What is a prolapsed stoma?
A prolapsed stoma for an ostomate is when your stoma, which is the opening on the outside of your torso for waste to pass through, protrudes from the body telescopically, with the potential to become quite large. This can happen for a variety of reasons and can be of concern, but there is no need to panic since a prolapsed stoma itself is not life-threatening. We will discuss this and more as you read on.
In this blog post, we will discuss what causes prolapsed stomas, the dangers they pose, and how to fix them.
What Causes Prolapsed Stomas?
There are nine different things that can cause a prolapsed stoma:
- Straining during a bowel movement
When you strain during a bowel movement or because of constipation, it puts extra pressure on your stoma and can cause it to bulge out.
- Being overweight or obese
Extra weight puts pressure on your abdominal walls and can cause the body to push out on the stoma opening, causing a prolapse.
The extra weight of pregnancy that pushes outward from the body can also put pressure on the abdominal wall and cause a prolapse.
- Connection of the ostomy pouch
The way that the ostomy pouch is attached to the body could put undue pressure on the stoma. A too-tight fit or even too-loose fit, depending on the setup of the attachment, can cause a prolapsed stoma.
The wafer, or flange, should fit closely around the stoma. If there are any gaps, paste should be used. This will help prevent a prolapsed stoma.
- Chronic coughing and/or sneezing
If you have a chronic cough, it can put extra pressure on your stoma and cause it to prolapse. Having the flu, symptoms from a cold, or other respiratory illnesses can cause a person to sneeze and cough more frequently. The pressure from sneezing and coughing can push the stoma out past its regular place of rest.
Prolonged coughing and sneezing can cause a prolapsed stoma.
- Lifting heavy objects
Lifting heavy objects can also put extra pressure on your core muscles, which puts pressure on your stoma and may cause it to prolapse. Doctors recommend lifting no more than 10 pounds, give or take, depending on the person.
- Weak core muscles
A prolapsed stoma can occur if the core of the patient, the abdominal support of the body itself, is poorly developed. This can happen in infants and in those who have a weaker core muscle structure. The muscles may not be strong enough to hold the bowels in place, and this can cause a prolapsed stoma.
Developing a tumor in the region close to the stoma can put pressure on the stoma if the tumor is growing, causing the stoma to prolapse.
- An excessively large stoma opening on the body
If during surgery the surgeon created an opening for the stoma on the torso that was excessively large, this can cause the stoma to prolapse. Surgical steps to correct this may be determined by a doctor if it is necessary.
Cecily of Living Beyond the Bag gives a helpful guide to stoma prolapses from her own experience:
A Quick Guide to Prolapses
What does a stoma prolapse look like?
Things to watch out for if you stoma starts to look different or larger that may be the signs of a prolapsed stoma are:
- The stoma is protruding from the body more than it has in the past. It may look more like telescoping in some cases.
- The stoma color may change from its most usual color to a darker pink, red, or even purple. This can be a sign that the blood is not able to access the full stoma; something may be blocking it. Be sure to have your stoma checked by a healthcare professional to determine if this is the case or not.
- The stoma should feel warm, but if it starts feeling cool to the touch, it is likely prolapsed.
- The stoma is swollen and larger than before.
- Be aware that the stoma and its shape can change depending on your body’s position. For example, when lying down, the stoma’s length and size go back to a more normal appearance, but when you get up, you notice the signs that it is prolapsed.
Is a prolapsed stoma dangerous?
Typically, a prolapsed stoma is not dangerous. It can cause complications for the process of putting on and taking off your pouch, and it makes your torso area look different.
A prolapsed stoma is cause for concern if the blood supply has been cut off, even slightly, and then waste cannot pass through.
There is an increased risk of infection when the tissue around the stoma area is irritated.
Also, a prolapsed stoma may make it more difficult to have a bowel movement, which can further irritate the tissue around the stoma and the stoma itself.
If you have a prolapsed stoma and you have not been able to bring it back in with much success, it is important to see a doctor so they can treat the condition before it becomes more serious.
How to Fix a Prolapsed Stoma
The following offers advice on 7 options on how to fix a prolapsed stoma:
- Lie down in a comfortable position. Using the palm of your hand, apply flat, gentle pressure to the stoma to see if you can push it back into its usual position.
- You can also try using a cold compress while your pouch is in place while also using the palm of your hand to gently direct your prolapsed stoma back into its original position.
- To treat a swollen, prolapsed stoma, you can use granulated sugar to draw out the excess fluid from the swollen stoma and help reduce its size. Be mindful that when the sugar draws fluid out of the stoma, the fluid in the colostomy pouch will be syrupy, so do not be alarmed; that is the result.
- To help relieve the pressure on a prolapsed stoma, stool softeners may help reduce straining during bowel movements, which can help reduce the risk of further prolapse.
- Be aware that alcohol consumption can cause constipation and thus put a strain on your bowel movements. Vasopressin is a hormone that helps your body hold fluid by preventing it from exiting in the urine.
Alcohol has the ability to reduce your body’s ability to release vasopressin, which will make you urinate more. When you urinate more, the risk of dehydration is higher, and you are also more likely to become constipated as a result. Constipation and the straining required for a bowel movement under these circumstances can then lead to a prolapsed stoma.
If the methods above are not effective:
If you are overweight or obese, losing weight may help reduce pressure on your abdominal wall and help treat the prolapse. Losing weight also works towards preventing a prolapsed stoma.
In some cases, surgery may be necessary to treat a prolapsed stoma.
Prolapsed stomas can be annoying or even concerning if not treated properly, but there’s no need to worry; there are methods you can take to prevent and reduce the prolapse on your own.
If you have a prolapsed stoma that is not responding to the methods mentioned in this article, see a doctor so they can treat the condition before it becomes more serious.
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