction or prolapsing of stoma
- Parastomal Hernia
- Bowel obstruction or bowel blockages
Below we have discussed the problems and the methods to prevent these conditions and most crucially what should you do to cope with them.
Stoma skin irritation or problems
The discomforts or issues near the stomal skin or peristomal skin are the most occurring and reported problem by ostomy patients. Not only itching or discomfort is the problem it can also affect the adhering property of the pouching system, it can lead to the stoma leaking and more skin issues.
There are several reasons for skin discomfort or irritation:
- Feces contact with the skin
In patients with colostomy, there is a proem termed pancaking. It means accumulation of the feces on the top of the pouch, it is the reason for lifting of the pouch and the bowel contents come in contact with the skin, which leads to itching, soring, or irritating skin. As you know that the output as a result of ileostomy is more acidic because of the incomplete breakdown of enzymes in the colon. That’s why these enzymes if come in contact with the skin it can cause a breakdown of the skin. So y need to make very sure that the waste does not come in contact with the skin.
- Improper fitting of the pouching system
It is very crucial to ensure the proper fitting of the pouching system into and around the stoma.majority of the vendors of ostomy systems provide a stoma measuring guide and cards which can help you to measure it properly and cut it the skin barrier accordingly. You must ensure that the hole fits in properly around the stoma avoiding any possible gaps. You should observe that the hole must not be too small that it does not fit in the stoma or it may cause any injury to the stoma leading to the bleeding. You must measure your stoma regularly. You must observe every minor change in the size, color, and shape of the stoma.
- Skin Allergies
Sometimes the ostomates may get allergic to any Ostomy products such as skin barriers. This can cause rash and lads to itchy and weepy skin. You can consult with your Ostomy nurse in this regard.
If the bag or the Ostomy pouch does not adhere to the skin properly then it may cause stoma leakage. In some cases overfilling of the bag and more output can also lift off the pouch and cause leakage. In this regard, you need to make some changes to your diet.
How to avoid stoma leakage?
If the leakage is constant and you are facing difficulty coping with these issues you must ensure that your pouch is attached properly. Make sure that there is no gap and it adheres properly around the stoma. You can consult with your ostomy nurse. She can help you to select the best pouching system and she can also determine the reason for the leakage.
There are a lot of vessels around the stoma. If you rub near the stoma roughly or you hurt it by mistake during cleaning the stoma, it may rupture any of the blood vessels and the stoma may begin to bleed. If the pouch is attached too much tightly then bleeding can also occur.
What to do to prevent stomal bleeding?
If there is any internal bleeding you must inform your health care expert, it may be due to intestinal bleeding. If there is blood for more than 24 hours then you must contact your doctor without wasting time.
Sometimes a stoma may elongate a little above the skin. This elongation or protrusion depends on the type of your colostomy or ileostomy and the size of the bowel. In the case of ileostomies, there is more protrusion. It is very normal.
If the stoma remains flat to the skin and there is no protrusion then this condition is termed a retracted stoma. The retracted stoma can be a calamity as it leads to problems with the adhesion of the pouching system, which may increase the risk of soreness and breaking of the skin.
The condition in which the stoma protrudes out more than normal length is called a prolapsed stoma. If left untreated it can cause infection or cuts. It is more common in the case of colostomies. The reasons for a prolapsed stoma are:
- Weakness of abdominal wall
- Weight gain
- Surgical methods
How to take care of a prolapsed stoma?
You should observe closely the color and size of your prolapsed stoma because it can affect the supply of blood to the stoma. It can also obstruct feces. You must take advice from your healthcare expert and follow his advice.
Parastomal hernia is a condition when the intestinal loops accumulate behind the week muscles of the stoma. The presence of the hernia can be indicated by any lump or bulge behind the stoma. A person suffering from this condition can’t predict bowel movements and it may lead to diarrhea and constipation.
How to manage Parastomal Hernias?
You can use Ostomy belts or specially designed underwear to manage the parastomal hernias. The majority of the individuals undergo this condition after the surgery. You can avoid parastomal hernias by not lifting a lot of weight, holding the muscles while coughing and sneezing, wearing support clothing while exercising, and avoiding weight.
After the surgery, some individuals face partial or complete bowel obstruction. It may happen due to certain foods which can’t be digested properly by the digestive system. Severe pain abdomen, vomiting, or hard abdomens are some common symptoms of bowel obstruction.
How to get rid of bowel obstruction?
You should stop consuming solid foods; increase the consumption of water, taking hot liquids such as tea, warm shower. You should draw your knees near the chest and move side to side. If there is continuous vomiting then contact the doctor.