What are stoma granulomas?
A stoma granuloma is usually a small, raised, red bump that appears where the stoma meets the skin, though it can also form on the stoma itself. Some are barely noticeable and are only picked up when bleeding prompts a review with your stoma care nurse. Others are more obvious; you may have just one, or several, and they can range from small to more extensive in size and coverage.
Because granulomas can bleed, they may loosen the adhesive area of your flange and lead to stoma leakage. They can also interfere with the template size of your appliance, which results in a poorer fit and general discomfort. It's worth getting any granuloma checked by your stoma care nurse, who can advise on the best way to manage it.
What causes granulomas around a stoma?
Granulomas often develop from friction, where a poorly fitting appliance rubs against the stoma, or from ongoing skin irritation caused by effluent contact. Infection can also trigger granulation, as can disruption to the skin's healing process following surgery.
How is a granuloma around the stoma treated?
The first step is checking your appliance fit. Your stoma care nurse will review your template size and confirm there's a 1–2mm gap around the stoma, so the edge of the hole isn't rubbing against it and the contents of your bag aren't reaching your skin.
Treatment often starts with a protective paste such as Orabase. The most effective option is usually silver nitrate, applied directly to the granuloma by your nurse. This creates a mild chemical burn that shrinks the granuloma and can eliminate it entirely — typically applied weekly during an appliance change over a four-week period, with progress reviewed each week. A seal may also be used afterwards to apply gentle pressure to the area, and switching to a mouldable flange can help reduce further friction.
If these approaches don't work, your hospital team might consider cryotherapy, which freezes the affected tissue, or cauterisation, which uses heat to remove it. For granulomas that are extensive, bleed heavily, or haven't responded to other treatments, your surgeon may recommend surgical removal.
Can granulomas come back after treatment?
Yes, granulomas can reoccur even after successful treatment. If a granuloma isn't causing bleeding or discomfort, it's often better to simply monitor it. Should it return, get in touch with your stoma care nurse for a further review.
FAQ: Stoma granulomas
What is a stoma granuloma?
A stoma granuloma is a small, benign growth that develops on or around the stoma, usually appearing as a raised red bump.
What does a stoma granuloma look like?
Most are small, raised, and red, often found at the junction where the stoma meets the skin, though some are barely visible until they bleed.
How is a granuloma treated?
Treatment usually starts with checking the appliance fit, followed by options such as protective paste, silver nitrate application, cryotherapy, or in some cases, surgery.
What effect does hypergranulation have on the stoma?
Hypergranulation can cause bleeding, discomfort, and a poorly fitting appliance, as the extra tissue interferes with the template size and seal around the stoma.