Stoma bleeding – Cause for concern?

It is always worrying when your stoma or the skin around it bleeds. Stomas are incredibly vascular with a lot of blood vessels near the surface, which means it can bleed easily due to the extremely good blood supply. Therefore, it is not unusual to find a small amount of blood on the cloth when cleaning your stoma. Knowing what to do next and when to get help from healthcare professionals is important, so here are some tips to help guide you.

What to do, if you notice blood on your stoma?

If you spot any bleeding, it is important to take the time to examine your stoma. Have a good look whilst changing your stoma appliance and to try to determine where the blood is coming from. Keep an eye on the contents of your pouch throughout the day/night and check whether the bleeding is in the pouch or simply around your stoma.

Usually the bleeding comes from one of three sources:

1. From the stoma itself
2. From the skin around your stoma (peristomal skin)
3. Or internally via your stoma and into your stoma pouch
   

What could be the reasons for bleeding?

Overstimulation

If the bleeding is minor and you notice spots on the wipes as you clean, the bleeding may be coming from the edges of the stoma. The stoma is incredibly vascular and can easily bleed, if knocked or caught by the edges of the stoma appliance. This is usually nothing to worry about and happens to most ostomates at some time or another. Try pressing gently with a wipe to the area which is bleeding and the bleeding will usually stop. If it continues for more than 10 minutes, it is a good idea to discuss with your Stoma Care Nurse.

Leckages

Bleeding of the surrounding skin is very common and usually caused by skin irritation resulting from contact with excretions. A poorly fitting stoma pouch impairs adhesion to the skin and thus leads to leakage. Basically, such bleeding around the stoma is nothing to worry about and can be treated well. Speak to your Stoma Care Nurse to find a more suitable pouch and perfectly treating your sore skin.

If you need more information about how to manage sore and irritated skin click here.

Granulomas

These are another cause of bleeding from around your stoma. They are benign red, raised areas on or around the stoma. They are usually small in size but can vary. Granulomas develop usually from friction of the stoma pouch rubbing on the stoma itself, causing overstimulation of the damaged skin. Speak to your Stoma Care Nurse if you notice granulomas on or around the edges of your stoma as there are stoma pastes available to protect the skin and other treatments such as silver nitrate which can be used to help treat and control any troublesome bleeding.

Ulcers

Ulcers can occur for a variety of reasons. Causes can be an ill-fitting appliance, medications, or linked to your original diagnosis. Contact you Stoma Care Nurse for assessment.

Life-threatening causes

If you see blood inside your stoma pouch or mixed amongst your stool/urine, contact your Stoma Care Nurse or GP. For those with a colostomy or ileostomy it could indicate intestinal bleeding and for people with a urostomy it may be due to an infection such as a Urinary Tract Infection (UTI).

If you are on medication with anticoagulants such as aspirin or warfarin this may increase you risk of bleeding.

If the bleeding is heavy and continuous you should seek urgent advice from your GP, call 112 or visit a hospital should it persist.

Always rembember …

… to stay calm, if you notice some bleed. Most of the time it‘s a reaction of the mucous membrane to the friction and nothing to worry about. It is best to clean your stoma with soft, medical fleece compresses and do not press too hard on it - the stoma mucosa is insensitive to pain, but reacts to mechanical stress.

However, if the stoma is bleeding heavily or you can see that blood is coming from the bowel, you should consult your doctor directly. Also in case of big insecurities about the situation it’s always an good idea to call your Stoma Care Nurse to check it out.

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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!