Stoma problems – explanations, tips & tricks #1

For many people, a stoma marks the beginning of a new phase in their lives, one that can bring greater independence and security in everyday life. Of course, there can also be challenges – such as skin irritation, leaks or occasionally high stoma output. The good news is that with a few simple tricks, the right equipment and a little practice, these problems can usually be overcome. This blog post explains in an easy-to-understand way which stoma problems occur frequently, how to recognise them and which simple measures can make everyday life easier.

Allergic reactions

Allergic reactions are rare in stoma patients, but they can occur and irritate the skin around the stoma. Common causes of allergic reactions are certain ingredients in the care products, especially in the skin protection material, as this comes into direct contact with the skin, as well as accessories such as skin protection rings or pastes. Furthermore, aggressive cleaning products can damage the skin barrier and trigger an allergy. Early detection and the right measures help to reduce discomfort and prevent skin damage.

Common symptoms

• Redness and swelling around the stoma
• Burning or itching
• Blisters, pustules or rash
• Weeping or flaky areas

Measures

• Documantation: First and foremost, you should document the product, the onset of symptoms and their duration – this will help to identify the cause.
• Product change: If the skin reacts to the skin protection product currently being used, changing the product may help. Skin irritation is often caused by certain ingredients in the material. FORLIFE offers a hydrocolloid skin protection product containing alginate, which is often well tolerated by sensitive skin. It may therefore be a good option if a change of product is being considered. About our alginate products
• Gentle skin care: Only lukewarm water, no soaps or aggressive cleaners
• Protect your skin: Only use skin protection rings, pastes or protective films if they are well tolerated.
• Specialist advice: Consult a stoma care nurse or doctor, especially in the case of severe reactions. In some cases, an allergy test by a dermatologist may even be necessary.

Ulcers

An ulcer is an open sore on the skin around the stoma. It is a deeper skin lesion that is often painful and makes it difficult to apply stoma care products. Ulcers are usually caused by persistent irritation or inflammation of the skin at the transition from the stoma to the abdominal wall.

An ulcer on the stoma is a serious skin lesion that should be treated early on. With appropriate care, gentle treatment and professional support, healing and skin protection can be effectively promoted.

Consult your stoma care nurse for an assessment.

Mucocutaneous separation

In a stoma, a section of the intestine is brought out through the abdominal wall and attached to the skin. Mucocutaneous separation occurs when the connection between the intestinal mucosa and the surrounding skin (cutis) is partially or completely detached. This creates a gap or opening between the stoma and the skin. Mucocutaneous separation can be caused by circulatory disorders after surgery, infections in the wound area, delayed wound healing (e.g. in cases of diabetes, malnutrition or cortisone therapy), mechanical stress (e.g. stoma care that is too tight or changed too frequently) and postoperative swelling that puts tension on the suture.

Measures

• Early diagnosis: Regular check-ups by a stoma nurse or doctor, especially in the first few weeks after the operation.
• Wound cleansing and protection: After consulting with the attending physician, gentle rinsing with sterile saline solution and the use of hydrocolloid wound dressings or alginate compresses to absorb exudate and protect the skin are recommended.
• Customised stoma supplies: Precisely dimensioned baseplates and, if necessary, pastes or rings to seal the gap.

Irritated/sore skin

Sore or irritated skin is a common problem among ostomates. It can make everyday life difficult, cause pain and impair the adhesion of the pouch.

Since the symptoms of sore or irritated skin, such as redness, itching, burning or small blisters, are very similar to those of an allergic reaction, it is often difficult to identify the exact cause without professional assistance. Careful observation of the skin and, if necessary, consultation with a stoma care nurse or doctor are therefore particularly important.

Possible causes

• Leckages: Often lead to sore skin, as stool or urine comes into contact with the skin and irritates it.
• Trauma to the stoma or skin: Your stoma and the skin around it are sensitive and therefore need to be cared for properly. An incorrectly chosen baseplate can rub and cause injuries to the side of the stoma. These can become inflamed or develop into superficial ulcers.
• Foliculitis: This is an inflammation of the hair follicles. It manifests itself in the form of small pimples, which can sometimes be filled with pus and be painful. Folliculitis often occurs when shaving is not performed, so regular and careful shaving around the stoma is recommended.
• Change in excretion:If you use a closed pouch and frequently have loose stools, a pouch for ileostomies may be a practical alternative. It is easier to use and reduces the need for frequent pouch changes, resulting in less skin irritation.
  

If you would like to know more about treating sore skin, please click here.

Fungal infections

Fungal infections, usually caused by Candida albicans, can also occur in stoma wearers. Causes can include moisture under the dressing, a damaged acid mantle of the skin, wearing the stoma for too long or poor stoma hygiene. Antibiotics or a weakened immune system can also increase the risk.

Urostomy patients have a higher risk of fungal infections, as constant contact with urine, moist skin and skin irritation create ideal conditions for fungi to thrive.

Common symptoms

• Redness and shiny skin around the stoma
• Itching or burning
• Small white/yellowish spots or pustules
• Weeping areas under the baseplate
• Pouch sticks less well or slips more often

Measures

• Change pouch regularly: To reduce moisture
• Carefully clean and dry the skin: Ideally, only lukewarm water, no harsh soaps
• Antifungal medication as recommended by a doctor: Mostly water-based antifungal suspension
• Ventilation of the skin: If possible, take short breaks without the baseplate so that the skin can dry.

Conclusion

Healthy skin around the stoma is crucial for well-being and the functioning of the stoma care system. Various causes such as allergic reactions, ulcers, mucocutaneous separations, irritated skin or fungal infections can damage the skin and make everyday life difficult. Early detection, careful observation and proper care and adjustment of the care system are therefore important.

Documentation, product selection, gentle cleansing and, if necessary, the use of special skin protection materials or wound dressings contribute significantly to reducing discomfort and preventing skin damage. In the event of severe or persistent problems, professional support should always be sought from a stoma care nurse or doctor.

With the right measures, skin health can be maintained, healing processes supported and the quality of life of ostomy patients improved in the long term.

For more information about us or our products, please visit our website. There you will find, among other things, our detailed FAQ and other interesting blog articles 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!