You have no stoma output for 24 hours or even more? Then it is high time for you to run to the closest emergency department, because you are very likely to face a stoma blockage!

But let’s imagine something a little less scary. Having a dry mouth and feeling bloated can already be signs for a blockage. Being aware of those and other symptoms of a blocked stoma enables you to deal with a blockage at home – and you can probably handle it without another visit of the hospital. Sounds lovely, right?

Therefore, we will explain to you in the following the symptoms and causes of a stoma blockage, ways to prevent it, and what to do if you assume a stoma blockage – and what definitely not to do!

23 of 100* ostomates have had a stoma blockage at least once. Common symptoms are stomach ache, a dry mouth, feeling bloated, or a swollen stoma. To deal with a blockage, you can try to increase your fluid intake, put heat on your belly, gently massage your abdominal muscles, and take a walk. 

If there is no sign of improvement, contact your GP or the closest hospital.

*This survey was conducted in April 2021 among international stoma patients. The data results from 57 voluntary respondents. It was published in the following stoma-specific Facebook group “Ileostomy,colostomy, stoma and bowel support”.

Quick facts about stoma blockage

Some people refer to stoma blockage as bowel obstruction.

The most common causes of stoma blockage are poorly digested food and insufficient stoma hygiene.

A complete stoma blockage requires immediate medical attention for its quick resolution.

Blocked ileostomies usually become symptomatic more quickly than blocked colostomies.

What are the signs and symptoms of a blocked stoma?

Usually, you know you have a stoma blockage by looking at the stoma pouch. If the pouch is empty when it should have been filled up, you know there’s something wrong going on.

In addition to the empty stoma bag, the symptoms and signs of a stoma blockage can be some of the following: 

• Stomach ache that is intense and with a crampy character 
• Low stoma output or constipation
• Swollen stoma
• Nausea
• Vomiting
• Feeling bloated
• Dry mouth
• Low urine output
• Less appetite

Does a stoma blockage happen abruptly?

A stoma blockage, especially a blocked colostomy, might last for many hours before it manifests itself with symptoms and signs. In the first days, as the blockage builds up, you might feel constipated.

How does constipation feel like for a stoma patient? Here are some examples:

• You might feel full in the stomach or below it, in the pelvic area
• You might experience bowel cramps
• You might feel discomfort in the epigastric or pelvic region
• You might experience pain that radiates in the back

For an ileostomy, the exact opposite might happen. A blocked ileostomy usually becomes symptomatic quickly and it often is a matter of hours for it to become dangerous for your health.

A blocked ileostomy manifests quickly because of anatomical reasons: it is located in the small bowel, where stools have not yet been formed. Therefore, having Ileostomy stomach cramps should not be neglected.

Different types of stoma blockage

There are two main types of stoma blockage – partial blockage and complete blockage:

• Partial blockage: A partial stoma blockage may allow some liquid or gas to pass through the bowel obstruction and make it to the stoma pouch. As a result, you might see some liquid or mucus-like content in the pouch, but no stools at all. 
• Complete blockage: A complete blockage does not allow any kind of content to reach the stoma pouch, resulting in an empty pouch.

What are the causes of a stoma blockage?

The most common cause of stoma blockage are:

• Poor hygiene of the stoma
• Poorly digested food
• Local inflammation
• A twisted boweL
• Strangulation of the bowel due to parastomal or abdominal hernias
• Adhesions and scar tissues due to previous surgeries

A healthy peristomal skin is not only important to avoid blockage, but also to prevent almost any kind of issue related to skin irritations, stoma- or appliance issues.

It is therefore crucial to master your peristomal skincare routine.

How? We are telling you in this article all the details. Once you got it, it will be super easy for you to always ensure a healthy and happy stoma – and you.

How to deal with a blocked stoma

Although many suggest you can deal with a blocked stoma at home, it might be dangerous to risk it. The best stoma blockage treatment is to go to the hospital and receive medical care and attention. 

Bowel obstructions might cause your bowel to burst, leading to an acute abdomen. The health of your bowel depends on the frequency you evacuate and on the quality and quantity of your stools. Also, the functionality of your stoma depends on the movement habits of your bowel. 

A lazy bowel might indicate an obstruction. As a general rule, there are some things you can do and some others you shouldn’t when you have a blocked stoma:

DOs and DONTs for stoma blockage treatment

Whatever the type of ostomy you have, don’t do any of the following:

• Take laxatives without advice from your doctor.
• Eat more hoping that you will make your bowel move again.
• Insert anything in your stoma.
• Ignore the signs and symptoms.

