Not Everyone Knows

The experience of having a new ostomy can be quite frightening if one does not understand what is normal in stoma appearance and ostomy function and what is not normal. Although each ostomate is uniquely individual, there are some basic generalizations which can be cited in the postoperative period. For example, the normal, healthy stoma is bright red in appearance, resilient to the touch and may bleed slightly if rubbed when the peristomal skin is being cleansed. A marked change in stoma mucosa color or appearance should be reported to the physician or enterostomal therapist. Also, bleeding from inside the stoma (whether urinary or fecal) should signal a call to the physician for further testing.

It is normal for an individual with an ileal conduit or sigmoid conduit urinary diversion to have some mucus in the urine. Drinking sufficient amounts of water (8-10 glasses per day minimum) will help to keep the urine and mucus diluted.

It is normal for the skin surrounding the ostomy to be in the same condition as the skin on other portions of the abdomen. Redness, rashes, urine crystal buildup, etc., are not normal and should be reported to the enterostomal therapist or physician.

In individuals with colostomies and ileostomies who still have a rectum intact, it is normal to expel mucus through the rectum. The mucous membrane lining the rectum will continue to produce mucus, even though an individual is "re-routed."

It is normal for the stoma to change slightly in shape and size due to peristalsis (contractile motion of the bowel which propels contents through the intestinal tract). However, marked swelling, prolapse, or shrinking in size of the stoma should be checked by a professional.

It is normal for some colostomates and ileostomates to feel as though they still need to have a bowel movement (phantom rectal sensations) even though the rectum has been removed. The sympathetic nerves responsible for rectal control are not interrupted during surgery and therefore the sensations are still present. Knowledge of this fact may alleviate anxiety.

In summary, get to know your stoma and what is normal for you. Only by recognizing the norm can one know when and if a problem develops.