How to Prevent and Treat Blockages for Ostomy Patients

Understanding Stoma Blockages

Having a stoma can greatly improve quality of life for those with chronic gastrointestinal conditions or those who have undergone intestinal surgery. However, living with a stoma requires vigilance to avoid potential complications like blockages. When waste cannot pass through the stoma, an obstruction occurs. This causes the stoma to swell and can lead to severe pain, nausea, and vomiting if left untreated.

Fortunately, there are steps you can take to prevent, identify, and treat stoma blockages. Recognizing the early signs and acting quickly can help resolve the issue before it becomes an emergency situation requiring hospitalization.

What Causes a Blockage?

There are several potential causes of a stoma blockage:

• Scar tissue or adhesions from previous surgery
• A hernia near the stoma
• Twisting or telescoping of the bowel
• Impacted stool
• Certain medications that cause constipation
• Dehydration
• Ingestion of high fiber foods
• Stenosis of the bowel

Blockages are more likely to occur if the stoma opening itself becomes constricted or narrowed. Anything that slows or disrupts the forward movement of stool through the intestinal tract can also raise the risk of obstruction.

Symptoms of a Blockage

Watch for these signs that may indicate a stoma blockage:

• No output from the stoma for an extended time
• Swelling of the stoma
• Change in stoma color, such as dark red or purple
• Cramping pain near the stoma
• Nausea and vomiting
• Abdominal bloating or distension
• Constipation

The symptoms may come on gradually or relatively quickly depending on the cause. Even partial obstructions can produce symptoms, so don't wait to seek help.

Preventing Stoma Blockages

You can reduce the likelihood of experiencing a stoma blockage by taking these preventive measures:

Stay Hydrated

Drink plenty of fluids, at least eight 8-ounce glasses per day. Water, fruit juice, decaf coffee, and herbal teas help provide fluid to keep stool soft.

Monitor Your Diet

Avoid foods known to cause constipation, like cheese, eggs, and rice. Limit high fiber foods that could clog your stoma, including raw fruits and vegetables with skins or seeds, corn, popcorn, nuts, and coconut.

Use Laxatives Judiciously

Check with your doctor before taking over-the-counter laxatives. While they can help alleviate constipation, overuse can make your system reliant on them for bowel movements.

Move Your Body

Get regular exercise like walking, swimming, or riding a stationary bike. Physical activity helps stimulate the digestive tract to keep waste moving.

Care for Your Stoma

Check the stoma daily for any swelling, discoloration, or retraction. Use stoma powder and paste to fill uneven areas that could allow leakage. Change your pouching system regularly and seek help if the stoma opening seems too narrowed.

Avoid Blockage Triggers

Be cognizant of medications, foods, and activities that have caused obstruction issues for you previously. Keep a food journal to help identify problem items.

Treating a Blockage

If you suspect you have a stoma blockage, try these tips to find relief:

Massage the Abdomen

Gently rub the area around your stoma using circular motions. This can help relax the intestinal muscles and encourage the passage of stool.

Try Heat Therapy

Apply a warm compress or heating pad around the stoma site to stimulate movement in the bowels. Avoid direct contact with the stoma.

Change Positions

Move around, alternating between lying down, sitting, standing, and walking. Different positions can take pressure off parts of the intestine and allow stool to shift.

Take Sips of Warm Liquid

Drink small amounts of warm water, broth, coffee, or tea to help hydrate the gastrointestinal tract.

Use Laxatives

Try a gentle over-the-counter laxative like Milk of Magnesia with your doctors approval. However, some laxatives may further dehydrate the intestines.

Relax Abdominal Muscles

Reduce muscle tension in the abdomen by taking slow, deep breaths. You may also try leaning forward with your shoulders over your knees.

Manually Loosen Stool

If you can safely reach it, you may be able to gently loosen the material blocking your stoma using a finger. Ensure your hands are well cleaned beforehand.

Irrigate the Stoma

Using a special irrigation kit, introduce room temperature water into the stoma to flush out stool. Do this with care to avoid damaging the stoma.

When to Seek Emergency Care

Despite your best efforts, some stoma blockages will not resolve on their own. Contact your doctor or ostomy nurse if your symptoms do not improve within a couple hours. Seek emergency care immediately if you experience:

• Increasing or severe pain
• No stoma output for more than 4-6 hours
• Dark stoma color
• Excessive nausea, vomiting, or abdominal cramping
• Signs of dehydration such as dizziness
• Fever or chills

At the ER, they can provide IV fluids and electrolytes to stabilize you. They may also manually disimpact the stool or use imaging tests to determine if surgical intervention is required. Left untreated, a serious blockage can result in a bowel perforation.

Outlook for Stoma Blockages

While stoma obstructions can be frightening and painful, the prognosis is usually good with prompt treatment. Minor blockages often clear up within a day or two by simply following conservative at-home measures.

Prevention is ideal, as recurring stoma blockages can indicate an underlying condition needing correction. Work closely with your medical team to identify and address any factors impairing proper functioning of your stoma.

Patient education can also go a long way in avoiding blockages. Know how to keep your specific type of stoma clear and when to seek extra help. Familiarize yourself with over-the-counter laxatives suitable for ostomates. Remaining well hydrated and following a balanced low-fiber diet can likewise reduce your risk.

While stoma obstructions are usually manageable, don't take chances with your health. Monitor your stoma routinely and contact your physician at the first sign of trouble. swift action provides the best chance of a positive outcome.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.