The following is a list of things you should do at home when you suspect a stoma blockage:

• Stop eating solid foods.
• Keep yourself hydrated by increasing your fluid intake like warm tea or fresh fruit juices. Carbonated drinks, like coke, could also help in partial blockages. However, they don’t seem to be helpful in complete blockages, the production of gas rather increases the pain.
• Try some coffee. Although for some coffee is not the best beverage to drink because it has an excitatory effect on the bowel and might lead to painful bowel contractions, others find relief.  
• Take a warm bath to relax your abdominal muscles.
• Put some heat on your belly to allow your muscles to relax.
• Gently massage your abdominal muscles and encourage the area around the stoma to help the blockage and pass a bowel movement.
• Stay mobile. Take a short and slow walk or just walk slowly around your house and  try doing some gentle exercise by lifting your knees to your chest.
• Check whether you need to enlarge a bit the hole of your pouch and relieve the swollen stoma.
• Contact your GP or your stoma nurse. He or she might prescribe you some laxatives. Don’t use any laxatives without a medical prescription.

What happens at the hospital

Upon your arrival at the hospital, the doctor will take your medical and surgical history and perform a physical examination. Afterward, you will undergo an abdomen x-ray or another imaging test to seek for signs of bowel obstruction. 

If your doctor suspects dehydration, he or she will suggest that you have a blood exam along with the administration of intravenous fluids. 

If you arrive at the hospital with nausea or vomiting, your doctor might administer some anti-nausea drugs and might insert a nasogastric tube through your nose and to your stomach. This tube will relieve your stomach. The medical team is going to keep you at the hospital with no food until they see bowel movements that indicate blockage resolution. Once your blockage is over, they will introduce to you a special diet to help your bowel function again. 

However, in severe bowel obstructions, surgery might be the only solution.

What helps a trapped wind with a stoma?

Some people might feel bloated or experience crampy abdominal pain due to trapped gas that cannot be relieved. To avoid false alarms, all you have to do is be aware of what you eat. In the following you can find our tips: 

The best way to avoid having trapped wind with a stoma is to restrict yourself from eating foods that produce more gas than others. An example are high-fiber foods that are more prone to creating a blockage through undigested parts. You also might want to remove the peel of fruits and vegetables because it is hard to digest and might lead to a blocked stoma. 

How to prevent a stoma blockage? Diet recommendations

General recommendations suggest that the sooner you start eating again after stoma surgery, the quicker your bowel will function.

The secret is how well you chew your food. Most surgeons suggest you can eat anything before and after the surgery, as long as it is healthy, easily digested, and chewed well. However, your body signs are the only ones you should trust and pay attention to.

Do not forget that a portion of healthy food is not always easily digestible. 

General tips to prevent stoma blockage include the following:

• Eat small portions often to help your bowel recover.
• Eat soft and easily digestible foods.
• Pay some extra attention to chewing your food well.
• Supplement your diet with extra protein and vitamins especially if your appetite is low. 
• Increase fluid intake, especially water and fresh fruit juice.
• Start with bland foods, such as yogurt.

Besides that, we suggest you to use the Bioderm Stoma Plus regularly, since this ostomy specific cleanser prevents your skin from irritation and from further aggravation of the problem.

Q&A

Could you still not find the answer to your question? We have collected the most frequently asked questions related to stoma blockage:

How long can a stoma blockage last?

A stoma blockage can last from hours to days unless it resolves by itself or you go to the hospital. Waiting for a long time might pose a severe risk for your health. In general, a colostomy blockage can last longer than an ileostomy one, due to the different anatomical and functional roles of the large and the small bowel.

What happens when a stoma stops working?

When a stoma stops working you might feel symptoms and spot some signs of stoma blockage. Your stoma bag will probably be empty and you might feel bloated or have a stomachache. Furthermore, you may have a swollen stoma.

How often should a colostomy have output?

People with a colostomy usually empty their bag around 6 to 8 times per day. However, there is no general rule on how often a colostomy should have output. The frequency of stoma output depends on what and how often you eat.

How do you get rid of an ileostomy blockage?

To get rid of an ileostomy blockage you have to adjust your diet, drink more fluids, and try to manually relax your abdominal muscles. It is also important to stay active. Ileostomy patients should not take laxative because they are at high risk of severe dehydration. If your blockage lasts for too long, we recommend that you go to the hospital.

What does an ileostomy blockage feel like?

An ileostomy blockage causes stomach cramps, combined with feeling bloated. You might feel discomfort and see changes in your stoma, such as swelling. Also, coughing might result in a pressure feeling in your stomach area.

How do you know if your colostomy is blocked?

It can be the first sign of blockage if your bag is empty when it should have been filled up. Other signs include abdominal pain, stoma swelling, nausea, vomiting, and the feeling of being bloated. Adjusting your diet and following some of the tips mentioned above can be helpful. If you don’t see signs of improvement, contact the hospital immediately. 

Can you have a bowel obstruction and still poop?

A partial blockage might allow some intestinal content to reach the stoma pouch. A complete blockage leaves the stoma bag empty. So, having a bowel obstruction and still pooping depends on the type of bowel obstruction. 

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