Living with a stoma

Leakage is a big concern for many people with a stoma. Read more information about leakage and find out how to prevent leakage.

Please note: Leakages can occur for a number of reasons. It is really important to determine a cause for your leaks, your Stoma Care Nurse will be happy to discuss this with you in further detail. Please do seek help and advice.

Following surgery you may find that your abdominal shape changes, especially if you gain or lose weight. This will effect the size of the stoma, therefore it is very important that the size of your stoma is checked regularly. An ill fitting bag will result in sore skin. It is therefore important to regularly check your template size and suitability of your stoma bag.

If you do not feel comfortable doing this, then you should contact your Stoma Care Nurse, as they will be able to help you with the measurements of your stoma.

A change in output from your stoma can cause issues with leakage. If the change in output continues for a number of days it is important for you to seek medical advice.

Ballooning occurs when your stoma bag blows up with wind. This is usually due to the filter becoming wet or blocked from stoma output. This can cause the bag to come away from the body.

If you are experiencing ballooning you could try implementing the following tips, which may help:

If you are using a filter cover, try removing it. The next thing is to consider your fluid and dietary intake:

• Spicy foods, some vegetables (onions, cabbage, peas, and beans) and fizzy drinks have been known to increase wind, so try to avoid these
• Avoid drinking with your meal as this can cause you to swallow excess air.
• Eating regular meals will reduce the build-up of wind.
• Do not chew chewing gum and avoid smoking, as both these activities increase the amount of air we ingest.

Please note: If you continue to have ballooning issues with your stoma bag, you should contact your Stoma Care Nurse for further advice and support.

Pancaking occurs when stoma output sticks to the top of your bag instead of dropping to the bottom.

• Add a drop of baby oil inside your bag to reduce sticking.
• Ensure your bag has enough air to prevent suction against the stoma.

Caring for your skin is an essential part of looking after your stoma. Unfortunately there can be times when the skin around your stoma can become sore, red or even broken. Below we can explore some reasons that this can occur.

Good skin care is vital to prevent sore skin. Sore skin is a common problem and is often seen, but easily treated.

There are a number of reasons why this may be happening. This isn’t a complete list, so please contact your Stoma Care Nurse for further guidance if your symptoms persist:

• Ill-fitting stoma bag
• Trauma to stoma or skin
• Product sensitivity
• Folliculitis
• Change in output

If you start to develop sore, irritated or even broken skin do not delay in contacting your stoma care nurse for appropriate advice on treatment and the need for alternative products. In the meantime:

• Ensure that your template is a good fit. Be mindful that the stoma in the initial few weeks following surgery will reduce in size. Equally if you have lost or gained weight this too can effect the size and shape of your stoma, consequently your templete size will need adjusting.
• Remove the adhesive on the stoma bag and check the back to see if there are any possible signs of urine or faeces, as this may have caused the skin irritation
• Check if there is any noticable damage or irritation around your stoma
• Check to see how well your stoma bag fits around your stoma. If your skin is exposed to the output of the stoma this can result in sore skin developing.
• Check to see if the adhesive has eroded, if so your stoma bag may have needed changing sooner. If this is the case, it may be beneficial to change your stoma bag more regularly.

The bowel has a very good blood supply, which is why the stoma is pink/red in colour. Whilst cleaning your stoma, a small amount of bleeding on the cloth is to be expected.

First, you should examine your stoma and determine where blood is coming from. Then with a clean, dry pad gently press the spot of blood. This usually stops the bleeding. If minor bleeding continues for more than a few minutes, please contact your Stoma Care Nurse for advice and support.

If there is an excessive amount of blood in your bag, please contact your Stoma Care Nurse.

If you see blood inside your stoma bag and/or in your stool you should contact your Stoma Care Nurse or GP. If you take anticoagulants such as; Warfarin or Aspirin this may increase your risk of bleeding.

Please note: If the bleeding is heavy, persistent or comes from the inside of the stoma you should seek urgent advice from your Stoma Care Nurse or GP.

A hernia develops when there is a weakness in the muscle wall. A parastomal hernia can occur around the stoma and is where part of your bowel pushes through the abdominal muscle to create a swelling under the skin of the stoma, which can cause discomfort or pain.

A hernia can develop at any time during and after your stoma surgery. Parastomal hernias can also develop over time, if the muscle stretches or becomes weaker.

A parastomal hernia is more common depending on the following risk factors:

• Age
• Weight
• Strenuous or heavy lifting
• Smoking
• Multiple abdominal and/or emergency surgery

It is important that you partake in some form of regular exercise, this could be simply a gentle daily walk.

Gentle exercise is important to try and prevent the development of a parastomal hernia. It is necessary to try and strengthen your core muscles, your Stoma Care Nurse is able to advise you on specific exercises.

Try to support your abdomen/stoma area by holding firmly when coughing sneezing, this will offer additional support to the muscles around this area.

It is recommended that you wear a light support garment as prevention. However, if you are taking part in strenuous activity, it is necessary to be measured for a more supportive garment. Your Stoma Care Nurse can arrange this for you.

In some people, the parastomal hernia will not cause any discomfort, but others may experience a dragging sensation, discomfort or pain. This will often depend on the size of the hernia and can be eased by wearing a measured support garment.

Living with a parastomal hernia can be difficult, but there are numerous abdominal support garments that are helpful in concealing and supporting the hernia.

It is possible to have surgery to repair the hernia depending on the symptoms and effect on quality of life, but this will be assessed on an individual basis by your Surgeon. Unfortunately, there may still be a risk of another hernia developing following the repair.

Please note: If you continue to have issues with your stoma hernia, you should contact your Stoma Care Nurse for further advice and support.

Sometimes the bowel can extend in length, similar to a telescope effect, and this is called a prolapsed stoma. Despite the prolapse, your colostomy should continue to be a healthy pink/red colour.and it should function in the usual manner. If things alter in any way and becomes darker it is important that you seek urgent medical advice.

If the stoma prolapses, it will invariably get bigger in size, so therefore it is important to check your template frequently as it may be necessary to use a larger stoma bag to accommodate the stoma. It would be helpful for you to check this with your Stoma Care Nurse

A stoma can prolapse if the muscles supporting it are weak or it may happen as a result of straining the abdominal muscles i.e. through lifting.

Any activity that causes an increase in intra-abdominal pressure – such as coughing or sneezing can cause a stoma to prolapse, therefore if you are suffering with a nasty cough or cold, try to gently support your abdomen when your cough or sneeze by simply holding the area firmly.

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.