A colostomy prolapse is when more of the intestines shift out of an incision site after that surgery. Medications can help with pain, but another surgery is the only way to fix this if the prolapse is impacting bladder or bowel activity.

Person with a colostomy bagShare on Pinterest
Sheila Alonso/Getty Images

Each year in the United States, approximately 100,000 people undergo a surgery that involves a colostomy. During a colostomy, part of an individual’s intestines is moved outside the body through an incision. A colostomy prolapse occurs when more of the intestines shift out of the incision site after the surgery.

This article will explain what a prolapse is and how it’s connected to a colostomy, as well as what treatments exist and how you might prevent problems in the future.

As their name implies, colostomy prolapses are prolapses that occur following a colostomy. A prolapse is a shifting of an organ or body part out of its normal position.

Colostomies are sometimes referred to as bowel diversion therapy. They’re performed to address lower bowel problems and offer additional ways for waste to pass.

A colostomy may be necessary if you have:

Colostomies can be temporary or long term and can involve different parts of the colon depending on where the impacted section is located.

During the procedure, one end of the large intestines is brought through the abdominal wall. The end of the colon that’s diverted through the incision in the abdomen creates a stoma. A stoma is an opening in the skin where waste can exit the body into a pouch. A stoma prolapse occurs in as many as 16% of stoma patients. The amount of bowel protruding from the body in these cases can vary greatly from 2–3 centimeters (cm) to 10 cm.

While a stoma prolapse can happen after any type of colostomy, it’s more likely after a loop colostomy. In a loop colostomy, the surgeon will pull a piece of the intestines out. This is then cut open and stitched to the skin to create a stoma. If it’s not secured inside the body as well, more of the intestines can pop through the opening.

Who’s most at risk for a colostomy prolapse?

People are more likely to have a prolapse following a colostomy if they:

  • are overweight or gain weight quickly following the surgery
  • have weak belly muscles
  • have a larger stomach opening from the surgery
  • put extra pressure on the belly from coughing, sneezing, constipation, or pregnancy
Was this helpful?

Not all prolapses are emergencies, but colostomy prolapses are serious when blood flow is cut off or waste can’t drain.

Potential signs of a stoma prolapse following a colostomy include the stoma:

  • sticking out more
  • swelling or changing color to purple, dark red, brown, or black
  • feeling cool to the touch
  • failing to release waste as expected

Other signs and symptoms of a prolapse can include:

  • appearance of a bulge or lump
  • feelings of pressure
  • problems peeing or passing bowel movements

Depending on the extent of the prolapse, your doctor may advise waiting and watching to see whether it gets worse. Medications may be offered to address pain or to help pass stools, but a colostomy prolapse is often only fully resolved with surgery.

A prolapse should be repaired if it’s causing pain or impacting bladder or bowel activity. Surgery to treat a stoma prolapse is necessary if symptoms don’t improve or the bag can’t be attached.

Treatment for a colostomy prolapse typically includes an operation done under local anesthesia where a polypropylene mesh strip is inserted. This procedure may also include removing damaged parts of the colon and rejoining it manually or with staples.

Some actions you can take to help prevent colostomy prolapse include:

  • not lifting excessively heavy objects
  • maintaining a moderate body weight
  • wearing support vests and belts when appropriate
  • eating a balanced diet with plenty of fiber and drinking lots of water to make bowel movements softer
  • practicing good hygiene to help avoid illnesses that may cause frequent coughing

If you already have a colostomy prolapse

It’s still important to follow the above actions to prevent making it worse. You may also wish to lay flat on your back for 20 minutes as this can relax the belly muscles and lessen pressure on the area.

A somewhat unusual-sounding way to help reduce stoma swelling is by applying a few tablespoons of granulated sugar to the outside of the stoma for 20 to 30 minutes. This will cause fluids in the stoma to be pulled out. If your stoma is swollen, you can also use a cold compress on it for up to 5 minutes.

Was this helpful?

A colostomy prolapse means your colon has shifted around from its expected position following a colostomy. When this causes pain or impacts your bowel movements, treatment is necessary.

A colostomy prolapse often requires some type of surgical procedure, so if you believe that you have one, it’s important to speak with your doctor about it. In addition to discussing your treatment options, they can advise you on ways to prevent prolapses in the future.