Possible Stoma Blockage Questions

I have had my colostomy for just over a month. Once my output stabilized, I started having my bowel movements for the first two hours each morning, with only minor outputs the rest of the day, until yesterday that is.

Yesterday, my output was limited to a single, small and very firm stool. Today, nothing yet except for tiny amounts of mucus/liquid and air. It's possible this is related to having mushrooms on my sandwich the days ago, but I don't know for certain.

I reduced my food intake to just a tiny amount yesterday, and so far today, only liquids. There is no pain, no swelling, no nausea.

I am in a foreign country and we fly home in three days. I really hope to avoid checking into the local hospital if I can. I had a very bad experience last time with local medical care.

My questions include:

1. Before this stoma, it wasn't completely uncommon to have a day with little to no bowel movement. Is it the same with a colostomy?
2. I have no local doctor or stoma nurse to call or visit, only clinics where the language barrier is a real issue. Should I be going to an urgent care facility today anyway? Do other ostomates sometimes have days with little or no output?
3. Any other guidance you can offer?

Thank you!

Hello,

I've had my colostomy for about 16 months.

The output does follow my bowel cycle before I got the colostomy. Sometimes, I go 2 days with nothing coming out of my stoma, no matter how much food I ate.

Yesterday, I emptied my bag twice in one hour. Just the way it goes.

Before my colostomy, I would have a bowel movement once every couple of days. Then every once in a while, 2 BMs in one day. Just the way my body works.

As long as you have no pain or fever, you should be good. Pain and fever can indicate blockage.

IMO, if you're not having any abdominal pain, you're not blocked. Drink lots of liquids, no need to lower your food intake, and enjoy your time. I have days where I poop a bunch and days where I poop none, it's all normal nowadays. I'm guessing that being in a not normal environment (another country), your normal food routine has been disrupted and that can change what you think is your normal pooping routine. Dang, BeachBoy typed faster than me. 😁 Go enjoy.

Thank you for this. As I'm sure you understand quite well, being new to a stoma means lots of questions and often accidentally finding something scary on Google... which is what happened here. I read a couple of sites that said 8 hours without output meant to get immediate medical treatment...

I'm going for a long walk now, hopefully that will stimulate my output so I can again set my overactive imagination to rest. 😉

The timing of the replies in no way diminishes their value. Thank you so very much. As I replied to Beach Boy, I am seeing behaviors I'm not yet familiar with, leaving me filled with questions and having unfortunate access to Google...

Thank you again, this is very helpful.

Words of Encouragement from Ostomy Advocates I Hollister

Just like you... I was freaked out the first couple of months with my colostomy. Over time, you'll get used to it.

The first few times I changed the wafer, it took 2 hours! I used to think, "Damn, this sucks!"

Now, it takes 15 minutes. Not a problem at all. One thing to keep in mind... changing the wafer too often will irritate and tear up the skin around your stoma (called peristomal skin). I go 7 days between wafer changes. I use a 2-piece Hollister system, so bag changes are easy. Snap the old one off, snap a new one on. Real handy if you're in a hurry and don't have time to drain a half-filled bag. I use the plastic disposal bags that come in the Hollister pouch box.

How would I know if I have a blocked stoma?

• So, what are the symptoms of 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 stoma blockage. A partial blockage is when a small amount of liquid can make it around 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.

• For a person with a colostomy, a blockage might not cause pain. If you experience symptoms like sweating or nausea, then you should go to the hospital.

• Another symptom of a blocked stoma, 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

    • Nausea

    • The stoma itself might start to show signs of swelling or color change

    • Dry mouth

    • A decrease in urine output

    • In severe cases – vomiting

Small update. I read that cutting the stoma hole bigger may make a difference. It was a small difference, but I did pass a very small stool. It was very dense and somewhat pliable, but nothing like my normal stool.

I'm concerned that there may be a larger chunk of what I passed today that is impeding my normal movements.

I'm in a foreign country for two more days, then flying internationally with an overnight layover, so I'll be at my destination airport in 4 days.

Medical care here has been the worst. I don't have anywhere to buy an irrigation kit. I've had a total of around 18" or so of end colon removed, starting at the sigmoid.

Would I be able to safely use a regular enema bottle to irrigate and possibly help get things moving?

Some less severe blockages can be treated at home using the following tips on how to unblock a stoma:

• 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 a 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 be 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.

• If you have a blocked stoma, it is important to reduce the foods you are eating but you MUST increase your fluid intake.