is it normal for a stoma to protrude

A stoma will normally protrude slightly above the skin level. The length of the protrusion will depend on whether you have a colostomy or ileostomy

(ileostomies tend to protrude further out) and the size of your bowel. A retraction of the stoma is when the stoma lays flat to the skin or below skin surface level.

Full Answer

How should a stoma protrude from the skin?

Retraction – a stoma will normally protrude slightly above the skin level. The length of the protrusion will depend on whether you have a colostomy or ileostomy (ileostomies tend to protrude further out) and the size of your bowel.

What does a normal stoma look like?

All stomas vary in size and shape. Some protrude outwards and others can be flat or flush to your tummy. No two stomas are ever the same. A colostomy may often appear slightly larger as the surgery has been performed on the large bowel (colon), whereas an ileostomy (small bowel) or a urostomy are smaller in size.

Is my stoma too long or prolapsed?

My stoma is too long! A stoma should protrude only a few centimetres from the body. However, sometimes a stoma will begin to protrude further than is ideal, referred to as a prolapse. A prolapsed stoma should continue to work as normal, and, so long as it maintains its normal colour, is not a cause for alarm or immediate surgery.

Why do stomas vary in size?

Another reason a stoma can vary in size is due to the type of surgery and stoma you have. For example, a loop stoma, which is often temporary, can be slightly larger and be more an oval shape compared to a permanent stoma.

What would cause a stoma to protrude?

A prolapsed stoma can occur as a result of straining the muscles surrounding the stoma during heavy lifting and other strenuous activity, or when the muscles surrounding the stoma are weak.

Should a stoma stick out?

It is therefore very common for the stoma to “pop out” when you are up and about during the day. However, whenever you reduce your abdominal pressure i.e. by lying down, the stoma will often slide back in and become normal size again. .

How much should a stoma protrude?

Colostomies should typically protrude 1.5 to 2.5 cm and stomas of the small bowel should evert 2.5 to 3.5 cm. Stomas that do not evert at least 1 cm above the skin surface 48 hours after surgery have a 35% chance of causing problems.

What does a protruding stoma look like?

The stoma can become dark red or purple, or sometimes a very pale pink, and may be cool to touch. You may also notice that your stoma does not function as well with a prolapse, potentially causing signs of an obstruction.

Can a prolapsed stoma fix itself?

Often, the prolapsed stoma fixes itself. But if it doesn't, here are some things you can do if you notice your stoma protruding: Lie down for 20 minutes. This allows for your abdominal muscles to relax and reduces pressure around your abdominal region.

When should I be worried about my stoma?

Signs of Stoma Problems The swelling does not decrease in the weeks following surgery or increases. Your stoma is having significant changes in size—more than half an inch—in the course of a day. The stoma is no longer beefy red or pink but pale in appearance. The stoma is no longer moist in appearance but seems dry.

What does a bulging stoma mean?

A parastomal hernia occurs when the intestines press outward near a stoma, the hole created for a colostomy or ileostomy appliance. This causes a bulge under the skin. It can also cause pain and bothersome leakage. Parastomal hernias are the most common complication of ostomy surgery.

Can you push your stoma back in?

Use the palm of your hand to apply gentle pressure to the stoma, very gently pushing it back into its usual position. 2. Another alternative is to apply a cold compress to the stoma with your pouch on. Then try to reduce the stoma again using the palm of your hand.

Does a stoma move in and out?

The actual movement of the stoma in normal everyday life, whenever you take your pouch off, it's very natural to see it shrinking back in again and just a normal peristaltic movement but what you should see is that the stoma naturally makes it way back out again.

How do you know if you have a stoma hernia?

Symptoms of a stoma hernia A bulge behind your stoma. Discomfort or pain around your stoma, this is often described as a “dragging sensation” Issues with keeping your stoma bag in place. Bloating.

Does a prolapsed stoma cause pain?

A prolapsed stoma should not usually cause you any pain or effect the way your stoma functions, although it may cause issues when it comes to fitting your stoma bag correctly due to the size and weight of the prolapsed stoma.

