Why stoma bleeding can happen
A stoma is created from the lining of the bowel. This tissue has a rich blood supply and is naturally delicate. Because of this, it may sometimes bleed if it is rubbed or irritated. There are several reasons this might happen, let's have a look.
Contact during cleaning
When you clean your stoma or change your pouch, the surface may bleed slightly. This is common and usually stops quickly.
Friction from the pouching system
The opening of the pouch or the adhesive barrier can sometimes rub against the stoma. Even gentle friction may cause a small amount of bleeding.
Irritation of the surrounding skin
The skin around the stoma (also known as peristomal skin) can become sore if output leaks onto it or if the pouch does not fit properly. When the skin becomes irritated, bleeding may occur.
Granulomas around the stoma
Sometimes small growths called granulomas form around the stoma. These are raised areas of healing tissue. Granulomas are usually harmless but may bleed easily if they are rubbed by the pouch or during cleaning.
Ulcers affecting the stoma or surrounding skin
In some cases, ulcers may develop on or around the stoma. An ulcer is an area where the tissue becomes damaged or inflamed. This can lead to bleeding or discomfort and should be assessed by a healthcare professional. In most situations, bleeding is minor and settles quickly.
What to do if your stoma bleeds
If you notice a small amount of bleeding from your stoma, try not to worry. Minor bleeding often stops on its own.
Applying gentle pressure with a clean cloth or wipe for a short time is usually enough to stop the bleeding.
It may also help to:
- clean the stoma gently rather than rubbing it
- check that the pouch opening fits comfortably around your stoma
- make sure the surrounding skin is protected from leaks
- speak with your stoma care nurse if irritation or bleeding happens often
Small adjustments to your pouching system can often make everyday care more comfortable.
When to seek medical advice for stoma bleeding
Although minor stoma bleeding is common, some situations should always be checked by a healthcare professional.
Contact your stoma care nurse or doctor if:
- the bleeding does not stop after applying gentle pressure
- the amount of blood seems heavier than usual
- you notice blood coming from inside the stoma or in the pouch output
- conditions such as ulcers or persistent granulomas may be present
These situations do not always mean something serious, but they should be assessed so you can receive the right support and treatment.
Living confidently with a stoma
Life with a stoma brings change, and sometimes unexpected moments too. Seeing blood can feel unsettling, especially if it happens suddenly.
But in many cases, stoma bleeding simply reflects how delicate the tissue is.
Understanding what is normal (and when to seek help) can make these moments easier to manage. And if something doesn’t feel right, your stoma care team is there to help you find the right solution so you can feel comfortable and confident in everyday life.
FAQ: Stoma bleeding
What should I do if my stoma is bleeding?
Minor bleeding from the stoma surface (especially during pouch changes or cleaning) is quite common and usually nothing to worry about. The stoma is made of bowel mucosa, which is rich in blood vessels and very sensitive to touch, meaning even gentle contact can occasionally cause a small amount of bleeding. Applying light pressure with a clean, damp cloth or gauze pad is usually enough to stop it. However, if the bleeding is heavier, does not stop within a few minutes, or occurs repeatedly without an obvious cause, it is important to contact a doctor or stoma care nurse to rule out an underlying issue.
What causes bleeding from a stoma?
The most common cause of stoma bleeding is mechanical irritation — for example, from cleaning too vigorously, a poorly fitting baseplate that rubs against the stoma, or friction from tight clothing. Since the stoma tissue is similar in sensitivity to the lining of the mouth, it can bleed easily even with minor contact. Less commonly, bleeding may be caused by granulation tissue, which is a small overgrowth of tissue that can form around the stoma, or by varices — enlarged veins around the stoma. In rarer cases, bleeding may point to an underlying condition affecting the bowel. Any persistent or unexplained bleeding should always be assessed by a healthcare professional.
What should I do if my stoma bag keeps leaking?
A repeatedly leaking pouch is one of the most frustrating challenges for ostomates, but it is almost always solvable. The most common culprit is a poorly fitting baseplate — if the opening is cut too large, output can leak onto the surrounding skin and compromise the seal. Uneven skin around the stoma, caused by scars, skin folds or weight changes, can also affect adhesion. Accessories such as stoma paste, seals or rings can help fill any gaps and improve the fit. It is also worth checking whether the pouch is being changed at the right time — waiting too long can cause leaks as the adhesive weakens. A stoma care nurse can assess the fit and recommend the most suitable products for your individual stoma shape and skin type.
Is blood in the stool with a stoma a cause for concern?
Blood visible in the pouch output — rather than on the stoma surface itself — should always be taken seriously and assessed by a doctor. While small traces of blood from minor surface irritation can occasionally mix with output, a noticeable amount of blood in the stool may indicate bleeding further along the bowel. Possible causes include inflammation, polyps, or in some cases more serious conditions affecting the gastrointestinal tract. It is important not to dismiss this as routine, particularly if the bleeding is bright red and persistent, or if it is dark and tarry in colour, which can signal bleeding higher up in the digestive system. When in doubt, always seek medical advice promptly.