This topic is about a person experiencing issues with their loop ileostomy stoma, which has become swollen, painful, and is causing spasms. They suspect there might be a connection to a recent COVID-19 infection. Here’s a breakdown of the situation and some helpful advice:

- The individual has had a loop ileostomy for three years. Recently, the lower half of the stoma became swollen and painful, especially before output occurs, although the output itself remains normal.
- Despite the swelling, both lumens of the stoma are open, suggesting there is no blockage. Lying down does not help reduce the swelling.
- The swelling has made it difficult to remove and reapply the pouch, affecting the seal. The pain is intense but comes and goes.
- The condition has lasted more than 24 hours, leading the person to consult with an ostomy nurse and plan a visit to the surgeon.
- Normally, the stoma size fluctuates, but this level of swelling is unusual and persistent.
- The nurse mentioned that gastrointestinal illnesses, including COVID-19, can cause stoma inflammation. The person had COVID-19 two weeks before the swelling started.
- They are experiencing severe intestinal spasms, a persistent cough from COVID-19 that worsens the stoma pain, and nausea.
- The nurse suggested cutting a larger opening in the wafer and using a barrier ring, but the swelling and pain continued.
- A surgical review was scheduled, and by late May, the swelling and pain began to subside. Both the nurse and surgeon suspected the inflammation was related to a bacterial or viral infection, possibly linked to COVID-19. The stoma and pouching routine have since returned to normal.

Here are some pieces of advice and insights shared by others:

1. Seek professional assessment immediately if pain and swelling persist. Contact an ostomy nurse or surgeon.
2. Swelling after severe diarrhea or gastrointestinal upset is common and often resolves within 24 hours.
3. Consider gas build-up as a potential cause and ensure it is vented properly.
4. Temporarily enlarge the appliance opening or use a barrier ring to prevent constriction and reduce pain while the stoma is swollen.
5. Monitor both lumens of a loop ileostomy for obstruction, as swelling may relate to unexpelled output in the distal lumen.
6. Be aware that COVID-19 can trigger unusual gastrointestinal symptoms, including stoma inflammation, nausea, and cough-induced pain.
7. Stay vigilant: if there is no improvement within a day or two, or if the pain worsens, seek further medical evaluation.