How is a stoma supposed to look?

A stoma is often described as resembling a rose bud. It may have a small spout and is pink and moist, much like the inside of the mouth. Although it looks raw, there are no nerve endings in the stoma so it has no feeling.

What should a normal stoma look like?

A healthy stoma is pinkish-red and moist. Your stoma should stick out slightly from your skin. It is normal to see a little mucus. Spots of blood or a small amount of bleeding from your stoma is normal.

What is a stoma supposed to look like?

What does a stoma look and feel like? A stoma is usually moist and pinkish-red, and will stick out slightly from your abdomen. The color is because it is a mucous membrane, just like the mucous membrane inside your mouth.

What should a fresh stoma look like?

Your stoma is the lining of your intestine. It will be pink or red, moist, and a little shiny. Stomas are most often round or oval. A stoma is very delicate.

What is a stoma prolapse?

An ostomy prolapse occurs when the bowel sticks out of the stoma opening in the skin further than it is expected. The stoma is protruding out abnormally. This stoma protrusion can be anywhere from 2 to 3 cm long to over 10 cm long.

How high is the risk of a stoma prolapse?

Stoma prolapse represents one of the most common late complications, occurring in 1–16% of stoma patients. The risk of a prolapse differs between different kinds of ostomies and ages. A US study was conducted between early 1998 to late 2000 with 204 participants who have had ileostomies or colostomies. It is found that the risk of developing a prolapsed stoma is 22% for adults and 38% for children. Furthermore, the risk is greater for people who have had a loop colostomy or loop ileostomy prolapse.

How do I deal with a prolapsed stoma?

In most cases, stoma prolapse management can be done by the patient themself. Often, the prolapsed stoma fixes itself. But if it doesn’t, here are some things you can do if you notice your stoma protruding:

When should I contact a medical professional for a prolapsed stoma?

Even when you are treating the prolapsed stoma yourself, it is important to keep your doctor and nurse in the loop so they know what is going on and can monitor your condition. Your doctor/nurse will be more familiar with your individual case, and can give you advice specific to your treatment.

What are the Most Common Stoma Complications?

The more common complications Ostomates might face are listed below. In this post we go into more detail on the following topics:

What is a retracted stoma?

Retracted Stoma – a stoma will normally protrude slightly above the skin level. The length of the protrusion will depend on whether you have a colostomy or ileostomy (ileostomies tend to protrude further out) and the size of your bowel. A retraction of the stoma is when the stoma lays flat to the skin or below skin surface level. This retraction can become problematic as it can affect the fit of your stoma bag and cause leaks, which can lead to sore and broken skin. This can be rectified by using a stoma bag with a convex wafer to push the stoma forward, an ostomy belt to help support the stoma and/or barrier rings or a barrier paste to help keep the output off the skin. In extreme cases, your surgeon may suggest re-siting your stoma for your comfort.

What is a stoma leak?

Stoma leakage usually results from a stoma bag that hasn’t been fitted correctly or from the bag unexpectedly filling quickly or the output becoming loose. Most ostomates will experience the occasional leak, which is nothing to be concerned about.

How to fit a stoma bag?

Most suppliers will include a stoma measuring guide and templates for you to accurately cut the shape. The hole should fit snugly around your stoma without any gaps. Make sure that the hole is not too small either so that it doesn’t dig into the stoma and cause any cuts or abrasions that could bleed.

How far out does a stoma protrude?

A stoma will normally protrude slightly above the skin level. The length of the protrusion will depend on whether you have a colostomy or ileostomy (ileostomies tend to protrude further out) and the size of your bowel.

Why does a loop colostomy prolapse?

Prolapses are more common in loop colostomies and there are several reasons why a prolapse may occur including a weak abdominal wall, rapid weight gain, pregnancy , surgical technique (such as a large incision in the abdominal wall, where the bowel was bought through to the surface) or a sudden pressure in the abdomen caused by coughing fit.

What are the problems with ostomates?

