A stoma is a surgically created opening on the abdomen that allows for the passage of waste, such as stool or urine, when the body’s natural elimination pathway is no longer functional. This procedure, known as an ostomy, is performed for various medical reasons, including cancer, inflammatory bowel disease, or trauma. Approximately one million people in the United States currently live with a stoma. Understanding the visual characteristics of a healthy stoma is a powerful tool for self-assessment and maintaining well-being.
The Essential Appearance of a Healthy Stoma
A healthy stoma is immediately recognizable by its consistent, deep red or pink color. This vibrant appearance is a direct result of the tissue being composed of intestinal or urinary tract lining, which is rich in small blood vessels. The color is often compared to the mucous membrane found inside the mouth or gums.
The surface of the stoma should look shiny, soft, and moist to the touch. This moisture comes from the constant production of mucus, a natural function of the bowel tissue that helps keep the surface lubricated. A healthy stoma will also have no sensation, meaning it is entirely painless when touched or cleaned, because the tissue contains no sensory nerve endings.
In terms of shape, the stoma is typically round or oval and often protrudes slightly from the abdominal wall, a feature known as being “budded.” While the size and exact degree of protrusion can vary, a common protrusion is between one and three centimeters. The stoma tissue itself is muscular and will exhibit minor movements, often appearing to contract or relax slightly as the digestive system performs peristalsis.
Understanding Different Stoma Types and Locations
The precise location and physical structure of a stoma are determined by the specific surgical procedure and the section of the bowel or urinary tract brought to the surface. Though the color and texture are universally similar, the size and protrusion differ based on whether it is a colostomy, ileostomy, or urostomy. A colostomy, which connects the large intestine to the abdominal wall, is often positioned on the left side of the abdomen.
Colostomies tend to be flatter or only slightly protruding from the skin, as the output is generally more formed or solid. This flatter profile is less likely to cause irritation from the semi-solid waste.
In contrast, an ileostomy, created from the small intestine, is most frequently located on the lower right side of the abdomen. Because the output is liquid and highly corrosive to the skin, it is typically constructed with a more defined spout or protrusion. This spouted design allows the watery contents to drain directly into the collection pouch without pooling against the surrounding skin.
A urostomy, which diverts urine, is also usually constructed with a spout and is often placed higher up on the right side of the abdomen. The spouted creation of a urostomy is necessary to ensure the continuous liquid output does not irritate the delicate peristomal skin.
Visual Indicators of Peristomal Health
The visual assessment of health extends beyond the stoma itself to include the surrounding skin, known as the peristomal skin. Healthy peristomal skin should look intact and smooth, matching the color and texture of the rest of the abdomen. Any signs of irritation, such as redness that does not fade, a rash, peeling, or weeping, can indicate a complication like irritant dermatitis, often caused by leakage of waste beneath the pouching system.
Minor bleeding is normal, particularly when cleaning the stoma vigorously, as the tissue is highly vascular, similar to rubbing a gum line. This slight bleeding should stop quickly and is not a cause for alarm. However, any heavy or continuous bleeding requires immediate medical attention.
Concerning indicators involve changes to the stoma’s color or shape. A healthy stoma should not appear dark purple, black, or dusky, as these colors suggest a disruption to the blood supply that requires urgent intervention. Similarly, a stoma that looks pale or blue may indicate a systemic issue like low oxygen levels.
Significant changes in shape, such as the stoma sinking back below the skin level (retraction) or an abnormal bulging or lengthening (prolapse), also warrant a consultation with a specialized healthcare professional.