Most stoma issues involve skin care, leakage, hydration, or supply problems. Always check product availability, encourage patients to contact their stoma nurse for clinical issues, and provide compassionate, non-judgmental support.
1. Peristomal Skin Problems
- Irritation / rash: Caused by leakage of stool/urine onto skin.
- Allergic reactions: To adhesives, wipes, or barrier products.
- Yeast/fungal infections: Often appear as redness, itching, or satellite spots around the stoma.
Pharmacy tip: Recommend stoma powders, barrier wipes/creams, and refer to stoma nurse for persistent issues.
2. Leakage & Appliance Problems
- Poor fit of appliance → leaks, odour, embarrassment.
- May be due to stoma shape changes, weight gain/loss, hernia, or skin folds.
Pharmacy tip: Ensure correct appliance supply, suggest barrier rings/pastes, and refer to stoma nurse if leaks continue.
3. Blockages (Bowel Stomas)
- Symptoms: cramping, bloating, no output, watery output, nausea/vomiting.
- Often caused by undigested food, adhesions, or stoma narrowing.
Pharmacy tip: Advise patients to chew food well, drink fluids, and seek urgent medical help if pain is severe or output stops.
4. High Output (Ileostomy)
- Output too watery or too frequent → dehydration, electrolyte imbalance.
- Can cause fatigue, dizziness, kidney problems.
Pharmacy tip: Remind patients about hydration, oral rehydration solutions, and refer if symptoms are persistent.
5. Stoma Prolapse or Retraction
- Prolapse: Stoma protrudes more than usual.
- Retraction: Stoma sinks below skin level, making pouching difficult.
Pharmacy tip: Cannot be managed in pharmacy — refer to stoma nurse or surgical team.
6. Parastomal Hernia
- Bulge around the stoma caused by weakened abdominal wall.
- May cause difficulty fitting appliances.
Pharmacy tip: Suggest support garments if appropriate but always refer to stoma nurse/GP.
7. Psychological & Lifestyle Challenges
- Body image issues, embarrassment, odour concerns, anxiety about leaks.
- Social isolation is common.
Pharmacy tip: Provide reassurance, be discreet, and signpost to support groups or stoma nurses.