You notice something looks different when you change your stoma bag. Perhaps there is a little more blood than usual, your skin is suddenly sore, or your stoma seems swollen. Your first thought may be, “Is this normal, or should I be worried?”

It is completely understandable to feel uncertain. After stoma surgery, you become familiar with your own routine, so even a small change can feel alarming. The good news is that many stoma problems can be managed with the right advice — and knowing which symptoms need prompt medical attention can give you much more confidence.

This guide explains some of the most common ostomy complications, what they may look like, and when it is important to speak with your stoma nurse, GP or NHS 111.

What Are Common Ostomy Complications?

Stomas can work very well for many years, but problems can sometimes develop around the stoma, the surrounding skin or the digestive system.

Some stoma complications are relatively minor, while others require prompt assessment. Common problems include:

• Sore or damaged skin around the stoma
• Stoma bleeding
• Infection
• Swelling or changes in the appearance of the stoma
• A prolapse or retracted stoma
• A parastomal hernia
• Changes in stoma output
• Dehydration
• A stoma blockage or bowel obstruction

The important thing is not to diagnose yourself based on one symptom alone. Your stoma nurse or GP can assess what is happening and advise you on the appropriate next step.

1. Sore or Damaged Skin Around the Stoma

The skin around your stoma should generally be protected by a well-fitting appliance. If the area becomes red, sore, broken or persistently irritated, it is worth getting advice rather than simply putting up with it.

Leaks, frequent appliance changes, friction or an opening that does not fit closely around the stoma can contribute to skin problems. Colostomy UK recommends speaking with a stoma care nurse if you are experiencing ongoing sore skin or leakage.

Your stoma nurse can check the fit of your stoma bag and help identify what may be causing the irritation.

Contact your stoma nurse or GP if:

• Skin soreness continues or gets worse
• The skin is broken or weeping
• Your stoma bag repeatedly leaks
• You are struggling to get your appliance to stay securely in place
• The shape or size of your stoma has changed

You do not have to wait until the problem becomes severe before asking for help.

2. Stoma Bleeding: When Is It a Concern?

Seeing blood around your stoma can understandably cause panic. A small amount of bleeding can sometimes occur because stoma tissue is delicate and may bleed when rubbed during cleaning or appliance changes.

However, bleeding that does not stop, bleeding coming from inside the stoma, or a large amount of blood in your stoma bag should not be ignored. Colostomy UK advises seeking medical advice without delay if bleeding does not stop or is coming from inside the stoma.

When to seek urgent help for stoma bleeding

Contact your GP urgently or NHS 111 if you have a significant amount of blood coming from the stoma or into your bag. NHS guidance lists heavy stoma bleeding as a reason to seek urgent medical advice.

If you are unsure whether the amount of bleeding is concerning, it is safer to ask your healthcare professional rather than trying to judge it yourself.

3. Stoma Infection

A stoma infection can affect the area around the stoma and may require medical treatment. Signs that something may be wrong include increasing redness, soreness, swelling or other changes around the stoma, particularly when these symptoms are getting worse rather than settling.

A high temperature or feeling hot, cold or shivery can also be a warning sign of infection. NHS guidance recommends urgent medical advice if someone with a colostomy or ileostomy develops these symptoms.

If you suspect an infection, contact your stoma nurse or GP. If symptoms are severe or you need urgent advice, NHS 111 can help you decide what to do next.

4. Stoma Blockage or Bowel Obstruction

One of the complications that deserves particular attention is a stoma blockage.

A blockage can cause stoma output to slow down considerably or stop. You may also experience abdominal cramping, swelling, nausea or vomiting. Colostomy UK notes that a blockage can be partial or complete, meaning some liquid or gas may still pass even when there is an obstruction.

For someone with an ileostomy, a stoma that becomes inactive for more than 12 hours is specifically listed by the NHS as a reason to seek urgent medical advice.

Warning signs of a possible blockage

Watch for a combination of symptoms such as:

• Much less output than is usual for you
• No output when you would normally expect some
• Abdominal cramps or significant tummy pain
• Swelling around the abdomen or stoma
• Nausea or vomiting
• Signs of dehydration

If you experience these symptoms, contact your stoma care nurse, GP or NHS 111 for advice. Severe pain, persistent vomiting or other serious symptoms require urgent assessment.

