In our previous appointment we introduced the topic of stomas, surgical procedures that allow diverting the normal flow of stool or urine to an opening created on the abdomen, highlighting in particular the differences between colostomy, ileostomy and urostomy. Stomas, whether temporary or permanent, require daily care and constant attention in order to ensure their functionality and prevent possible complications. However, like any surgical procedure, they may present adverse consequences, including cutaneous and fascial stenoses of the stoma’s external opening. Essentially this phenomenon consists of the progressive narrowing of the skin and fascial opening, which can hinder the proper passage of stool, causing discomfort and difficulties in stoma management.
When stenosis occurs
Stomal stenosis often develops as a consequence of other complications involving the stoma complex, such as abscesses, suppuration, ischemia, necrosis, fistulas, or separation of the mucocutaneous junction. During the healing process, these conditions may promote the formation of scar tissue around the stoma, leading to a narrowing of the opening. In addition to these complications, stenosis may arise for other reasons, including excessive tissue tension at the time of surgery, local infections or chronic irritation, skin incisions that are too tight or suboptimal in shape, trauma, or incorrect stoma management through the use of inadequate appliances or excessively rigid adhesives.
Management, prevention, and daily care
The treatment of stenosis varies depending on its severity:
- In mild cases, manual or mechanical dilations performed by qualified healthcare professionals may be sufficient.
- In more severe cases, a new surgical procedure may be necessary to properly restore the opening.
In the presence of a stoma, prevention plays a fundamental role. Constant monitoring by a stoma care nurse is essential. This professional, within the field of proctologic and pelvic nursing, manages the stoma patient through targeted interventions in prevention, care, rehabilitation, and health education. Even at home, the stoma patient must provide daily care to their stoma to prevent the onset of stenosis. It is important to:
- Regularly check the shape and patency of the stoma.
- Use appropriate appliances, selected with the support of a healthcare professional.
- Maintain proper skin hygiene and good hydration.
- Promptly report any changes in the flow, color, or appearance of the stoma.
The role of stoma dilators in managing stenosis
In cases of stomal stenosis, there are several therapeutic options to restore or maintain proper stoma function. Among these, stoma dilators play an important role; these are instruments designed to maintain or recreate an adequate stoma opening. These medical devices, when prescribed by a specialist, can also be used at home, allowing the patient to perform a progressive and controlled home dilation therapy. The goal is to prevent worsening of skin or fascial narrowing, facilitate normal stool passage, and improve daily comfort. Regular and supervised use of these devices can help reduce pain, avoid traumatic maneuvers, and maintain long-term stoma functionality. As with any treatment, it is essential that the patient strictly follows the instructions of the surgeon or stoma care nurse, who will determine the timing, methods, and sizes best suited to ensure a safe and effective outcome.
Living with a stoma: a normal life is possible
Today, thanks to advances in appliance technology, people with a stoma can lead a completely normal life. Modern collection bags are discreet, secure, and waterproof, allowing for showering, swimming, or going to the beach without any risk. The materials used are designed to ensure perfect adhesion, comfort, and odor control, enabling sports, travel, and social participation without limitations. Nevertheless, some misinformation still persists: many people associate a stoma with “illness” or “disgust,” when in reality it is a life-saving procedure that restores autonomy and health. Open discussion about stomas, awareness of new solutions, and overcoming taboos are essential to break stigma and promote a culture of respect and inclusion. Spreading accurate information and raising awareness is the first step toward improving the quality of life for people with stomas and fostering a more informed and welcoming society.
The contents of this page are for informational purposes only and should in no way replace the advice, diagnosis, or treatment prescribed by your physician. Responses to the same treatment may vary from patient to patient. Always consult your doctor regarding any information related to diagnoses and treatments, and meticulously follow their instructions.
