Swollen stoma: Causes, treatment and what to expect
It's common for your stoma to swell or change size and shape at different points in your recovery. In this guide, we look at what causes stoma swelling, how to manage a swollen stoma day to day, and when it's worth speaking to your stoma care nurse.
Why has my stoma swollen? Possible causes
Post-stoma surgery
Swelling is most pronounced in the days following your stoma surgery, when the stoma is often described as "oedematous." This usually settles within the first ten days of recovery, and your stoma care team will monitor both size and shape closely during this time.
Stoma constipation
A swollen stoma can sometimes point to a stoma constipation or a stoma blockage. If your bowel movements feel irregular, try increasing your fluid intake. Ileostomies rarely stop working altogether, so if this happens, contact your GP or stoma care nurse straightaway. With a colostomy, a mild laxative may help, but your nurse is best placed to advise on what's appropriate for you. Again, never take any medication (including laxatives) without consulting to a healthcare professional first.
Prolapse
A prolapsed stoma can develop quickly and, in some cases, extend several inches beyond the skin, which makes it hard to fit an appliance. It can shrink back down and reappear larger soon after, so your stoma care nurse will show you how to measure it yourself and adjust your appliance as it changes. A referral to your surgeon isn't usually urgent, but seek help immediately if the prolapse turns dark or dusky, stops working, or becomes painful as pain can be a sign of bowel strangulation, which needs emergency treatment.
Weight gain
An increase in stoma size often follows weight gain, especially in the months after surgery when your body may change quite a bit. It's worth remeasuring your stoma or asking your nurse to check the fit, so the aperture isn't too tight and the flange isn't sitting on new folds of skin.
Hernia
A parastomal hernia occurs when part of the bowel pushes through the abdominal muscle, and it's a fairly common experience among ostomates. This can create a bulge that makes the stoma look larger or flatter than before. Your stoma care nurse can advise on a support garment to help hold the hernia in place and keep your appliance secure. If the hernia becomes painful, changes your stoma's colour, or stops it working, contact your GP for a review.
How do you manage stoma swelling?
A cold compress can ease swelling: Wrap ice in a towel and hold it against the area for up to five minutes at a time, keeping your appliance in place as you do so. Keep an eye on your aperture size too, as it will need adjusting as the swelling changes; your nurse can show you techniques such as fluting, or recommend a seal to accommodate fluctuations while the appliance is worn. Choosing an ostomy appliance with enough room for swelling will also help protect the surrounding skin from soreness.
FAQ: Swollen stoma
What can I do if my stoma is swollen?
Start by checking your appliance still fits comfortably, and try a cold compress to help bring the swelling down. If the swelling is sudden, painful, or doesn't settle, speak to your stoma care nurse or GP.
How do you treat swollen stoma symptoms?
Treatment depends on the cause. A cold compress and a properly sized aperture can help with general swelling, while constipation may call for more fluids or a mild laxative, and a hernia or prolapse may need input from your stoma care nurse or surgeon.
What does an inflamed stoma look like?
A healthy stoma is usually pink or red and moist. If it looks dark, dusky, or discoloured, or if you notice pain, this needs urgent medical attention rather than home management.
Why is my stoma enlarged?
Common reasons include recent surgery, constipation, weight gain, a prolapse, or a parastomal hernia. Measuring your stoma regularly and checking your appliance fit can help you spot changes early.
