Should a stoma bleed?
First things first, is a stoma even supposed to bleed? Well, a small amount of bleeding and stoma irritation can be normal from time to time.
Because the stoma is made from delicate bowel lining, even gentle contact during cleaning or changing your ostomy bag may cause a few spots of blood. Minor bleeding usually settles quickly on its own and is not considered dangerous.
However, ongoing, heavy or unexplained bleeding should always be assessed by a healthcare professional.
What causes a stoma to bleed?
There are several common reasons why stoma bleeding may happen.
Cleaning or changing the stoma bag
One of the most common causes of bleeding from stoma tissue is gentle friction during cleaning or appliance changes.
The surface of the stoma is sensitive and highly vascular, meaning it contains many blood vessels. Even light rubbing with gauze or tissue may cause slight bleeding.
In most cases, this type of bleeding is mild and temporary.
Friction from the stoma appliance
Pressure or rubbing from the stoma bag or skin barrier can also irritate the stoma.
If the appliance does not fit correctly, constant friction may lead to repeated bleeding and stoma discomfort. Stoma leakage can also increase irritation and skin damage around the stoma.
If bleeding happens often, it may help to have a look at the fit of your pouching system with a stoma nurse.
Bleeding skin around stoma
Bleeding skin around stoma sites is often linked to skin irritation or leakage.
When stool or urine comes into contact with the skin repeatedly, the skin may become sore, inflamed or damaged. This is known as peristomal skin irritation.
Common signs include:
- redness
- soreness
- broken skin
- itching
- bleeding around the edge of the stoma
Protecting the skin and making sure the appliance fits properly helps reduce irritation and prevent further bleeding around a stoma. If you're unsure about where to start with the topic of stoma skin care, here's a respective guide for you.
Granulomas around the stoma
Sometimes small harmless growths called granulomas can develop near the stoma.
Stoma granulomas are overgrowths of healing tissue that may bleed easily when touched or cleaned. Although they are usually benign, they can sometimes cause discomfort or repeated bleeding from stoma areas.
If granulomas are suspected, they should be assessed by a healthcare professional or stoma nurse.
Ulcers or tissue damage
In rarer cases, ulcers may develop on or around the stoma. These are areas of damaged tissue that can cause pain, bleeding and irritation.
Ulcers should always be medically evaluated, especially if they do not heal or are associated with ongoing symptoms.
What comes out of a stoma?
What comes out of a stoma depends on the type of stoma a person has.
A colostomy usually produces more formed stool, while an ileostomy produces softer or looser output. A urostomy drains urine instead of stool.
Small amounts of mucus are also common because the bowel lining naturally continues producing mucus after surgery.
If you notice significant blood in the stoma bag, large blood clots or persistent bleeding, medical advice should be sought promptly.
How to treat a bleeding stoma
Mild bleeding often stops on its own and does not usually require emergency treatment.
If your stoma is bleeding lightly, it may help to:
- apply gentle pressure with a clean cloth or gauze
- avoid rubbing the stoma too firmly
- check the fit of your stoma appliance
- protect the surrounding skin from leakage
- use gentle, non-irritating products
If the bleeding keeps returning, your healthcare team may recommend adjustments to your pouching system or further assessment.
How to stop a stoma from bleeding
How to stop a stoma from bleeding depends on the cause.
Minor bleeding caused by cleaning or friction often improves by being gentler during stoma care and ensuring the appliance fits correctly.
If bleeding around edge of stoma areas is linked to skin irritation, treating the damaged skin and preventing leakage is extremely important.
However, heavy bleeding, bleeding inside the stoma bag or bleeding associated with pain should never be ignored.
Why is my stoma always leaking?
Frequent leakage may happen if the stoma appliance does not fit securely against the skin.
Changes in body shape, skin irritation, uneven skin surfaces or stoma size can all affect how well the pouch seals. Leakage may then lead to further irritation, soreness and bleeding around a stoma.
If your stoma keeps leaking, a stoma nurse can assess the appliance fit and recommend products better suited to your needs.
Are you about to choose your first ostomy appliance? Here's a guide for you.
When should you seek medical advice regarding a bleeding stoma?
Although mild stoma bleeding is often harmless, some symptoms should always be assessed professionally.
Seek medical advice if:
- bleeding does not stop
- the amount of blood seems heavy
- bleeding happens repeatedly
- blood appears inside the stoma bag
- you develop severe pain
- ulcers or granulomas are suspected
- the skin around the stoma becomes severely damaged
These symptoms do not always indicate a serious problem, but they should be checked to ensure appropriate treatment and care.
Bottom line: Stoma bleeding
Experiencing occasional bleeding and stoma irritation can feel worrying, especially in the beginning. Over time, however, many people become more familiar with what is normal for their body and when something may need attention.
With the right support, good stoma care and regular monitoring of skin and output changes, most causes of mild stoma bleeding can be managed effectively.
Living with a stoma takes adjustment: but it does not stop people from living active, independent and fulfilling lives.
FAQ: Stoma bleeding
What causes bleeding in a colostomy bag?
Small amounts of blood in a colostomy bag can happen if the stoma becomes irritated during cleaning or from friction caused by the appliance. Skin irritation, granulomas or ulcers may also lead to bleeding. Heavy or repeated bleeding should always be assessed medically.
Why is my stoma leaking all the time?
Frequent leakage is often caused by an ill-fitting stoma appliance, uneven skin surfaces or changes in stoma size. Leakage can irritate the surrounding skin and may lead to soreness or bleeding around a stoma.
What problems can happen after stoma surgery?
Possible complications after stoma surgery include skin irritation, leakage, stoma bleeding, blockages, hernias and infections. Many issues are manageable with proper stoma care and medical support.
What comes out of a stoma?
Depending on the type of stoma, stool, urine or mucus may come out of the stoma. A colostomy usually produces more formed stool, while an ileostomy produces softer output. Small amounts of mucus are also completely normal.