Areas of Expertise
About Stoma Complications
A stoma is a connection of the intestine to the skin. It can be either small or large intestine and involves placing a piece of odor-proof plastic, or ostomy appliance over the opening to collect the stool. This can then be emptied at the individual’s convenience. The presence of a stoma can predispose one to a number of complications, from skin breakdown to hernias to electrolyte disturbances.
The most common form of stoma complication is skin irritation from an ill-fitting ostomy appliance. The hole for the device should not leave any exposed skin – as this can lead to excoriation, peeling, and subsequent poor adherence of subsequent bags. Various creams and pastes are available to help with this. Consultation with a stoma nurse is the best way to learn how to get your appliance to fit correctly. There are a number of different configurations of stoma devices that can be used to get the best fit for each body habitus.
An additional complication of stomas includes high stoma output. This results in potentially serious electrolyte disturbances and dehydration. It is a higher risk with stomas created using the small intestine. Any output greater than 1.5 liters per day requires attention. Various medications such as Immodium or Lomotil can be used to slow down the intestines and allow the body to absorb more fluid. Alternatively, increased amounts of fiber can help thicken up the output and prevent water losses. Signs of dehydration include decreased or dark urine output. This is an indication one needs to increase water and electrolyte intake, which is best done in the form of an oral rehydration solution such as Gatorade or pedialyte.
Since a stoma is a hole in the abdominal wall, this hole can large and lead to a para-stomal hernia, or bulging of other intestinal contents out under the skin next to the stoma. This can occur with any stoma and if asymptomatic, does not require additional treatment. A large stomal hernia may require surgery to fix this.
For more information on stomas, visit the American Society of Colon and Rectal Surgeons website at: