Understanding stoma blockages better – causes, signs and solutions

A stoma can give many people a new sense of quality of life and freedom. However, even with an artificial bowel or bladder outlet, challenges can arise – one of these is what is known as a stoma blockage. In this article, you will learn what causes a blockage, what warning signs you should be aware of, and how to respond correctly in an emergency.

What exactly is a stoma blockage?

A stoma blockage is also known as intestinal obstruction and prevents stool from passing completely or partially. But why does this happen? Well, constipation is usually caused by food, inflammation, scar tissue (adhesions) or twisting of the intestine.

There are basically two types of blockages: partial blockages and complete blockages. A partial blockage occurs when a small amount of fluid can still pass through the obstruction. This usually results in liquid, slimy, foul-smelling stool coming out of your stoma. In the case of a complete blockage, nothing comes out of the stoma at all.

A stoma blockage with a urostomy is a potentially serious situation that requires special attention. Unlike a colostomy or ileostomy, which affects stool, this involves urine flow. A blockage can obstruct urine flow and lead to complications.

Possible causes

There are various reasons why a blockage may occur.

For colostomy and ileostomy:

Foods rich in fibre or difficult to digest (e.g. celery, asparagus, nuts, corn)
Scars or adhesions in the abdominal area
Narrowing (stenosis) of the stoma or intestine
Food that has not been chewed sufficiently
Fluid deficiency
[Hernias](https://unora.co.uk/market-site-uk/stoma-care/stoma-hernia-symptoms/) near the stoma

For urostomy:

Mucus production that can block the stoma opening
Stenosis (narrowing) at the stoma
Adhesions in the area of the stoma or the urinary diversion
Fluid deficiency

Some people are more sensitive to certain foods or situations. It is worth keeping a food diary if you experience frequent symptoms.

Typical symptoms

The most obvious sign of a blocked stoma are your excretions – or rather, little to no excretions. If you notice a change in the regularity of your bowel movements or urinary output, this may indicate a blockage.

With a colostomy, constipation can develop gradually and last for several days. It is not always immediately noticeable – sometimes there are no clear signs. Therefore, it is possible that an incipient blockage may initially go unnoticed. Since the digestive rhythm varies from person to person, you should be alert if you have not had a bowel movement after three to four days – especially if you are also experiencing pain.

With an ileostomy, constipation can occur relatively quickly and without any warning signs. Since you should have regular bowel movements throughout the day with an ileostomy, it is usually very alarming if your ostomy pouch remains empty for several hours.

Other symptoms of a blocked stoma with colostomy and ileostomy are as follows:

Sudden or increasing abdominal pain
Swollen abdomen
Nausea and vomiting
Dry mouth
The stoma itself may show signs of swelling or discolouration, indicating reduced blood flow

A blockage of the urostomy can have serious consequences and should be detected early. Since urine normally flows continuously from the urostomy, changes in urine flow are the most important warning sign.

Other symptoms of a blocked stoma with a urostomy include the following:

Reduction in urine volume
Full feeling or pressure in the abdomen
Back pain or flank pain
Fever, shivering or general feeling of illness
The stoma itself shows changes such as swelling or no discharge

The sooner you recognise these signs, the better you can react – often, blockages can be resolved yourself in the early stages.

Dealing with a blocked stoma

If you suspect a stoma blockage, there is no need to worry at first. However, you should speak to your stoma care nurse or doctor as soon as possible. You can resolve most blockages yourself with a few simple tips and tricks.

Tips & Tricks

Stay calm: Calm yourself down and observe the situation. Stress can cause additional cramping in the intestines.

Drink plenty of fluids: Increase your fluid intake. In addition to water and warm tea, drink fresh fruit juices. Sometimes carbonated drinks can also help.

Gentle massage: Gently massage the area around your stoma to relieve the blockage.

Heat: Take a warm bath or try using a heat pad, as this can help relax your abdominal muscles.

Physical activity: Keep active, as this promotes digestion and helps relieve constipation. You can also try the following exercise: Lie on your back, bend your knees towards your chest and gently swing from side to side.

Check the stoma opening: If your stoma is more swollen than usual, you should check whether the opening of your pouch needs to be cut slightly larger.

Note for people with a colostomy: Your family doctor can prescribe laxatives. Don't forget to drink plenty of water to help the medication work better.

When should you consult a doctor?

Immediate medical attention is necessary if:

severe, persistent pain occurs
no stool or gas discharge for 6–8 hours (ileostomy)
Fever or chills may also occur
vomiting begins
the stoma is blue to pale or severely swollen
the condition does not improve despite self-help measures

In such cases, medical relief may be necessary, e.g. via an enema, a feeding tube or, in rare cases, surgery.

Attention: If a urostomy is blocked and urine can no longer flow, this is a medical emergency, as urine can accumulate in the kidneys and cause permanent damage.

How to reduce the risk of stoma blockage

Good preparation is the best strategy. These tips will help you avoid blockages:

Nutrition

Chew well
Cook fibre-rich foods well or purée them
Hard-to-digest foods (e.g. nuts, legumes) in small quantities and well prepared
Test new foods individually

Liquid

Drink 1.5–2 litres daily – more if you have an ileostomy
Look for signs of dehydration

Mobility

Go for daily walks or do some light exercise
Strengthen abdominal and core muscles – also to prevent hernias

Documentation

A food diary helps to identify personal triggers
Document symptoms and eating habits
Check stoma care regularly

Conclusion

Stoma blockages can be worrying – but they don't have to be. If you know the causes, take the signs seriously and know how to react, you are well prepared. With a little mindfulness in everyday life, many blockages can be avoided or prevented at an early stage.

If you are unsure or have recurring complaints, talk openly with your medical team – together you will find solutions that suit your lifestyle.

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