After ostomy surgery, either colostomy or ileostomy, you may experience side effects such as mucus discharge from the anus, issues like ostomy bag leaking, skin irritation, and others.
During ostomy surgery, part of your bowel is removed, and an opening is created in the abdomen to form a stoma, through which waste is expelled. This means waste bypasses some portion of the intestine, as well as the rectum and anus. In some cases, the rectum and anus are also removed.
Side effects from the surgery can be bothersome. However, they can be successfully managed, and patients with ostomies can live fulfilling lives. This article explains ostomy surgery, rectal discharge, and ostomy odor and leaks. It will also explain parastomal hernia and stoma blockage.
If the discharge from the bottom is bloody or smelly, make an appointment with your healthcare provider to discuss the issue as soon as possible.
What Is Ostomy Surgery?
Acolostomyis created when part of the large intestine is removed from the body. The part of the rectum that is left is called the rectal stump. The end of the remaining intestine is then connected to the abdomen through a surgically created stoma. Waste leaves the body through a stoma and is collected in an appliance that is worn on the outside of the body.
An ileostomyoccurs when the small intestine is connected to the abdominal wall. This is usually after the large intestine has been completely removed. But sometimes, the large intestine is left (typically in order for it to heal) inside and is bypassed through the use of the stoma.
People who have a permanent stoma may choose to either have their rectum removed or keep it. Those who have the potential to reverse their ostomy in the future may elect to keep their rectum. The amount of rectum remaining will vary from person to person. It will depend greatly on the reason for the ostomy, such as those that are performed to treatIBD, colon cancer, trauma, or other conditions.
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Mucus Discharge from the Anus After an Ostomy
Sometimes, there can still be discharge from the bottom, where the rectum and the anus are located, even though there's a stoma. The frequency of needing to empty some fluid out of the rectum varies from one person to another, along with the reasons why this happens. In many cases, this is a normal, expected occurrence, and there is nothing to worry about.
The rectum is living tissue and continues to produce mucuseven though it is not "hooked up" to anything, and stool is not passing through it. Mucus is a part of normal stool, although not usually present in a great enough quantity for it to be visible. In the absence of stool, mucus passing through the rectum becomes more apparent.
Mucus might be relieved out of the rectum by sitting on the toilet and passing it as one would pass stool.
What to Do About Leaks
Some people find that themucus can leak out of the rectum at times, especially if it tends to be of a watery consistency.Some gauze or a sanitary napkin worn in the undergarments may help catch unexpected leaks.
It may also help to sit on the toilet periodically to try to expel the mucus even before feeling the urge to pass it.
You might have the benefit of working with a wound ostomy continence nurse, or an ostomy nurse for short. This registered nurse cares for and serves as a resource for ostomy patients.
Odor from an Ostomy Bag
Although a well-fitting ostomy bag often does not produce a noticeable smell, people with an ostomy bag might notice an unpleasant odor under certain circumstances. Here are some things to consider:
- Bag fullness: Change the bag as needed to prevent it from becoming too full, which can loosen the seal and cause odors to escape.
- Seal: A heavy bag or a seal not adhered adequately can cause a smell.
- Leaking: An ostomy bag that leaks is likely to produce an odor. To prevent leaking, the bag should be changed regularly.
- Diet: Certain foods, notably fish, eggs, and some vegetables, can contribute to ostomy smells. The foods that can cause smells vary from person to person, so consider keeping a food log if you suspect your diet may be contributing.
If your ostomy bag smells bothersome, see your healthcare provider. Some tools for minimizing odors include using lavender oil in the bag and trying products designed for the purpose.
Leaking Ostomy Bag
To understand ostomy leaks, defining what constitutes a leak is essential. A leak in an ostomy bag can happen when ostomy contents are under the skin barrier and in contact with the skin. It does not have to leak further and be in contact with the person's clothing.
Reasons ostomy bags might leak include:
- Skin irritation
- Ill-fitting equipment
- Overfilled ostomy bag
- Incomplete seal around the skin barrier
- Type and placement of ostomy
While uncomfortable, a leaking ostomy bag is not the patient's fault. Speak with a healthcare provider if your ostomy is leaking because they can help patients reduce leaks in several ways.
Skin irritation is a common complication. Reasons for skin irritation can include allergic reactions to stoma skin care products such as barrier films, irritation from the repeated use of adhesive, and contact with ostomy contents.
Parastomal Hernia
A common complication of an ostomy is parastomal hernia. When this happens, a portion of the intestine protrudes through a weak spot in the abdominal wall. It can be noticeable as a lump or other irregularity in the abdomen. They can be harmless, but they can also cause strangulation of the intestine, which is an emergency.
Parastomal hernia is treated with surgery to strengthen the abdominal wall with mesh.
Having an ostomy can be a significant change, but with some adjustments, you can still participate in work and social activities, including travel and a fulfilling sex life. Learning as much as possible about your ostomy and taking advantage of patient education resources from healthcare professionals is a key part of integrating an ostomy into a high quality of life.
Stoma Blockage
A stoma blockage, also called a stoma outlet obstruction, happens when stool blocks the opening of the stoma and cannot pass into the ostomy bag. Risk factors include surgical technique of the original procedure and people with thick abdominus rectus muscle. Symptoms of stoma blockage include:
- Nausea
- Decreased ostomy output or just fluid output
- Abdominal pain and swelling
- Swelling at the ostomy site
- Vomiting
If you are experiencing symptoms of a blocked stoma, stop eating and drinking and call a healthcare professional.
Summary
Colostomies and ileostomies are two types of ostomies. An ostomy is a procedure in which an opening is created in the skin so that waste can leave the body. The waste collects in a bag outside the body. A colostomy is formed from the large intestine, while an ileostomy is formed from the small intestine.
Leaks, odors, blockages, and hernias are common complications of ostomy. However, there are many ways to deal with these complications so that people living with ostomies can lead regular and fulfilling lives.
