Prolapsed Stoma

What is a prolapsed stoma?

A prolapsed stoma is a complication of an ostomy. This surgery makes an opening in your belly (stoma), so your poop (stool) goes into a bag attached to your body and not your rectum and anus.

In a prolapsed stoma, a small section of your intestine pushes out through the stoma. That makes the stoma longer than when it was made. You may have a prolapsed stoma after a colostomy or ileostomy.

A prolapsed stoma isn’t serious. But it can be alarming and upsetting when it happens. Typically, your healthcare provider can move the intestine back where it belongs. Very rarely, you may need surgery to replace the intestine and fix the stoma.

What are the symptoms of a prolapsed stoma?

The most obvious symptom is that you see your intestine push out through the stoma and the stoma gets longer. The amount of intestine can vary between 2 centimeters (about 1 inch) to 10 cm (more than 4 inches). A prolapsed stoma may hurt and irritate your skin. It may affect how well your ostomy bag seals to your skin, too.

What causes a prolapsed stoma?

Pressure on your abdomen can cause it. For example, the condition can happen if you have:

• Constipation
• Conditions that make you sneeze hard or cough or strain a lot
• Having overweight or gaining weight after your surgery
• Weak belly muscles

What are the complications of a prolapsed stoma?

Very rarely, a prolapsed stoma can cause serious issues like:

• Bowel obstruction. A prolapsed stoma can keep undigested food from moving through your intestines.
• Incarceration. With this issue, your intestine sticking out from your belly gets stuck in the stoma.
• Strangulation. A prolapsed stoma can cut off blood supply to the rest of your intestines so they begin to die (necrosis).

How is prolapsed stoma treated?

Treatment for a prolapsed stoma depends on your situation. If the prolapsed stoma doesn’t cause complications, your healthcare provider may recommend nonsurgical treatments.

For example, they could gently press on the exposed intestine so it moves back into your belly. Or they could place a cold compress on it or pour table sugar on it. Those steps can reduce swelling and may help the intestine move back in place. Your provider may show you how to do these treatments on your own.

Your provider may recommend surgery if a prolapsed stoma causes complications. For example, they may:

• Re-do the stoma site to replace the exposed intestine.
• Remove the exposed intestine and attach a new section of your intestine.
• Make a new stoma in another section of your belly.

Can a prolapsed stoma fix itself?

It can, but it’s best if you let your healthcare provider know you have a prolapsed stoma. That said, your exposed intestine may slide back through the stoma on its own. It may help if you lie down and relax your belly muscles. That can help the exposed intestine move back into your belly.

Outlook for a prolapsed stoma

In general, treatment to place your intestine back into your belly takes care of the issue. But the condition can come back. If that happens, you’ll need more treatment.

When should I see my healthcare provider?

Contact your provider if you see changes in your stoma function. For example, if your intestine pushes on your stoma, it may cause your stoma’s edge to lift from the surface of your skin. When this happens, you can’t keep your colostomy bag in place, or the stoma fills your colostomy bag.

When should I go to the ER?

Very rarely, a prolapsed stoma can cause serious complications like blocking your intestine (obstructed bowel). Go to the emergency room if you have symptoms like:

• Abdominal pain, especially sharp pains that come and go
• Bleeding from your stoma
• Changes in color, like your stoma turning purple or black; this is a sign that your stoma tissue is dying
• Loss of appetite
• Nausea and vomiting