If you have a stoma, you may find the thought of a stoma blockage frightening! A blockage is also known as a bowel obstruction and the passing of some or all of the output (stool) is prevented from happening. But why does it happen? Well, a blockage is usually caused by food, inflammation, scar tissue (adhesions) or twisting of the intestines.
If it happens you will feel some specific symptoms, which can often be dealt with swiftly at home. Here are some tips to help you look for the signs of a blockage and what to do if it happens.
How would I know if I have a blocked stoma?
Usually, the most obvious sign is the stoma output may slow down or may even stop working altogether. There are two types of blockage, a partial blockage is when a small amount of liquid can make it round the obstruction, resulting in a liquid/mucus type of offensive-smelling bowel motion from your stoma. The second is a complete blockage, when nothing comes out of your stoma at all!
For a person with a colostomy, a blockage could happen over several days and you may start with feeling constipated, so it might not be as obvious at first. For a person with an ileostomy, a blockage can happen fairly quickly and usually without any constipation. As you pass output regularly throughout the day with an ileostomy, it is usually alarming when things become quiet! You will know when you have a blockage as your bag will be empty when usually it is filling up.
Another symptom in addition to your output slowing down is stomach-ache. You may start to feel waves of cramping and abdominal pain, which may worsen if the symptoms you experience are unresolved.
Other symptoms include:
- Swollen abdomen
- The stoma itself might start to show signs of swelling or colour change
- Dry mouth
- A decrease in urine output
- In severe cases – vomiting
How to deal with a blockage at home
If you suspect a blockage, it is important that you speak to your stoma care nurse or your GP urgently for their advice. Some less severe blockages can be treated at home with the following tips:
- Increase the amount of fluids you are drinking. Choose fresh fruit juices in addition to water and hot tea. Sometimes carbonated drinks may help.
- Gently massage around your stoma to try to encourage the blockage to work its way out.
- Have hot bath or try using a heat pad, as this may help your abdominal muscles relax so you can pass a bowel movement.
- If your stoma appears more swollen than usual, it may worth checking if the hole of your pouch needs to be cut slightly larger.
- Try lying down and lifting your knees to your chest, rolling gently from side to side.
- For people with a colostomy, your GP or Stoma Care Nurse may prescribe some laxatives, use these as prescribed and don’t forget to drink plenty of water with these as it will help them work better.
- Keep mobile as this will help your digestion and therefore help with the blockage.
Should I avoid any particular foods if I have blocked stoma?
If you have a blockage, it is important to reduce the foods you are eating but you MUST increase your fluid intake.
What do I do if the home remedies have not worked?
- The abdominal cramps become more severe.
- There is no output from the stoma for 8-12 hours
- You are showing signs of dehydration.
- Or you are vomiting
Call NHS 111 for advice or ask a friend or family member to drive you to the A&E department at your local hospital. Do NOT wait to seek medical attention.
What will happen at hospital?
The doctor will ask you about your medical and surgical history. A physical examination will be done and an x-ray will be performed. It may be that the doctor will ask for CT scan to be performed also, depending on what can be seen on the x-ray. Blood tests will be taken if the doctor thinks you are dehydrated and intravenous (IV) fluids may be given to you via a cannula (small tube in your arm).
A naso-gastric (NG) tube maybe inserted through your nose and into your stomach which will relieve you from any vomiting and also help to relieve your stomach. You may be kept in hospital for a couple of days usually until the blockage has cleared. You probably will not be allowed anything to eat until your stomach starts working again, then diet will be very slowly introduced and monitored for any problems. Surgery is usually a last resort if the obstruction cannot be resolved.