Colostomy prolapse is a complication of colostomy surgery where the bowel protrudes through the stoma. This complication can make it hard to care for the stoma and may affect quality of life.

A colostomy is a surgical procedure that involves making an opening in the abdomen, known as a stoma, to provide an alternative way to eliminate stool. This procedure may help treat various medical conditions, such as inflammatory bowel disease (IBD). Sometimes, the condition is referred to as a stoma prolapse.

A 2022 study notes that conservative treatment usually manages the condition. However, surgery is necessary when the length of bowel protrusion exceeds 6–7 centimeters (cm).

Symptoms may include pain, skin irritation, and bleeding. In rare cases, the symptoms can be very severe and cause problems, such as an obstruction, according to research from 2017.

This article discusses colostomy prolapse, including the symptoms, causes, treatment, and when to seek help. It also provides answers to frequently asked questions.

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A colostomy is a surgical procedure to make an opening in the abdominal wall and bring the end of the colon — or large intestine — through it to the skin. This opening is called a stoma, and it can be temporary or permanent.

When a person without a colostomy has a bowel movement, it passes to the outside of the body through the anus, which is the opening at the end of the colon. In contrast, when someone with a colostomy has a bowel movement, it passes through the stoma into a bag attached to the skin.

A prolapse is one of the potential complications of a colostomy. It happens when the bowel protrudes through the stoma to a greater extent than the surgeon anticipates. The length of the protrusion can range from 2–3 cm to more than 10 cm.

Learn more about colostomies.

Evidence indicates that less severe prolapses may not produce symptoms. When symptoms do occur, the main ones include:

  • skin irritation
  • pain
  • trouble fitting bags that cover the stoma, otherwise called appliances
  • bleeding

In rare cases, symptoms can involve:

  • strangulation, which is the compression of tissues — an effect that hinders circulation
  • incarceration, which is the displacement of prolapsed tissue, where it becomes trapped in the body
  • obstruction, which is a blockage that prevents feces from exiting the body

The most common causes include:

  • obesity
  • an opening in the abdominal wall that is too large
  • poorly developed abdominal muscles
  • physical exertion during activities such as heavy lifting
  • increased abdominal pressure from factors such as:
    • pregnancy
    • tumor
    • sneezing and coughing

According to a 2017 study, risk factors may include:

  • older age
  • a lack of site marking on the abdomen before surgery
  • bowel obstruction at the time of surgery involving the stoma creation

Treatment involves either conservative interventions or surgery, reports a 2020 study.

Conservative interventions

Conservative interventions can usually manage the condition well. These include manual and postural reduction. Manual reduction involves applying continuous pressure to help the bowel return to its proper place.

Postural reduction consists of lying down for 20 minutes to relax abdominal muscles and reduce the pressure within the abdomen. An additional conservative intervention involves measures to reduce swelling.


Surgery is necessary when the bowel protrusion is 6–7 cm. A 2017 study explains that surgical options include:

  • Stoma reversal: This involves reattaching the piece of bowel in the stoma to the colon and then closing the stoma.
  • Stoma resection: This entails removing the diseased part of the bowel in the stoma and pulling a healthy section of the bowel through.
  • Relocation: This procedure puts the stoma in a new location.

If a person experiences any symptoms — such as irritation or bleeding — or has trouble fitting the bag over the stoma, it is time to contact a doctor. A doctor can provide advice about how to care for a prolapse at home, which may include:

  • using a larger bag to accommodate the increased size of the stoma
  • changing the bag more often
  • protecting the stoma from external trauma through means such as avoiding leaning against a counter when cooking and changing the rise of pants to be below or above the stoma

A doctor can also monitor the condition’s severity to know as soon as symptoms necessitate surgery. In cases of very severe symptoms, a delay in surgery can pose risks.

Below are some commonly asked questions on colostomy prolapse.

Is a prolapsed stoma dangerous?

Yes, the most severe grade of a colostomy prolapse involves life threatening symptoms, states a 2022 article. These include:

  • ischemia, which is an inadequate blood supply to the stoma
  • incarceration
  • obstruction

Is it common for a stoma to prolapse?

The incidence varies depending on which part of the colon a surgeon brings through the stoma. If the surgery involves the end portion of the colon, the incidence is 2–10%. However, if the surgery involves the transverse colon — the middle part of the colon — the incidence can be as high as 30%.

Can a prolapsed stoma fix itself?

No, it does not fix itself. Less severe grades of the condition require conservative treatment, while more severe grades may require surgery.

A colostomy prolapse is a potential complication of a colostomy procedure. It occurs when the bowel protrudes through the stoma farther than it should.

Symptoms may include pain, bleeding, and skin irritation, but sometimes serious effects can occur. Causes of the complication may include obesity, heavy lifting, and increased abdominal pressure.

While conservative treatment usually manages the condition, lengthier protrusions of the bowel require surgery.

If a person has even mild symptoms of a prolapse, they should contact a doctor, who can provide special care recommendations and monitor the condition’s development. Severe symptoms are life threatening and necessitate immediate surgery.