A stoma can be life-changing, offering improved health and quality of life for many individuals. However, it can come with challenges. Understanding common stoma problems can make a significant difference in helping you to manage your stoma.
Below, we highlight 10 of the most common stoma issues, their causes and how to spot, prevent and manage them. We’ll also provide links to other helpful stoma resources so that you can read further about common problems with stomas.
Do you have a urostomy? We have a dedicated guide to urostomy problems which may be more relevant to you.
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Skin irritation is one of the most common issues with stomas. This irritation can manifest as redness, itching, or even pain and bleeding. Irritated peristomal skin can quickly escalate to a skin infection if not treated.
Irritated skin increases the likelihood of your stoma appliance not fitting properly, leading to leaks and more skin irritation – it’s a vicious cycle. This is why it’s important to prevent this by using the right stoma products.
Learn more: Peristomal skin protection
Stoma leaks can be distressing and, as we have already discussed, lead to stoma skin problems. While stoma leakage is a common stoma problem, it shouldn’t happen regularly and disrupt your everyday life.
Frequent stoma bag leaks indicate that you should reassess your stoma bag fit or care routine. Stomas change in size and shape over time, especially soon after surgery, so it’s important to be proactive to prevent stoma leakage as much as possible.
Read more: Stoma leakage
A stoma blockage can occur when undigested food or adhesions (e.g. scar tissue) restrict the flow of waste through the stoma.
Symptoms may include cramping/tummy ache, swelling, less output than usual, or even no output at all for several hours. You may also experience nausea and vomiting. This can occur with both an ileostomy and colostomy but it’s easier to spot with an ileostomy because they are more active.
Some stoma blockages can be treated at home. Short walks, gently heating or massaging your abdominal area and eating/drinking liquids can help if you suspect you have a blockage. However, it’s important that you contact your stoma nurse or GP for advice if you suspect you have a bowel obstruction (especially if you have an ileostomy, as these are often more severe).
Read more: Stoma blockages
Pancaking occurs when stool gets stuck at the top of the stoma bag instead of falling to the bottom. This can cause the stoma bag to collapse against the stoma, potentially leading to leaks or blockages. It’s often associated with thicker output and can make emptying the bag difficult.
Our full guide to pancaking can be found here: Stoma pancaking
Ballooning happens when gas accumulates inside the stoma bag, causing it to inflate like a balloon. This can lead to discomfort, odour release when emptying the bag, or even detachment of the appliance.
Read our full guide to ballooning
Concerns about stoma odour or excess gas can cause anxiety in social situations for ostomates. While most stoma bags are designed to control odour, improper sealing or certain foods can exacerbate the issue.
Read our full guide to stoma odour
A parastomal hernia occurs when part of the bowel pushes through the abdominal muscles around the stoma. This condition can cause discomfort, bulging, or difficulties with appliance fitting. Although alarming, parastomal hernias are one of the most common stoma problems and rarely cause major complications.
Find out more about parastomal hernias
Sometimes, a stoma can sink below the skin level (retracted) or extend further out than usual (prolapsed). Both conditions can complicate appliance fitting and stoma care, although they are usually nothing to worry about. Loop stomas are more likely to prolapse than end stomas.
Read our full article about stoma prolapse
It is normal to experience some rectal discharge, even if you have a stoma. This will only happen if you have parts of your digestive system below the stoma still in place, such as if you had a Hartmann’s procedure or a loop stoma. The discharge could be made up of:
You may feel the urge to empty your bowels, or it may leak out without warning. The discharge is usually harmless and easily managed, but can cause problems if it is particularly persistent.
Read more in our full article on rectal discharge
Adapting to a stoma can be psychologically and emotionally challenging. Issues like body image concerns, anxiety, or depression are common, especially early in the adjustment process.
Read more: Quality of life in stoma patients
Managing a stoma can feel overwhelming at times, but with the right knowledge and resources, many stoma issues can be effectively managed or prevented. Whether you’re dealing with stoma leaks, skin irritation or emotional challenges, remember help is always available. You are not alone and there is a great community of ostomates who understand what you are going through.
Explore more free stoma advice and support or connect with others via StoCare’s Instagram.
If you are a medical professional and are interested in finding out how StoCare products can help your patients or requesting a repeat sample order, please email info@rhodespharma.co.uk.
Although all our articles are written alongside qualified medical professionals, this information is for guidance only and does not replace advice given by your healthcare advisors.