Bleeding spot on stoma - need advice!

I have had an ostomy for 25 years and I know the stoma can bleed when wiping or cleaning. I noticed in the past month that I have a small spot on my stoma that bleeds a little more when changing the appliance and sometimes when I rub the area over my stoma to move contents down away from top of bag before I remove the appliance there is blood on edge of wafer from doing this. It does stop and is not coming from inside of stoma. Maybe it is a granuloma or small ulcer? Sometimes it does not bleed after a change. Anyone had experience with this and any suggestions to put over the spot to keep it from rubbing against pouch? The stoma nurse would not see me because the bleeding is coming from the actual stoma and told me to see my G.I doctor, but he told me to see a stoma nurse. I just wanted it looked at to be sure that is all it is. It looks healthy and I have had some small bumps on it for years and was told they were from friction from the pouch. Anyone experience this or have suggestions? (I use Convatec products)

Thanks!

Hi Paige, what you described is exactly what I have: a small, slightly raised spot that bleeds when I wash/wipe around my stoma. I have been taking a small dab of paste on my finger and dabbing it on the spot, letting it dry before putting on the wafer. It doesn't seem to be getting larger or smaller.

Thanks! Does it bleed if you rub the area over your stoma with your pouch on? Mine never used to do that before, but all of a sudden it seems to be more sensitive. The bleeding does stop but just alarming. I did use paste, and then when it rubbed off after I applied the pouch, it bled. Does your bleeding come and go? Wondering if powder with steroid in it will help heal it.

Hi Paige,

Yeah, I have what you have. Could be a couple things, but nothing too serious. I typically wait for mine to stop bleeding before I install the barrier. If you want to prevent it from bleeding once you have your barrier/bag on.......just dab it with some Marathon skin protectant (aka Krazy Glue). But don't use Krazy Glue. If you don't normally use Marathon as a skin protectant then it would get expensive, as a tube costs like 7 to 10, and once you crack it open it will dry out very quickly......so not the economical route to take. You can buy stuff called "Liquid Skin" or the generic "Liquid Bandage" almost anywhere, and it's pretty much the same thing, only much cheaper. Any type of 'thick' skin protectant would work, but not the thinner barrier wipe-on films like Cavilon.

The cause of the bleeding can just be a blood vessel very close to the surface of your skin.......which a dermatologist could cauterize for you, or you could do it yourself, but I don't recommend that. If you've been using topical steroids on that skin, it can be getting "thin" from the steroids. In that case, you've done permanent damage and should really talk to a dermatologist about weaning off and replacing it with something not as damaging.

Hope that helps.

Regards,

Bob

Thanks everyone.... The spot that is bleeding is not on the skin surrounding my stoma... it is right on my stoma, on the mucosa... I stop the bleed with a wet cloth and some powder but the area has become sensitive to the pouch rubbing against it and definitely bleeds more when I clean the actual stoma. Have been fine between pouch changes. The stoma nurse was not very helpful and would not have me come in to look at it since it is coming from the actual stoma and not the skin. Maybe it is an area that keeps healing and then gets irritated with pouch change? Has anyone had a granuloma right on the stoma... on the mucosa? Thinking of putting something on that area on the bag to prevent it from irritating that spot. Not sure what would work.... Vaseline?

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You might also blow a little air in the bag so it does not lay flat on the stoma.

Hi Paige, I can't see if it bleeds with the pouch on as they are opaque. The bleeding only happens when I wash, so I dab it with TP until it stops, then I apply the paste.

Hi Paige,

I understand. I have the same situation as you. Whereas most stomas have the mucosal skin separated from the surrounding abdominal skin....making that nice clean rosebud...my mucosal skin has instead sort of melded with my abdominal skin, so there is no clean separation between the skin types. So I have a lot of mucosal skin around my stoma, and no rosebud. The problem with covering the bleeding area as you suggest, with something like Vaseline, is that it will wipe off fairly quickly. You'd need to cover it with something that lasts longer. And covering a bleeding area is not easy. I'd suggest you get with a wound care nurse and discuss options. I've read, but not seen firsthand, that Tranexamic acid (TA) is currently being used to stop bleeding of mucosal skin. I believe, but have not verified, that it's available OTC under the brand name Cyklo-F, and is used for heavy menstrual bleeding. You can call your pharmacy to see if they have it. The other skin products that have TA in it also have other ingredients to help with wrinkles, etc......so don't know if they'd be as effective. But those are available on Amazon, etc. But chat with your wound care nurse first, as there could be some downsides to TA that I'm not aware of. Or maybe there are better options out there.

Regards,

Bob

I have this too. In my case, it may be an abrasion from the non-functioning air filter on the bags I use. But it doesn't hurt or seem to get worse. Once I had what looked like patchy erosions in the mucosa on the stoma. That freaked me out because I thought it meant ulceration had spread to my small intestine (I have an ileostomy). But it healed on its own. It may also have been abrasions of some sort. I had been wearing a tight-fitting band. I think it's very possible that this is not a problem and not something that needs to add to your worries. Keep your eye on it, clean it, and make sure it doesn't get worse. xx

I seem to get blood quite often, especially after a day of work. It bleeds quite easily. I never worried too much about it. It seems to take quite a bit of abuse. I have a tight band over the top, and it prolapses about 3 inches when I work. Plus, it bleeds when I change it.