Signs of a Problem With Your Stoma

A stoma is an opening created during surgery on the intestines. When the intestine does not function well enough to move stool out through the anus, a procedure can reroute part of the intestine to the surface of the abdomen. Waste can be eliminated into a pouch attached outside the body, called an ostomy appliance.

A man in pajamas with hand over his lower stomach
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The stoma is delicate, especially in the days and weeks immediately after surgery. The stoma can be injured, or tissue can die if the stoma is not receiving an adequate blood supply and being well cared for.

Types of Stoma

There are three main types of stoma:

  • Ileostomy: The ileostomy drains waste from the small intestine. This type of stoma should be expected to produce more watery, less formed stool as the stool has less time in the digestive tract to have excess water removed.
  • Colostomy: This type of stoma drains waste from the large intestine, and should drain a less liquid more stool-like type of waste.
  • Urostomy: Unlike the colostomy and ileostomy, this type of stoma drains urine rather than stool. 

The Normal Stoma After Surgery

A stoma should be a beefy red or pink color. The tissue that makes a stoma is the lining of the intestine and should be moist and shiny. It is very similar in appearance to the inside of your mouth along your cheek.

A normal stoma in the days after surgery may be swollen and may also produce mucus. While the stoma itself should be moist, the skin around the stoma should be normal in appearance.

The skin closest to the stoma may be irritated by the surgical procedure, but it should otherwise be normal in color, texture, and temperature. It should not look angry or infected.

The skin may be tender initially during the healing process and may feel irritated by a normal cleaning. The skin immediately surrounding the stoma and the stoma can be irritated by the cleaning process. A small amount of blood from the stoma itself is not unusual while it is healing.

It is normal to try several different ostomy appliances to get the best fit for you; some people find that appliance adhesive is irritating to the skin and have to try a different brand or type of appliance. 

Signs of Stoma Problems

Discuss any of these signs with your healthcare provider:

  • The swelling does not decrease in the weeks following surgery or has a very large increase in size unexpectedly.
  • The stoma is no longer beefy red or pink, but pale in appearance.
  • The stoma is no longer moist in appearance or seems dry.
  • Your stoma is very dark and appears dark red, purple, or even black in color.
  • Your stool is always watery or diarrhea, but soft or firm stool was expected in your discharge plan.
  • The stoma appears to be discharging pus.
  • Your appliance won’t fit properly, has to be changed more frequently than expected, or is irritating your skin.
  • The stoma seems as though it is being “strangled” by the appliance.
  • You feel pain from the stoma.
  • Your stoma is having significant changes in size—more than half an inch—in the course of a day.
  • Your stoma appears to be pulling itself back into your abdomen or expanding outside of your abdomen.

Signs of Skin Problems Around a Stoma

Contact your healthcare provider if you see these signs int he skin around your stoma:

  • The skin around the stoma appears infected and/or it is red or angry in appearance.
  • There is pus or discharge present.
  • The skin isn’t healing well.
  • The skin around the stoma appears irritated by the stoma appliance and may be red, chapped, flaky, scaled, raw, or burn-like in appearance. This can be caused by harsh cleansers, so be sure to clean gently and with a mild soap.
  • Your skin hurts, has a burning sensation, or changes in color.
  • Your skin develops sores or breakdown around the stoma or where the appliance rests.

When to See a Healthcare Provider/Go to the ER

Major color changes in a stoma, with the stoma becoming pale or dark, are a sign that the tissue is not receiving the blood supply that it should. This type of change should be immediately reported to your surgeon, whether the surgery was recent or in the past.

If you cannot reach your surgeon, a stoma that is not getting an adequate blood supply is an appropriate reason to be seen in the emergency room. 

Signs of infection in the skin surrounding the stoma or the stoma site itself, or a fever above 99.5, should be reported to your surgeon in the weeks following surgery.

Frequently Asked Questions

  • What are the signs of a healthy stoma?

    A healthy stoma should be a beefy red or pink color. After surgery, the stoma may be moist, but the skin surrounding it should appear normal.

  • What if the stoma is swollen?

    Some swelling of the stoma is normal in the days after surgery. If the swelling continues for weeks and doesn't improve, it may be a sign to contact your doctor.

  • What are the signs of stoma infection?

    Some signs of a stoma infection are if the skin surrounding it appears red or angry, pus or discharge is present, sores develop around the stoma, or if it's painful. If you develop a fever above 99.5 after surgery, you should contact your doctor.

  • Why is blood coming out from my stoma?

    After surgery, it's normal for a small amount of blood to come out of the stoma. If the stoma begins to leak more than a few drops of blood, though, contact your healthcare provider or surgeon.

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  1. American Cancer Society. Caring for a colostomy. Updated June 12, 2017.

  2. MedlinePlus. Ileostomy—caring for your stoma. Updated April 16, 2018.