Although after an ostomy operation most people lead normal lives, some patients to experiences some problems with their stoma.

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BALLOONING

This is when excess gas collects inside the bag causing it to inflate. This can happen if the filter which allows gas to pass through becomes blocked. To prevent this from happening the patient should:

• -Not cover the filter.

• -Make sure the filter is covered while showering/bathing/swimming so it does not get wet.

• -Check that there is space between the filter and contents.

• -Try a different appliance that has a different filter.

• -Avoid high fibre foods that are more likely to produce gas.

                                                              

 

GRANULOMAS

These are a lumpy lesions due to inflammation in dermis. They can be due to granulation tissue from poor wound healing and infection, bowel metaplasia, and Crohn’s disease. It can sometimes cause bleeding and discomfort, as well as preventing bag adhesion leading to leakage.

Silver nitrate is the main treatment option for this condition, and needs to be applied approximately 2-3 times a week by a healthcare professional. If friction is an issue then a ‘stoma paste’ can be applied onto the stoma, as well as a lubricating gel in the pouch.

 

BAD ODOUR

This can occur due to leakage, or if the filter is not working correctly. The filter in the stoma bag contains a deodoriser that if working properly should stop all potential odours. There are drops and granules available to put inside a new stoma bag to reduce smell. Something as simple as the patient changing their bag could help stop the problem.

There are certain dietary alterations that can stop with odour such as drinking tomato juice or buttermilk, easting natural yoghurt and parsley, and taking peppermint capsules.

 

PANCAKING

This is when the faeces collects around the stoma, and can be pushed through the edge of the seal instead of into the bag. This can happen if there isn’t enough air in the bag, so the output doesn’t fall downwards.

Lubricating the inside of the bags can help with this, and can be done so with baby oil or a similar product. Care should be taken as to not get the oil on the adhesive or it will lose its stickiness.

 

SKIN IRRITATION

Maintaining healthy skin around the stoma allows for the bag adhesive to be more effective. If the skin is red, sore or broken then the adhesive will not stick properly and it may allow leakages which will exacerbate the problem. Sore skin can be caused by a number of reasons, a few being:

• -A change in stoma size so that it is no longer sitting comfortably in the bag flange.

• -Pancaking as discussed above.

• -Weight gain or loss as this can change the shape of your stomach and how the pouch lies on the skin.

• -Any scar or swelling  may also cause the bag to sit uncomfortably on the skin and irritate.

To help avoid and alleviate this problem patients should be advised to only use warm water to clean around the stoma, as soaps and perfumed products may cause irritation. They should take care when removing the pouch and adhesive, and make sure the skin is completely dry before applying  new one.

 

PARASTOMAL HERNIA

This is on of the most frequent complications following the creation of a stoma, occurring in up to 50% of patients. If is a incisional hernia that allowed the abdominal contents to protrude through the muscle near the stoma. It is a weakness in the wall of the abdomen where the stoma is attached to the muscle wall. It causes a bulge or lump. Contributing factors can be being overweight, lifting heavy objects and using steroid drugs. Support belts can usually be used around the abdomen to manage a hernia. In extreme cases when it causes strangulation or obstruction surgery may be required.