Stoma Skin Problems. Issues or problems with the skin around the stoma is probably the most common complication for ostomates. Not only is having sore skin extremely uncomfortable for the patient but it can also compromise the attachment of the bag to the skin causing leaks and leading to further skin damage.

What is a stoma?

Normal Appearance. Signs of Stoma Problems. Signs Skin Problems. When to See a Doctor. A stoma is an opening created during surgery on the intestines. When the intestine does not function well enough to move stool out through the anus, a procedure can reroute part of the intestine to the surface of the abdomen.

How to tell if stoma is dry?

Signs of Stoma Problems. Discuss any of these signs with your doctor: The swelling does not decrease in the weeks following surgery or has a very large increase in size unexpectedly. The stoma is no longer beefy red or pink, but pale in appearance. The stoma is no longer moist in appearance or seems dry.

Why is my stoma red?

The skin around the stoma appears irritated by the stoma appliance and may be red, chapped, flaky, scaled, raw, or burn-like in appearance. This can be caused by harsh cleansers, so be sure to clean gently and with a mild soap. Your skin hurts, has a burning sensation, or changes in color.

How to tell if a stoma is infected?

Contact your doctor if you see these signs int he skin around your stoma: 1 The skin around the stoma appears infected and/or it is red or angry in appearance. 2 There is pus or discharge present. 3 The skin isn’t healing well. 4 The skin around the stoma appears irritated by the stoma appliance and may be red, chapped, flaky, scaled, raw, or burn-like in appearance. This can be caused by harsh cleansers, so be sure to clean gently and with a mild soap. 5 Your skin hurts, has a burning sensation, or changes in color. 6 Your skin develops sores or breakdown around the stoma or where the appliance rests. 1 

How long does it take for a stoma to swell after surgery?

Some swelling of the stoma is normal in the days after surgery. If the swelling continues for weeks and doesn't improve, it may be a sign to contact your doctor.

What happens if you can't reach your surgeon?

If you cannot reach your surgeon, a stoma that is not getting an adequate blood supply is an appropriate reason to be seen in the emergency room.

What does it mean when your stoma is dark?

Major color changes in a stoma, with the stoma becoming pale or dark, are a sign that the tissue is not receiving the blood supply that it should . This type of change should be immediately reported to your surgeon, whether the surgery was recent or in the past. 1 .

What happens when a stoma is too narrow?

This may cause abdominal cramps, increased wind and obstructed or explosive output.

What to do if stoma is not passing?

The output itself can be made easier to pass by eating low-residue foods, drinking more fluids and taking stool softeners or laxatives . If these don’t resolve the problem, you may need surgery to refashion the stoma.

How long does it take for a stoma to stop bleeding?

However, if bleeding is persistent and doesn’t stop after 5–10 minutes, you should apply pressure to the area and contact your stoma nurse.

How to prevent granulomas from forming?

The best way to prevent granulomas from occurring is to make sure the pouch aperture is just the right size. It needs to fit closely enough to stop the contents reaching the skin, without being so tight it rubs against the stoma. The skin can also be protected using barrier accessories, including powders, sprays and rings.

How long does it take for bowel adhesions to form?

After the operation to create a stoma, most people (over 90%) will develop new adhesions around their bowel within days after surgery. These help hold the bowel in place and are generally harmless, with most people unlikely to ever be aware of their presence.3

Why do stoma spout?

Ideally, a stoma should spout a couple of centimetres from the surrounding skin, as this allows it to drop its contents right into the pouch. Sometimes a stoma will retract back into the skin, causing it to either lie flush (level) with the skin or sit within a dip below this level. This could be the result of issues with stoma formation, restricted blood flow or tension on the bowel, as well as weight gain or other changes in the surrounding skin.

Why do colostomies prolapse?

A prolapse occurs when the stomach muscles that hold the organs in place are not strong enough to resist the pressure pushing on them from within the body. Stomach muscles can get weaker due to abdominal surgery, a lack of exercise or other health problems; meanwhile obesity, heavy coughing or serious constipation can put extra pressure on the bowel. Watching out for any of these issues and taking extra precautions is the best way to minimise the risk of a prolapse.