Blocked behind stoma

[Connie01]

Hi all.
I ate a coconut macaroon on Thursday and caused a blockage behind my ileostomy. It began to clear Friday after a night of hell.

It is now Monday night and my stoma is twice the size it was and I have a large swelling behind it. The pain is horrendous each time it expels any output.

I starved last night and the pain subsided. I've eaten a bit today, low residue and I am back to the pain.

What should I do? Who should I see? Is this urgent?

Thanks,

Connie x

 

[nogutsnoglory]

Please goto the ER, pain and doubling size is not normal. If you can, take a print out of this for the nurses www.ostomy.org/uploaded/files/ostomy_info/blockage_card.pdf

Good luck and please keep us posted.

 

[DJW]

Go to the ER.

 

[Susan2]

I agree. If you have tried a warm bath or shower, massage of the stoma and surrounding area, plus lots of liquids (warm in preference to cold) and these haven't worked, ER is the place for you.

 

[UnXmas]

I agree with all the above - this could well be urgent. I've had blockages which passed on their own without having to go to hospital, but never had any swelling or change in stoma size, and once the blockage had passed, although for a few days I still had pain when the stoma was active, the pain got less and less pretty fast. It sounds like you may still have a blockage. What is your output like? But please see a doctor right away.

 

[Connie01]

Thanks everyone. Seems I had a blockage and the stoma was prolapsing. Also there is the start of a hernia behind it.
Initially they were discussing surgery but the blockage has cleared. They have decided to see if the stoma settles back to normal itself.

Phew!!!!! Thanks again.

Connie x

 

[nogutsnoglory]

Glad to hear you can avoid surgery for now. Hope it heals naturally!

 

[UnXmas]

My stoma prolapsed once too, but the doctor was able to put it back in without surgery - he literally just pushed it back in with his hands, and taught me how to do it too, in case it happened again. It did happen once more, and I was able to get it back in myself. (Now I have a new stoma, which hasn't prolapsed, not yet anyway!) Apparently simply lying flat on your back for a while is enough to make it go back in in some cases.

From what I was told, a prolapsing stoma usually isn't serious; it would only need surgical correction if it's out all the time or so often that it's difficult to get bags on. Blockages are another matter, as you probably know. Do your doctors think the prolapse and blockage are connected? Was the blockage caused by what you ate?

I'm glad to hear the blockage cleared - hopefully the rest will sort itself out!

 

[Connie01]

Yes, they were connected - I ate a coconut macaroon - and I knew they were to be avoided! I had no idea it would cause this much trouble.

Thanks for all your advice. I feel much better today.

Connie x

 

[cleuger]

Are you not suppose to eat coconut with a stoma? I had no Idea I eat mounds bars all the time of course I just got my stoma but I still eat them. Seams like I read someone else has a prolapsed Stoma is this something common? I see your doing better that's good to know : )

 

[Susan2]

Insoluble fibre can be a problem with a stoma, more so with an ileostomy than with a colostomy. The small intestine is smaller in diameter than the large intestine - obviously duh! - so the stoma outlet is smaller.

It is possible to build up a ball of fibre behind the stoma and this becomes more dense and harder as the liquid seeps out through the stoma. More fibre coming through adds to this blockage, so it is important try to clear it as soon as possible. My stoma nurse said to drink lots of fluids (preferably warm rather than cold), have a warm shower or bath and massage around the stoma and the blockage. I was able to clear a blockage (caused by a large piece of cake containing ground almonds and semolina) this way. If none of this works, go off to the ER.

DO NOT poke anything into your stoma under any circumstances!

 

[UnXmas]

Are you not suppose to eat coconut with a stoma? I had no Idea I eat mounds bars all the time of course I just got my stoma but I still eat them. Seams like I read someone else has a prolapsed Stoma is this something common? I see your doing better that's good to know : )

Coconut can be a problem - I never eat it. I would wait at least six weeks from your surgery if you do decide to try it. If you've already eaten some with no problems, I would still be cautious and hold off eating anymore for a bit longer.

Prolapses I think are fairly common, though like I said, usually they are not serious. I think some people are more prone to them than others (I've had pelvic prolapses and, before my stoma, rectal prolapses, so I'm obviously prone to them!), and a lot of it has to do with the type of stoma, how it is situated and whether there are weaknesses caused by surgery.

 

[R20]

Had a similar experience with Prolapses a couple times when I was younger. Seemed to coincide with Bourbon drinking - dunno why. Had three doctors all pushing on it to get it back in. No kidding they poured sugar all over it. Apparently the sugar dehydrates the stoma and makes it shrink. Hasn't happened in last 10 years luckily. Although while travelling in europe in heat of summer a couple years ago I had a 30% prolapse which never returned to normal. Just living with it now as got more important things to worry about.