Common stoma problems

Pancaking

Pancaking is a term used to describe the condition where a wet, sticky stool sits at the top of the pouch and does not drop down into the pouch. This can cause sore skin and the pouch to lift at the flange.

Action:

  • cover the filter with the cover/sticker provided with the appliance and add one or two pieces of scrunched tissue paper into the pouch prior to application, in addition to covering filters

and/or

  • add a small amount of baby oil carefully inserted directly into the pouch.

Refer to stoma care specialist service if problem persists.

Hernias

A significant swelling behind the stoma may indicate a hernia. This can also cause an enlargement of the stoma.

Action:

  • ensure that the pouch still fits the patient correctly. The pouch may need to be resized (cut to fit the stoma).

Refer to stoma care specialist service if problem persists.

If the stoma stops working and the patient is in extreme pain, contact the patient's GP immediately.

Prolapse

Occasionally the stoma protrudes forward and may fill the bag. Ensure that the stoma remains pink and healthy and if not then refer to the patient's GP.

Action:

  • Ensure that the stoma remains pink and healthy and if not then refer to the patient's GP.
  • Resize the pouch to fit the stoma and refer to stoma care specialist service as soon as possible.

Retraction

Occasionally the stoma may retract back into the abdomen so that the output excoriates the skin.

Action:

  • In these cases re-size by enlarging the flange hole by 2mm and then apply a circle of paste immediately around the stoma on the skin.

Refer to stoma care specialist service as soon as possible.

Leaks and dips

If the patient is complaining of leaks an assessment of the reason needs to be made:

Action:

  • remove the pouch;
  • observe the abdominal area with the patient sitting, standing and lying down, making a note of any dips, crevices or skin folds, which may cause the leak
  • If the skin is excoriated, or wet refer to section on skin care for guidance.

 

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