A possible complication of an ileostomy is a prolapse of the stoma. This occurs when the stoma protrudes too far outside the skin. A prolapsed stoma is not typically dangerous but can lead to serious complications.

An ileostomy is a procedure in which surgeons create an opening in the abdominal wall and bring the end of the small intestine, called the ileum, out through the incision to form a stoma.

The patient will pass stool through the stoma, rather than through the rectum, and into a bag.

A prolapse — in which the stoma protrudes abnormally, or the bowel protrudes through the stoma — is rare and occurs in 3% of ileostomies.

This article looks at an ileostomy prolapse, its signs and symptoms, its causes, and when to seek medical attention. It also looks at treatment and possible complications.

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A stoma prolapse after an ileostomy can refer to either the protrusion of the stoma, in which the stoma extends further than is typical, or the expansion of the intestine or bowel through the stoma.

The prolapse can occur intermittently, which doctors call “sliding.” It can also be fixed, meaning it does not come and go but is constantly present.

In many cases, an ileostomy prolapse is not a serious cause for concern, and doctors may be able to treat the protrusion at the patient’s bedside or instruct the patient on self-care at home.

In cases where the prolapsed stoma is more than 6–7 centimeters (cm), a person may require surgical treatment. Also, certain complications of an ileostomy prolapse may require immediate medical attention.

Learn more

Learn more about an ileostomy.

There are various signs and symptoms a person may experience that can indicate an ileostomy prolapse. These include:

  • unusual stoma protrusion
  • skin irritation around the stoma
  • difficulty fitting appliances, such as an ostomy bag or pouch
  • bleeding
  • open wounds called ulcerations
  • discomfort around the stoma

Doctors do not always know the exact causes, but certain risk factors may increase the risk of ileostomy prolapse.

Risk factors that may lead to prolapse include:

A person should seek medical attention if:

  • they have not passed stool for several hours and have abdominal pain
  • they are nauseous or vomiting
  • the stoma is dark red, purple, or black
  • the stoma is bleeding
  • at-home treatment does not affect the prolapsed stoma

Doctors can often treat ileostomy prolapse with ice and sugar. They may apply ice or sugar to the stoma, which can cause it to shrink or retreat.

In more severe cases, a person may require surgery. Options for surgery include:

  • Reversal: In some cases, a surgeon can reverse a temporary stoma, but this is not always feasible or possible.
  • Resection: A surgeon may amputate the prolapsed section of the stoma and suture another piece of the intestine to the opening to create a new stoma.
  • Revision: A surgeon may place a sleeve or stent into the stoma.
  • Relocation: The surgeon may open the abdomen, detach the stoma from the opening, and relocate it to a new site.

Learn about the procedure for an ileostomy reversal.

Complications are rare in an ileostomy prolapse but can be serious medical emergencies that require immediate medical attention.

Complications can include:

  • Strangulation: This involves the loss of blood supply to the intestines, which can result in severe pain and may be life threatening.
  • Ischemia: A reduction of blood and oxygen flow to the intestines.
  • Necrosis: Irreversible tissue death caused by reduced blood flow.
  • Incarceration: Intestinal tissue may become trapped outside of the stoma.

Below are answers to some frequently asked questions about ileostomy prolapse.

What does a prolapsed ileostomy look like?

A prolapsed stoma after an ileostomy could be swollen and longer than usual, protruding further out of the body than normal.

It may be sliding, and come and go intermittently, or remain constant.

A prolapsed stoma may also appear darker in color and can be red, purple, or black.

How does someone fix a prolapsed ileostomy?

A person should discuss home treatment with a doctor and seek medical attention before attempting treatment independently.

An ileostomy prolapse may respond to a person lying down on their back to relieve abdominal pressure, using a cold compress to relieve swelling, and using granulated table sugar to remove fluid from the stoma.

If these treatments do not affect the prolapse, a person should contact their doctor.

A prolapsed stoma is a rare complication of an ileostomy. The stoma may protrude farther than usual, or the bowel or intestine may expand through the stoma. The prolapse may be intermittent or constant.

A person may notice signs and symptoms of prolapse, such as skin irritation, difficulty fitting their ostomy pouch, bleeding, and discomfort.

Doctors can often treat a prolapse nonsurgically, but severe cases require emergency medical attention.

This is because a prolapsed stoma can lead to serious, life threatening complications in a small number of cases. These include strangulation, ischemia, necrosis, and incarceration.

A person should seek medical attention if they are vomiting or nauseous, have not been able to pass stool, have abdominal pain, or notice discoloration of their stoma.