Have you had an ostomy? Or has someone you know had one? Sometimes after this surgery, you may feel, or even see, that small opening in your stomach, the stoma, is protruding a little. This is what we medically call a prolapsed stoma. It's normal to feel a little nervous and scared when you see this. However, most of the time, it's not serious. Let's talk about this in detail, shall we?
What exactly is a prolapsed stoma?
Simply put, a prolapsed stoma is a minor complication that can occur after your ostomy surgery. As you know, an ostomy is a procedure where your stool does not pass through your anus normally, and a small opening (stoma) is made in your abdomen to allow your stool to drain into a bag. This stoma is made by removing part of your small intestine or large intestine.
So, in a `(Prolapsed Stoma)`, a small part of your intestine pushes out through the `(stoma)` that was created. Then the `(stoma)` appears a little longer than when it was originally created. This condition can be seen after a `(colostomy)` surgery or an `(ileostomy)` surgery.
Imagine, it's like when you're wearing a sock and a small part of it rolls out, which is what happens here.
Although this can be very scary, it is usually not a serious condition. Your doctor can often put the protruding part of your bowel back in place. It is very rare for this to require surgery again.
What are the symptoms of a prolapsed stoma?
The main symptom you will see is that part of your intestine is pushed out through the `(stoma)`, and the `(stoma)` appears to be longer. The size of the part of the intestine that comes out like this can vary from person to person. It can be as small as 2 centimeters (about an inch), or it can be as large as 10 centimeters (more than 4 inches).
Other symptoms include:
- There may be pain around the stoma.
- The skin around the stoma may become red and inflamed .
- The ostomy bag you are using may not fit properly against your skin. This means that stool is leaking between the bag and your skin.
It's hard not to panic when you see something like this. But remember, the most important thing is to seek medical advice.
Why does the stoma protrude like this? What are the reasons?
A prolapsed stoma is mainly caused by increased pressure inside your abdominal cavity. Think of it like a pressure inside your stomach, trying to push something out through the weakest spot. This can happen in the following situations:
- Constipation: If you are constipated frequently, the pressure inside your abdomen increases when you try to pass stool. This can affect your stoma.
- Loud sneezing, coughing, or straining: If you have a chronic medical condition (such as asthma or chronic bronchitis) that causes you to cough or sneeze, the pressure inside your abdomen can increase more than you think. Straining while lifting heavy objects can also cause this.
- Weight gain or obesity after surgery: If you suddenly gain a lot of weight, it can also increase the pressure in the abdominal cavity and cause the stoma to protrude.
- Weakened abdominal muscles: If your abdominal muscles are weak due to surgery or other reasons, that can also affect this. Just like when a wall is weak, it pushes the chest out from the inside.
- Pregnancy: This condition is more likely to occur during pregnancy, as pressure on the abdomen increases.
- Having a large tumor in the abdominal cavity: This is a bit rare, but if there is one, it can also increase the pressure.
Therefore, it is important to take care of your stoma and be aware of possible causes of this.
What are the possible complications of a prolapsed stoma?
As I mentioned before, most of the time, a prolapsed stoma is not serious. However, very rarely , it can lead to serious problems. That is why it is important to seek medical advice as soon as symptoms appear.
- Bowel obstruction: The protruding part of the intestine can cause undigested food to become stuck in the intestines, preventing it from moving down the intestine. This can cause bloating, vomiting, and stomach cramps.
- Incarceration: This is when the part of the intestine that has come out of the stomach gets stuck in the stoma, preventing it from going back in. This can be quite painful.
- Strangulation: This is the most dangerous complication. If the part of the bowel that has come out is too tight, the blood vessels that supply it are compressed, and the blood supply is cut off, that part of the bowel begins to die. This is called necrosis. If this happens, the stoma may change color (dark purple, black). This is an emergency.
Although complications like these are rare, it is important to be aware of them.
How is a prolapsed stoma treated?
