Complications - Colostomy

There are a number of possible problems you may experience after having a colostomy.

Rectal discharge

If you've had a colostomy but your anus is intact, you may have some mucus discharge from your bottom. Mucus is produced by the lining of the bowel to help with pooing.

The lining of the bowel continues producing mucus, even though it no longer serves any purpose. It can either leak out of your bottom or build up into a ball, which can become uncomfortable.

Some people have rectal discharge every few weeks, while others have several episodes a day.

Contact your GP if there's blood or pus in the discharge – it may be a sign of infection or tissue damage.

Managing the discharge

You may find it helps if you sit on the toilet every day and push down as if pooing. This should remove any mucus and stop it building into a ball.

But some people find this difficult because surgery can reduce the sensation in the anus. Contact your GP if this is the case, as you may need further treatment.

Glycerine suppositories that you insert into your bottom can often help. When the capsules dissolve, they make the mucus more watery, so it's easier to pass.

The mucus can sometimes irritate the skin around your bottom. Using a barrier skin cream should help. You may need to try a few before you find one that works for you. Ask a pharmacist for advice.

Some people find that eating certain foods increases mucus production. While there's no scientific evidence to support this, you may want to try keeping a food diary for a few weeks to see whether certain foods could be linked to an increase in mucus production.

Parastomal hernia

A parastomal hernia is where the intestines push through the muscles around the stoma, resulting in a noticeable bulge under the skin.

To reduce your risk of getting a hernia:

• wear a support garment (belt or underwear)
• avoid heavy lifting and straining
• maintain a healthy weight – being overweight can place additional strain on your abdominal muscles

A parastomal hernia may make it more difficult to hold the colostomy in place and change it.

Most hernias can be managed with the help and support of your stoma nurse. In some cases, surgery may be needed to repair the hernia. But the hernia can come back, even after surgery.

Stoma blockage

Some people develop a blockage in their stoma as the result of a build-up of food.

Signs of a blockage include:

• not passing many poos, or passing watery poos
• bloating and swelling in your tummy
• tummy cramps
• a swollen stoma
• nausea or vomiting, or both

If you think your stoma is blocked, you should contact your GP or stoma nurse immediately, or call 111 as there's a risk your colon could burst.

Other complications

Other problems you can have after a colostomy include:

• skin problems – where the skin around the stoma becomes irritated and sore; your stoma care team will explain how to manage this
• stomal fistula – where a small channel or hole develops in the skin alongside the stoma; depending on the position of the fistula, appropriate bags and good skin management may be all that's needed to treat this problem
• stoma retraction – where the stoma sinks below the level of the skin after the initial swelling goes down, which can lead to leakages because the colostomy bag does not form a good seal; different types of pouches and appliances can help, although further surgery may sometimes be needed
• stoma prolapse – where the stoma comes out too far above the level of the skin; using a different type of colostomy bag can sometimes help if the prolapse is small, although further surgery may be required
• stomal stricture – where the stoma becomes scarred and narrowed; further surgery may be needed to correct it if there's a risk of blockage
• leakage – where digestive waste leaks from the colon on to the surrounding skin or within the abdomen; trying different bags and appliances may help an external leak, but further surgery may be needed if the leak is internal
• stomal ischaemia – where the blood supply to the stoma is reduced after surgery; further surgery may be needed