A stoma is a surgically created opening on the abdomen that allows waste, such as urine or stool, to exit the body when the natural pathway is not functional. Stoma prolapse occurs when a part of the intestine pushes outward through this opening, becoming longer or more prominent than its usual appearance. This article explores whether a prolapsed stoma can resolve on its own.
Understanding Stoma Prolapse
A prolapsed stoma appears longer, larger, or more swollen than its normal size, protruding further from the body. It can extend anywhere from 2 to over 10 centimeters. While a healthy stoma is moist and pinkish-red, a prolapsed stoma might appear darker, such as red, purple, or even black, if its blood supply is compromised. This protrusion can be constant or intermittent, sometimes receding when lying down.
Factors contributing to stoma prolapse include increased abdominal pressure from activities like coughing, sneezing, straining, or heavy lifting. Weak abdominal muscles or a large surgical opening can also play a role. Prolapse is more commonly observed in loop ostomies compared to end ostomies, and weight gain or pregnancy may also increase the risk.
Addressing the “Self-Correction” Question
A prolapsed stoma does not fix itself spontaneously and almost always requires medical evaluation. While minor prolapses might intermittently recede when a person lies down, this is not a permanent resolution. Underlying structural changes, such as weakened abdominal muscles or how the intestine was secured during surgery, prevent it from returning to its normal position without intervention.
The intestine extends through the stoma opening due to internal pressure and the lack of sufficient support to hold it in place. The stoma is a surgically created opening, and its stability depends on surrounding tissues. Unlike other body parts that might heal or retract, it lacks muscular control to pull the prolapsed segment back.
If a stoma has prolapsed once, it indicates a weakness, making it susceptible to future prolapses. This persistent vulnerability highlights why professional medical advice is important rather than waiting for independent resolution. While the appearance can be alarming, most prolapses are not immediately serious unless specific concerning symptoms arise.
Immediate Actions and When to Seek Care
If a stoma prolapse occurs, individuals can take some immediate, gentle steps while preparing to contact their healthcare provider. Lying down can sometimes help the stoma to recede or reduce in size due to decreased abdominal pressure. Applying gentle, sustained pressure around the stoma, or using a cool compress, may also assist in its reduction. It is also important to ensure the stoma appliance (bag) is cut to the correct, larger size to accommodate the prolapse and prevent irritation or damage to the expanded stoma.
Close monitoring of the stoma’s appearance and function is important. Individuals should contact their healthcare provider or stoma nurse for advice and support as soon as a prolapse is noticed, even if it appears to reduce on its own. Urgent or emergency medical attention is necessary if concerning signs develop. These signs include the stoma changing color to dark red, purple, or black, which can indicate a compromised blood supply.
Other warning signs that require immediate medical care include severe abdominal pain, persistent bleeding from the stoma, or if the stoma stops functioning and waste cannot pass. Nausea and vomiting, along with an inability to pass stool, also signal a potential obstruction and necessitate urgent evaluation.
Medical Intervention and Long-Term Management
Healthcare professionals manage stoma prolapse through various interventions, from manual reduction to surgical procedures. Manual reduction involves gently pushing the protruding intestine back into the abdominal cavity. This technique is often effective for mild prolapses where the stoma remains healthy in color. Applying sugar to the stoma can help reduce swelling, making manual reduction easier.
For persistent or severe prolapses, surgical intervention may be required. Common approaches include stoma revision, where the existing stoma is reconstructed to prevent further protrusion. Other surgical methods might involve re-siting the stoma to a different location or reinforcing the abdominal wall for better support. The choice of intervention depends on the prolapse’s severity, its impact on daily life, and the individual’s overall health.
Long-term management involves regular follow-ups with a stoma care nurse to ensure proper appliance fit, skin integrity, and early detection of recurrence. Since a previous prolapse indicates a predisposition, individuals may be advised on techniques to minimize abdominal pressure. Ongoing monitoring and appropriate care contribute to maintaining comfort and stoma function.