Colostomy Complications: Plus Prevention and Treatment (2024)

About 150,000 new colostomies or ileostomies are performed each year in the United States. Colostomy procedures are done as a planned procedure or an emergency measure to reroute solid waste. Colorectal cancers and injuries are common reasons for these procedures.

Colostomy procedures date back hundreds of years. But despite physician experience and advancements in clinical technology, complications are still pretty common. It’s estimated that 21–70% of people with colostomies experience some level of complication.

This article explores some of the most common complications you can expect with a colostomy, how they may be prevented, and what a doctor may do to address potential concerns.

Skin irritation is one of the more common complications of a colostomy. The tissue used to create a colostomy or stoma is usually made of the mucous membrane that lines the section of intestine being diverted.

This tissue can be delicate and is likely to bleed with normal cleaning. It can also be irritated by stool, cleaning products, adhesives, and other products or processes required for stoma care.

If you have sensitive skin or a history of skin irritation, talk with your healthcare team before your colostomy is placed. You may be able to use certain techniques or products designed for more sensitive skin to prevent initial irritation that might lead to bigger issues.

It’s also important to use only water and gentle cloths to clean your stoma. Harsh cleaners and wiping aren’t necessary and may cause unnecessary irritation.

This potential complication develops when your stoma is sucked back in (retracts) or sticks out from (prolapse) its initial location.

These complications are usually the result of too much tension or pressure in one direction or another. Risk factors for these problems include:

Weight loss and moderate weight management can help prevent these complications. Special attachments between your stoma and collection bag, or even a surgical revision, might be needed to correct the problem.

A stoma blockage can be the result of stool that’s too hard to pass through your stoma. This may be caused by dehydration. It can also be the result of prolapsed sections of your intestines, which obstructs the flow of stool through your stoma.

A healthcare professional will give you specific instructions on stoma care and maintenance, as well as the types and amounts of food and liquids you’ll consume with a colostomy. It may take some trial and error to find the right balance for your body, but over time, you’ll learn what foods and amounts can lead to changes in your stoma output that might cause a blockage.

In some cases, the tissue around your stoma can become inactive or cut off from its blood supply. These complications can lead to a loss of function at the stoma site or even tissue death (necrosis).

Necrosis is a serious complication that can increase your risk of infection or even the need to have your colostomy surgically revised or reversed.

Stomas are only one part of the colostomy package. A sticky device and collection bag is usually placed over the opening to collect stool and other output.

Learning the proper application technique and how to use your particular device is important. Improper cleaning, application, or maintenance can lead to problems with leaking, which in turn can increase your risk of skin irritation, infection, or both.

If you’re experiencing leakage with your collection system, talk with or visit your healthcare team. They can work with you to determine the cause and figure out prevention strategies.

Hernias usually develop from areas weakened by a surgical incision. The rate of hernia development in colostomies is estimated at around 40%, and this complication can develop as long as 10 years after the initial surgery.

Risk factors for herniation are similar to those of stoma prolapse, so proper care of your stoma site and health weight management can help prevent this kind of complication.

Dehydration or fluid and electrolyte balances are possible with any kind of intestinal stoma. Depending on the location of your stoma and how much fluid is or isn’t being removed from your stool before it’s secreted, the amount and type of output you have can vary.

Colostomies that are placed higher up in your intestine typically have a higher water content. This is because your large intestine hasn’t had a chance to reabsorb as much liquid back into your body before the stool exits from your stoma.

Your healthcare team will advise you on how to monitor your output based on your specific type of stoma and what changes you can make to your eating and drinking habits to help balance your body’s fluid levels and prevent dehydration.

When a colostomy is created, the main goal is to divert stool to a new opening instead of your rectum. But it can take some time for any stool or waste that’s already in your colon to clear completely from your system after surgery. Some people even notice periodic rectal leakage long after their colostomy is placed.

Pus or discharge can be a symptom of infection, but small amounts of stool leaking from your rectum isn’t usually a cause for concern.

A healthcare professional may suggest sitting on the toilet daily or every so often to evacuate any buildup that may collect in your rectum.

Colostomies are openings created in your large intestine to divert stool from naturally passing through your rectum. These surgeries have been done for a long time, but complications are still possible and fairly common.

Before getting a stoma, talk with a healthcare professional about maintenance and what you can do to prevent any possible complications. Also discuss what to look for after you have a stoma so that you can alert your doctor right away if you notice concerning changes.