Bleeding from the stoma can be alarming, but in many cases, it’s minor and not a cause for concern. Learn about common causes, when to seek medical attention, and how to prevent irritation to keep your stoma healthy.
Should I be Worried About Bleeding From My Stoma?
Bleeding from the stoma can be concerning, but in many cases is minor and not a cause for alarm. The stoma is rich in blood vessels, making slight bleeding typical and expected. It is particularly common in the weeks following surgery as the stoma heals but can also occur due to routine cleaning and friction from the bag. It is important to recognize when bleeding is normal and when it may indicate an underlying issue that requires medical attention. Much of the following general information is for ileostomies and colostomies but can also be applied to urostomy stomas.
Possible Causes of Bleeding
1. Cleaning and Irritation
Bleeding is often caused by routine cleaning. The stoma is made from the same tissue as your gums. Sometimes, if you brush your teeth too hard, you get some bleeding from your gums, and it stops. The same thing may happen when cleaning your stoma.
Preventative measures include patting instead of wiping. Here’s more information on routine care and cleaning. If bleeding occurs but stops quickly, it is usually not a cause for concern.
If you notice bleeding during cleaning, first examine the stoma and the surrounding skin to determine its source. Then gently apply pressure to the source using a clean wipe; this usually stops minor bleeding.
2. Skin Irritation
Bleeding from the skin around the stoma is usually due to irritation from a leaking or ill-fitting pouch. Speak with your Nurse Specializing in Wound, Ostomy, and Continence (NSWOC) or health-care provider about achieving a proper fit and using the most suitable products. You can also refer to this article on skin irritation under the ostomy flange.
3. Granulomas
Granulomas are small, raised areas on or around the stoma that can bleed easily, but are not harmful. They form due to excessive tissue growth, often due to irritation or an ill-fitting pouch. If granulomas cause persistent bleeding, consult your NSWOC or health-care provider for management options.
When to Seek Medical Attention
While minor bleeding is normal, persistent or heavy bleeding requires medical attention. Contact your health-care provider if:
- Bleeding lasts longer than 10 minutes.
- You notice blood in your stool or are unsure whether the bleeding is from the external stoma or internal bowel.
- You notice blood in your urostomy bag. (This can be a sign of a urinary tract infection (UTI).)
Signs of a Medical Emergency
Go to the emergency room or seek urgent medical attention if you experience:
- Bleeding that does not stop.
- No stoma output for more than four hours. (This can be a symptom of a bowel obstruction.)
- Severe abdominal pain, nausea, or vomiting. (These can be symptoms of a bowel obstruction.)
- Signs of dehydration, including reduced stoma output, dizziness, light-headedness or reduced oral intake.
Additionally, certain medications like aspirin, warfarin and other blood thinners can increase the risk of bleeding. If you take these medications and experience unusual bleeding, consult your health-care provider.
Conclusion
Occasional minor bleeding from the stoma is normal, but persistent, heavy or unexplained bleeding should never be ignored. Understanding the potential causes and knowing when to seek medical help can ensure your stoma remains healthy and functions properly. If you experience prolonged bleeding, blood in your stool or signs of dehydration, contact your health-care provider or seek emergency care. Proactively addressing concerns early, such as by preventing irritation and being gentle with the stoma, can help prevent complications and promote overall well-being.
Source
By Erika Kana, RN, Content Writer, Ostomy Canada Marketing Team.
Erika Kana is a Calgary-based Registered Nurse and health content writer. She has experience in geriatric and medical-surgical nursing and specializes in emergency nursing. Her diverse nursing experiences have sparked an interest in wound and ostomy nursing. Erika regularly seeks out ways to learn more about ostomy management and research.
7 Responses
It comes out quite a few times . A lot comes out of me regarding probably what I eat.
Hi Gloria,
Bleeding from the stoma isn’t usually affected by what we eat. However, it is possible if you’re eating certain red foods, like beets, tomato juice, or cherry flavoured drinks, that these can mimic the look of blood. Additionally, if you are concerned or if you have more bleeding then normal, it’s worth checking in with your healthcare provider for an assessment.
Let me know if anything is unclear
Wow. Was shocked to read about the urgency to seek medical help if there has not been output for over four hours. I have had that happen for over a full 32 hours. Thinking I need to consult my Dr.
Is it normal to for the stoma to swell up, be quite red with bleeding? I am 2 months post-op. It had shrunk, but is reverting back.
Thank you for reaching out and sharing your situation. To help us better understand and advocate for your needs, please fill out the Medical Lifestyle Advisory form at the following link:
https://www.ostomycanada.ca/medical-lifestyle-advisory-committee-questions/#mlac-questions
I have had a bladder stoma for 5years. For the past 3 years periodically pure blood fills up the whole stoma bag. This used to happen for 1 night every 3weeks then the next day it is normal again.
However the last nearly 2years things have changed . I have it for a couple of days and this is every month or less. I have taken photos to show the doc and specialist but was told couldn’t investigate because I am very prone to bladder infections. Surely there a reason for this ?. I am on blood thinners because of a heart murmur or such… is this why ?
Thank you for reaching out and sharing your situation. To help us better understand and advocate for your needs, please fill out the Medical Lifestyle Advisory form at the following link: https://www.ostomycanada.ca/medical-lifestyle-advisory-committee-questions/#mlac-questions