Stoma blockages can cause the output from your stoma to slow or stop altogether. The latter can happen unexpectedly and sometimes be a medical emergency, so it’s essential to watch out for signs that your “plumbing” needs assistance.

While the jury is still out why obstructions occur in some ostomates and not in others, experts believe eating a fibre-rich diet or failing to chew food properly is most often to blame. Other causes of blockages include scar tissue or bowel adhesions that might block the passage of waste in either the small or large intestine.

It is not uncommon for people with a stoma to, at some point, experience stoma blockages.

Do I have a partial blockage or a total stoma blockage?

In the case of a partial bowel blockage, a tiny amount of liquid output can bypass the obstruction in the intestine, resulting in a liquid/mucous bowel motion through your stoma – either with or without gas.

In the case of total bowel obstruction, the colon cannot release any output through the stoma.

Causes of stoma blockages

Some conditions can exasperate bowel obstruction. If you have been previously diagnosed with any of the following conditions, you should seek medical assistance by contacting your general practitioner or a stoma nurse specialist:

• Diverticulitis

• Inflammatory bowel disease, which can result in strictures or a constriction of the gut that can lead to blockages

• Volvulus, also referred to as a twisted bowel

• Abdominal or parastomal hernia, which can lead to bowel strangulation

• Adhesions or strictures resulting from colorectal surgery

• Abdominal or pelvic surgery performed recently

• Colon cancer

Good to know: Poorly digested food is the leading cause of individuals with stomas suffering a partial or whole intestinal obstruction.

Signs and symptoms of stoma blockages

As discussed above, the most visible indicator of stoma blockages is a stoma output that slows or stops entirely. A colostomy patient may experience a blockage over the course of several days, beginning with constipation and extreme discomfort and often excruciating pain

On the other hand, people with ileostomies can experience a blockage in less than 24 hours. Because people with ileostomies often empty their stoma appliance between five and seven times per day, a blockage is easier to detect. You’ll experience less output and a decreased need to empty your stoma device.

Additional symptoms you may experience that could indicate stoma blockages include:

Extremely painful
Abdominal cramping (around the stoma or across the abdomen)
Enlargement of the abdomen or stoma
Decreased urine output
Brown urine, caused by dehydration as a result of not wanting to consume fluids due to feeling ill
Vomiting

In addition to decreased output, you also suffer waves of cramping and stomach pain, which may intensify if your symptoms persist.

What to do when stoma blockage is suspected

If you have an ileostomy and suspect a bowel blockage, you must immediately contact your Stoma Care Nurse Specialist or your primary care physician for guidance. When you can start to feel pain and discomfort try and take a mild laxative orally.

Speak to your healthcare provider if you experience any stoma problems, including stoma blockages.

Can stoma blockages be dealt with at home?

In short, the answer is maybe. Some less severe blockages can be addressed at home. However, this DOES NOT apply to ostomates with an ileostomy.

For mild blockages, you can try the following:

• If your stoma begins to swell, you should replace your pouch by making the baseplate somewhat larger than usual to accommodate the swelling

• If you have no output or very little output from your stoma, and you do not feel sick or vomit, you should cease eating solid food and consume only liquids such as soup, heated broth, ice-cream, and plain yoghurt

• If feasible, go for a brief stroll. By being mobile, you improve the blood supply to your intestine, which aids peristalsis (the movement of the gut’s muscles) and should assist in resolving the obstruction;

• Massage around the stoma or the entire abdominal region. As the majority of blockages occur close below the stoma, this may assist in dislodging the obstruction

• A heating pad or a hot bath may assist you in relaxing your abdominal muscles and removing the obstruction

Good to know: Don’t take any laxatives or stool softeners unless directed by your doctor.

How can you prevent stoma blockages?

Suppose the intestinal blockage is not a result of scar tissue or bowel adhesions. In that case, you can try the following recommendations to lower your future risk of having new stoma blockages:

Chew the food well until you can break it into small pieces. Doing so reduces the likelihood of food particles being lodged in your bowel and producing a blockage.
Take your time. Allow your body sufficient time to fully chew, digest, and absorb food by eating slowly.
Limit your intake of bran and other high-fibre grains.
Eat only small amounts of foods that are high in cellulose. These include raw vegetables, unpeeled fresh fruits, bamboo shoots, bean sprouts, cabbage, celery, coconut, corn, mushrooms, pea pods, dried fruits, nuts, and seeds.
Drink at least 8 to 12 cups of fluids each day.

This piece on stoma blockages was written by Vera SA: a leading supplier of ostomy underwear for men and women.

Vera SA is a proud partner of CANSA and The South African Society of Ostomates.

Contact VERA SA at 082-833-9200, email info@verasa.store, or log onto https://www.verasa.store/ for more information.