If you have a ``Prolapsed Stoma'', your doctor will decide how to treat it based on your condition. As mentioned earlier, if there are no complications, you can resort to non-surgical treatments.
Non-surgical treatments:
- The doctor will put the intestine back in place: The doctor can very gently push the part of the intestine that came out and put it back into the stomach.
- Cold compress: Placing something like ice on the protruding part of the intestine (not directly, but wrapped in a piece of cloth) helps reduce swelling and help the intestine move back into the intestine.
- Sugaring: This may sound a bit strange, but sprinkling a little table sugar over the protruding intestine will help reduce swelling and help it move into the intestine. Sugar has an osmotic effect, which is what reduces swelling.
Sometimes your doctor may show you how to do these simple treatments at home. However, never try them on your own without medical advice.
Surgical treatments:
If the simple treatments mentioned above do not work, or if complications have occurred due to the prolapsed stoma, your doctor may recommend surgery.
- Reconstructing the stoma in place: The part of the bowel that came out is put back in, and the stoma is strengthened and reconstructed.
- Removing the protruding part of the intestine and replacing it with a new one: Sometimes the protruding part of the intestine may be damaged. If this happens, the part is cut out and removed, and a good part of the intestine is taken and a new ``stoma`` is created.
- Creating a new `(stoma)` in a different location on the abdomen: Sometimes, if the `(stoma)` cannot be created in the existing location, a new `(stoma)` may have to be created in another suitable location on the abdomen.
Don't be afraid of these surgeries. Your medical team will choose the treatment that is best for you.
Does a prolapsed stoma develop spontaneously?
Yes, sometimes it can happen. However, if you notice that you have a `(Prolapsed Stoma)`, it is best to inform a doctor. Because, you need to know exactly whether it is really a `(prolapse)` or some other problem.
However, sometimes the part of your bowel that came out can go back in through the stoma on its own. If you lie down and relax your stomach muscles, this may happen. However, it is not always possible to expect this to happen.
What is the outlook for a prolapsed stoma?
Usually, the problem is resolved after treatment and your bowel is reattached to your stomach. However, it is possible for this condition to recur. If this happens, you will need to undergo treatment again. Therefore, it is very important to follow your doctor's instructions and take care of your `(stoma)`.
When should I see a doctor?
If you notice any changes in the way your stoma works, see a doctor right away. For example:
- If you feel like your bowel is pushing out of your stoma.
- If the edges of the stoma appear to be protruding above the skin surface.
- If your colostomy bag is not staying in place properly, or if the bag fills up quickly (more than normal) with stool coming from the stoma.
If you see things like this, don't ignore it.
When should I go to the Emergency Treatment Unit (ETU) ?
As I mentioned earlier, very rarely, a prolapsed stoma can cause serious complications, such as intestinal obstruction. If you have any of these symptoms, go to the nearest hospital emergency room immediately:
- Abdominal pain , especially a sharp pain that comes and goes.
- If you are bleeding from your stoma .
- If the stoma changes color (e.g., dark purple, blue, or black), this means that the tissue in the stoma is starting to die.
- Loss of appetite .
- Nausea and vomiting .
- Fever.
If you have any of these symptoms, don't waste time and seek medical help immediately.
Finally, things to remember (Take-Home Message)
If you have a colostomy or ileostomy, you are probably already somewhat aware of the various problems that can affect your stoma. However, it is normal to feel shocked, scared, and worried when you see a prolapsed stoma, that is, a part of your intestine protruding.
But remember, a prolapsed stoma is usually not a serious medical condition. In most cases, it can be treated with simple treatments. The most important thing is to let your medical team know if you notice anything unusual in your stoma. They are here to help.
Never hesitate to ask your doctor or stoma nurse about your stoma, how to care for it, and any problems that may arise (like this prolapsed stoma). Your awareness is your greatest strength.
If you have any questions, don't be afraid to ask. We're all here to help you.
` Stoma, prolapse, ostomy, colostomy, ileostomy, bowel, surgery
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