A stoma represents a surgically created opening on the abdomen, designed to reroute bodily waste, such as stool or urine, when the natural pathways are compromised. Understanding the visual characteristics of a stoma is important for individuals managing one, as its appearance can indicate its health and proper function. This article aims to provide a clear description of a stoma’s typical look and what visual cues might signal a healthy or unhealthy state.
General Appearance of a Healthy Stoma
A healthy stoma typically presents as a vibrant, beefy red or pink, resembling the moist mucous membrane found inside the mouth or gums. This color indicates a robust blood supply, which is necessary for the stoma’s health. The surface of a healthy stoma also appears moist and somewhat shiny, reflecting the continuous production of mucus by the intestinal lining.
The texture of the stoma tissue is soft and smooth, composed of bowel tissue rather than skin. While initially swollen after surgery, a healthy stoma gradually reduces in size over several weeks. Stomas are usually round or oval, though their exact form can vary.
A stoma often protrudes slightly from the abdomen, but it can also lie flush with the skin, depending on the individual and surgical technique. Its size varies and may undergo minor changes as initial swelling subsides. An important characteristic is the absence of sensory nerve endings, meaning touching or cleaning it does not cause pain.
Different Types and Their Visual Characteristics
While the fundamental appearance of healthy stoma tissue remains consistent across types, variations exist. These differences include their typical location and how they manage waste.
A colostomy, which is created from the large intestine, is commonly located on the left side of the abdomen. The output from a colostomy is usually more formed or semi-solid, as much of the water has been reabsorbed in the remaining large intestine. Colostomies can often sit flatter against the skin compared to other stoma types.
An ileostomy is formed from the small intestine and is generally situated on the lower right side of the abdomen. Its output is typically liquid or mushy, as less water is absorbed in the small bowel. Ileostomies often have a more prominent protrusion, or “spout,” to help direct the corrosive, enzyme-rich liquid output directly into a collection pouch, protecting the surrounding skin from irritation.
A urostomy, which diverts urine from the kidneys, is also commonly found on the right side of the abdomen. This type of stoma typically features a visible spout, formed from a small segment of the intestine, onto which the ureters are attached. This ensures urine drains efficiently into the collection pouch, preventing skin contact and irritation. Despite these differences in location and protrusion, the healthy tissue of all stoma types maintains the characteristic bright red or pink, moist appearance.
What to Expect Around the Stoma
The area immediately surrounding the stoma, known as the peristomal skin, is important for assessment. Healthy peristomal skin should appear similar to the skin on any other part of the body: intact, smooth, and free from redness, rashes, or irritation. Some temporary redness may be noted when an adhesive barrier is removed, which is considered normal, but persistent redness can signal an issue.
A collection pouch, also referred to as an appliance, is worn over the stoma to collect waste. These appliances are designed to be discreet and secure, adhering to the skin around the stoma. The pouch is visible during changes and its presence is a key visual aspect of stoma management.
The output, whether stool or urine, will be visible within the collection pouch. Its consistency and color will vary based on the type of stoma and an individual’s diet or hydration. For instance, ileostomy output is typically liquid, while colostomy output can range from semi-solid to solid.
Recognizing a Healthy vs. Unhealthy Stoma
Observing the visual cues of your stoma is important for identifying its health status. A healthy stoma consistently appears bright red or pink, remains moist, and does not cause pain when touched. The skin surrounding it should also be intact, without signs of irritation.
However, certain visual changes may indicate a potentially unhealthy stoma and require attention. Color changes are significant; if the stoma becomes pale, dusky, purple, or black, this could signal issues with blood flow. Swelling that persists or increases beyond the initial post-operative period is concerning. While slight spotting during cleaning is normal due to the stoma’s vascularity, excessive or continuous bleeding should be investigated.
Issues with the peristomal skin, such as persistent redness, a rash, open sores, or signs of infection like pus-like discharge, indicate irritation or damage. Changes in the stoma’s shape, such as it pulling back into the abdomen (retraction) or protruding excessively (prolapse), also require assessment. If any of these concerning visual changes are observed, it is important to contact a healthcare professional, such as a stoma nurse or doctor, for guidance.