Understanding And Managing Prolapsed Stoma In Ostomy Patients

A prolapsed stoma is a complication that can occur in individuals living with an ostomy, representing a significant concern for patients’ physical health and quality of life. A stoma is an artificial opening made surgically to divert the flow of feces or urine in patients with particular bowel or urinary conditions.

Understanding Prolapsed Stoma

A prolapsed stoma refers to a condition where the stoma extends further out from the abdominal wall than usual. Typically, a stoma should protrude about 1/2 to 1 inch from the abdomen. However, in a prolapsed stoma, this length increases, leading the stoma to appear swollen and elongated. The prolapse can occur gradually or suddenly, often related to increased abdominal pressure, obesity, or weak abdominal muscles.

Potential Issues

A prolapsed stoma often triggers discomfort, embarrassment, and difficulty in managing the ostomy, which significantly affects the patient's daily life. Here are some issues associated with a prolapsed stoma:

- Impaired Stoma Function: A prolapsed stoma may hinder the normal flow of waste, leading to obstructions or irregularities in the elimination process.
Skin Irritation and Infection: The exposed stoma is vulnerable to friction, pressure, and contact with waste, potentially leading to irritated or infected peristomal skin.
- Difficulty in Appliance Fit: The altered stoma shape and size necessitate adjustments in ostomy appliances, often making it challenging to achieve a snug and secure fit.
- Reduced Quality of Life: Patients with a prolapsed stoma often experience emotional distress, anxiety, and reduced self-esteem due to the condition's visual and functional impact.

Preventive Measures

Adopting lifestyle practices that minimize abdominal pressure can prevent stoma prolapse. These include maintaining a healthy weight, avoiding heavy lifting, and engaging in core-strengthening exercises under professional guidance. Additionally, patients should attend regular follow-up appointments to monitor their stoma's health and function.

Solutions and Management

A prolapsed stoma requires medical attention to determine the suitable management approach. Depending on the severity, doctors may suggest the following options:

- Stoma Care Practices: Adopt meticulous stoma care routines to protect the prolapsed stoma from trauma and infection. This involves using well-fitting appliances, gentle cleansing procedures, and barrier products to shield the sensitive peristomal skin.
- Stoma Belt or Support Garment: A stoma belt or supportive garment can offer external support to the prolapsed stoma, alleviating strain and assisting in maintaining the stoma's position.
- Manual Reduction: In some cases, healthcare professionals might teach patients how to gently push the prolapsed stoma back into place. However, this technique should only be performed after receiving explicit instructions and approval from a qualified healthcare provider.
- Surgical Intervention: Persistent or severe stoma prolapse may necessitate surgical correction. The surgery aims to reposition and secure the stoma, potentially involving a revision or relocation of the stoma.

Based on discussions from the MeetAnOstoMate Discussion Forum, here are some tips for managing a prolapsed stoma:

1. Seek Medical Attention: A stoma prolapse can be a serious condition, and it's important to seek medical attention if it occurs.
2. Consult with an Ostomy Nurse: Consulting with an ostomy nurse can help in understanding why the prolapse occurred and how to prevent it from happening again.
3. Use Pressure: Some individuals have found relief by putting pressure on the stoma with their hand to help it retract.
4. Consider a Hernia Belt: Wearing a hernia belt can provide extra support and help prevent a stoma prolapse.
5. Be Mindful of Activities: Be cautious of activities that engage core muscles, as they can potentially cause issues with the stoma.
6. Seek Advice from a Surgeon: Seeking advice from a surgeon is crucial to explore potential solutions, such as putting a mesh over the stoma.
7. Share Experiences: It's beneficial to share experiences and seek support from others who have gone through similar situations.

These tips are based on the experiences and advice shared on the MeetAnOstoMate Discussion Forum. Always consult with healthcare professionals for personalized advice.

Check out these links for more information:

• Help! Stoma Prolapse Scare - Need Advice! (August 06, 2020)
• Concerns about Stomal Prolapse - Need Advice (December 15, 2010)
• Managing My Ostomy: Tips and Techniques for Daily Living (November 19, 2018)
• Prolapsed Stoma - Seeking Advice on Coping & Solutions for Intestinal Protrusion (July 30, 2020)
• Managing Peristomal Open Wound: Need Barrier Advice (September 29, 2021)
• Managing High Output Stomas: Seeking Advice and Tips (July 22, 2019)
• Tips for Healing and Preventing Irritation Around Your Stoma (April 08, 2016)
• 10 Tips for Newbies: Advice from a Newbie (May 20, 2011)
• Need help with managing my colostomy - work, pancaking, pain, and blockages (May 18, 2014)
• Seeking advice for managing frequent leaks and blowouts with ileostomy (June 06, 2020)