Stoma Prolapses Are Often ‘Alarming, But Not Dangerous’ After Colorectal Cancer Surgery

Stoma prolapses are usually “alarming, but not that dangerous,” for patients who have an ostomy, explained Stephanie S. Yates, a nurse practitioner from Duke Cancer Center’s Wound Ostomy Clinic in Durham, North Carolina.

Prolapses occur when patients with an ostomy — more frequently a transverse ostomy or an ileostomy — have part of their intestine push through the opening (called the stoma) in their abdomen that is used to drain waste.

Yates explained that sometimes a prolapse will “go back in by itself,” and when it occurs, there is not much that patients can do to keep the intestine from bulging, though they should talk to their health care team to determine if the surgeon should intervene.

Transcription

Prolapse is an alarming thing when it happens to people.

I will say that in our colostomy population, especially the permanent ones, we don't see prolapse happen very much. Prolapse occurs more in a transverse colostomy, which is much higher in the colon, or an ileostomy, where they're in a loop fashion.

Patients need to know what type of stoma I did I get? Did I get an end stoma, which means one end of the intestine is brought to the skin and that's it? Or did I get a loop stoma, meaning both ends of the intestine, (are) brought up as if you would kink off the garden hose and you would open up opening so both ends are right there. One is going to be working, the end that comes from the house of the garden hose, if you will, and the other end is just in there, but it sits in there. And the one that doesn't work is almost always the one that probably lapses.

While it's alarming, it's really not that dangerous, but you do want to be in touch. Sometimes they will go back in all by themselves. You can relax, recline and just kind of chill out and sometimes it goes back in other times it doesn't … If a prolapse decides to happen there's not a lot that you can do to really keep it in. Sometimes an abdominal binder or snug-fitting clothing over it will give it the suggestion to stay in, but it's a hard thing to manage.

It's a relatively simple fix with your colorectal surgeon but that generally depends on what else is going on, whether that's really needed or not.

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