5. Dehydration and Changes in Output

Staying hydrated can be particularly important for people living with a stoma. The NHS notes that both colostomy and ileostomy patients can experience dehydration. Signs can include tiredness, a dry mouth and unusually high stoma output.

This is especially important if your output suddenly becomes much more frequent or watery than normal.

If you notice a significant change in your output or symptoms of dehydration, speak with your stoma nurse or another healthcare professional. They can advise you based on your individual stoma and medical history.

6. Prolapse, Retraction and Hernias

Sometimes the physical appearance of a stoma changes.

A prolapse happens when the stoma extends further out than usual. Retraction is when the stoma moves back towards or below the skin level. A parastomal hernia can cause swelling or a bulge around the stoma.

These changes do not necessarily mean that something dangerous is happening, but they should be assessed by your stoma nurse or GP. The NHS notes that different appliance types or other treatments may sometimes be used depending on the problem.

If you suddenly notice a significant change in the appearance of your stoma, contact your healthcare team for advice.

When Should You Seek Medical Help?

It can be difficult to know whether to wait, call your stoma nurse or seek urgent help. A useful approach is to pay attention to changes from what is normal for you.

Contact your stoma nurse or GP if:

• Your skin remains sore, red or damaged
• Your stoma has changed in size, shape or position
• You are experiencing repeated leaks
• You have ongoing discomfort around the stoma
• You are concerned about bleeding
• Your usual output pattern has changed
• You are unsure whether a new symptom is normal

Seek urgent advice from your GP or NHS 111 if you have:

• A large amount of blood in your stoma bag or coming from the stoma
• Severe abdominal or tummy pain
• Significant or worsening swelling
• No stoma output for longer than is normal for you
• An ileostomy that has been inactive for more than 12 hours
• Nausea and vomiting
• Signs of dehydration
• A high temperature, or you feel hot, cold or shivery

These symptoms can sometimes indicate infection, dehydration or bowel obstruction and should be assessed promptly.

If you feel seriously unwell or believe you need emergency medical attention, seek emergency help rather than waiting for a routine appointment.

What Can You Do When Something Changes?

When you notice a new symptom, try not to panic. Instead, take a moment to compare it with your usual stoma routine.

A simple checklist:

1. Look at the change. Note what is different from your normal appearance or output.
2. Check how you feel. Pay attention to pain, nausea, fever, dizziness or unusual tiredness.
3. Check your output. Has it slowed, stopped or increased significantly?
4. Contact your stoma nurse or GP if you are concerned or the problem continues.
5. Seek urgent advice if you have severe symptoms or any of the warning signs above.

Keeping track of your usual stoma output and appearance can make it easier to recognise changes early.

You Do Not Have to Handle Stoma Problems Alone

One of the hardest parts of living with a stoma can be wondering whether a problem is “serious enough” to ask about. Please remember that your stoma nurse is there to support you, including with problems that may feel embarrassing or difficult to explain.

You can also find practical information and peer support through organisations such as Colostomy UK and the Ileostomy & Internal Pouch Association (IA). Colostomy UK also provides information on common stoma problems and has a dedicated helpline.

Most importantly, you know your own normal better than anyone. If something has changed and it does not feel right, asking for professional advice is always reasonable.

Final Thoughts

Ostomy complications can be worrying, but recognising the warning signs can help you respond calmly and promptly. Changes such as sore skin or minor irritation may be manageable with support, while heavy bleeding, severe pain, dehydration, infection symptoms or a possible blockage need more urgent attention.

When in doubt, speak with your stoma nurse or GP, and use NHS 111 when urgent advice is needed. You never need to feel embarrassed about asking for help — your healthcare team has seen these problems before and is there to support you.

At Colo-Majic, we believe stoma care should feel a little easier and more comfortable. Our biodegradable ostomy liners are designed with everyday care in mind, and you can explore Colo-Majic or request a free sample to see whether they are right for your routine.

Suggested internal link opportunity: Link the phrase “biodegradable ostomy liners” to Colo-Majic’s product page or an existing article explaining how its liners work.