Pain around the stoma – 8 possible reasons

Of course, it is unpleasant if you experience pain around your stoma - especially if you are recovering from surgery. Understanding the possible cause of your pain is the best way to avoid major problems.

Most people with a stoma occasionally experience minor problems that can cause discomfort, e.g. leakages leading to sore skin, granulomas or blockages. Pain is a clear sign that something is wrong. So listen to your body and seek help from your stoma care nurse or GP in the first instance.

Reasons for a painful stoma

1. Leakages & sore skin

Leakages occur as a result of the stoma appliance not fitting properly. The excretions come out, touch the skin and cause irritation. This can be incredibly uncomfortable and, if left untreated, can also cause major problems such as infections.
To be honest, the chance of a leak occurring at some point is very high. Even the smallest gaps, too tight fitting of your appliance or simply a poorly fitting product can lead to leaks. It is therefore worth making sure that the ostomy supply fits perfectly. Your stoma care nurse will always be on hand to provide you as much help and advice as possible.

Already have sore skin? Find out here, how to treat skin irritations in the best possible way.

2. Ulcers

Ulcers can form around your stoma and under your stoma appliance. They can occur for a variety of reasons and may be related to your underlying diagnosis, medications or even the appliance you are using. Ulcers very often cause pain and discomfort. Please consult your GP or your stoma care nurse.

3. Granulomas

Granulomas are benign growths that can develop around the stoma. They appear as small, raised, red bumps. Granulomas are common and most people experience them as very annoying. They can be painful to touch and bleed very easily, especially when the skin around the stoma is cleaned. The bleeding can loosen the adhesive of the ostomy appliance, which in turn can lead to leakages. Although they are problematic and often painful, you don't need to worry about them. It is still a good idea to discuss your symptoms with a healthcare professional.

4. Constipation

Constipation is often a problem with colostomies. Abdominal cramps and hard stools are the first symptoms and can quickly become very unpleasant.

Tips & Tricks:

Try to eat a high-fibre diet (wholemeal bread, fruit and vegetables) and drink plenty of water (6-8 glasses).

Check your medication. These may also be the cause of your constipation.

If your constipation persists for longer than 2 to 3 days without improvement, contact your stoma care nurse or GP. Taking laxatives could be a solution.

5. Narrowing or blockage of the stoma

Depending on the type of surgical procedure, stomas can become partial or completely blocked. Such blockages can be caused by certain foods that are difficult for the bowel to digest or by growths and scar tissue in the bowel that impede bowel movements.
You can recognise a stoma blockage by the fact that your pouch fills more slowly than usual or your faeces are suddenly very watery. Another sign may be abdominal pain, which will increase rapidly if the problem is not resolved.

Tips & Tricks:

Avoid solid foods and increase your fluid intake at the same time.

Prefer warm drinks.

A warm bath can relieve your abdominal pain.

Lie on your back, pull your knees to your chest and sway forwards and backwards.

Try to move or massage your stomach.

If left untreated, blockages can lead to a hard, swollen abdomen, severe pain, nausea and vomiting. If you notice these symptoms, please consult your GP immediately.

For more useful tips on how to relieve a stoma blockage, click here.

6. Retracted stoma and stenosis

A retracted stoma means that the stoma is positioned under the skin. This can occur with a urostomy and ileostomy as well as with a colostomy. The causes are usually difficulties in forming the stoma, the weight and the shape of your abdomen. Retracted stomas can lead to significant problems with leakage and should be carefully assessed by your stoma care nurse. It may be necessary to change to a different appliance - convex products are often recommended.

A stenosis causes the stoma to become very narrow and small. The discharge from your stoma becomes ribbon-like or even liquid. You should also monitor this with your stoma care nurse, as your stoma may need to be carefully dilated. You may also be advised to take laxatives to keep the stool soft so that it can be passed easily and without discomfort.

7. Parastomal hernia

Hernias occur when muscular weakness is present. A parastomal hernia appears around the stoma when a piece of the intestine pushes through the abdominal muscle and forms a swelling under the skin. Hernias can vary in size. Some people experience a tugging feeling, discomfort or even pain.
Your stoma care nurse can prescribe you a support garment to provide some stability to the hernia and relieve your discomfort.

8. Prolaps

Sometimes it may happen that the bowel slips out further and stretches itself out. This can occur if the muscles that support the bowel are weakened or if the abdominal muscles are overloaded by heavy lifting. Normally this does not cause any pain. It is important that the stoma always retains its pink/red colour and continues to function normally. If it darkens in colour in any way, you MUST see a doctor urgently.

Tipps & Tricks:

As the stoma enlarges due to the prolapse, it is important to check the size of your baseplate and adjust it if necessary.

You may also feel more comfortable with a larger pouch. Try it out for yourself.

Lying flat reduces the size of the stoma and can be helpful when changing the pouch.

A support garment that can be put on while lying down is also an advantage in order to control the prolapse.

Find the right product at the right time

It usually takes a few weeks for your stoma and faeces to settle down after the operation. It is therefore quite possible that your requirements for products will change shortly after the procedure. As time goes on, changes in your body may lead to your favourite product no longer fitting as well as before.

Whether you are a new ostomate user or more experienced, our smart Product Navigator can help you find the best product for your individual needs. You too can find your Perfect Fit!

Discover Product Navigator

For more information about us or our products, please visit our website. There you will find, among other things, our detailed FAQ and other interessting blogarticles all about the topic stoma. You can also contact us via our social media channels or send us an e-mail. We look forward to hearing from you!