Have you noticed that your stoma no longer seems to sit as proudly above your skin as it used to? Perhaps it looks flatter, has started pulling inward, or you are suddenly dealing with leaks that were not a problem before. It is completely understandable to feel worried when your stoma changes appearance.

A retracted stoma can make everyday stoma care more difficult, particularly if output starts getting underneath the adhesive or onto the surrounding skin. The good news is that stoma retraction can often be managed with the right assessment, appliance adjustments and professional support.

Here is what you need to know about the possible causes, signs and retracted stoma management, and when it is important to speak with your healthcare team.

What Is a Retracted Stoma?

A retracted stoma is one that has pulled inward, so that the opening sits at or below the level of the surrounding abdominal skin rather than projecting slightly above it.

Stoma retraction can happen with a colostomy, ileostomy or, less commonly, a urostomy. It may develop shortly after surgery or occur later, so a stoma that changes over time should not simply be ignored.

The degree of retraction can vary. Some people have a mildly sunken stoma, while others may find that the stoma sits noticeably below the skin surface.

What Are the Causes of a Retracted Stoma?

There is not always one single reason for stoma retraction. Several factors can contribute, including changes in the tissues around the stoma.

Common causes of retracted stoma include:

• Tension on the bowel or other tissue used to create the stoma
• Changes in abdominal shape or weight
• Scar tissue around the stoma
• A stoma that was initially positioned under tension
• Changes in the abdominal wall after surgery
• Swelling or changes during the healing process
• Conditions that affect the tissues around the stoma

A stoma may also appear more recessed when the abdomen changes position. For example, it can look different when sitting compared with standing.

This is why your stoma nurse can be so helpful. They can assess the stoma and the surrounding skin in different positions and help determine whether the change needs further treatment.

What Does Stoma Retraction Look or Feel Like?

The most noticeable sign is usually a change in how far the stoma projects from the skin.

You may notice that the stoma appears flatter or seems to sink into the abdomen. Another important clue is a change in how your stoma bag behaves.

Possible signs include:

• More frequent leaks around the base of the stoma
• Output getting underneath the adhesive
• Irritated or sore skin around the stoma
• Difficulty getting the bag to seal securely
• A visible change in the position or shape of the stoma
• The appliance becoming less reliable than it was previously

Remember that not every change in a stoma means there is a serious complication. However, a new or worsening change deserves attention, especially if it is accompanied by leakage or skin problems.

Why Can a Retracted Stoma Cause Leaks?

One of the biggest practical problems with stoma retraction is achieving a good seal.

When a stoma sits below the surrounding skin, output may not flow neatly into the pouch. Instead, it can spread across the skin before entering the bag. This can allow moisture and digestive output to reach the adhesive area.

Repeated exposure to output can make the skin around the stoma sore and can make it even harder for the appliance to adhere properly.

This can become a frustrating cycle: leakage irritates the skin, irritated or uneven skin makes the seal harder to maintain, and the poorer seal can lead to more leakage.

That does not mean you have done anything wrong. Sometimes the appliance simply needs to be adapted to the shape of your abdomen and stoma.

How Is a Retracted Stoma Managed?

The best approach depends on how deeply the stoma has retracted, the shape of the surrounding skin and whether you are experiencing leakage or skin problems.

A stoma nurse can help you find an appliance and accessories that suit your individual needs.

1. Have Your Stoma Assessed

If you notice a new change in your stoma, contact your stoma nurse, GP or NHS healthcare team for advice.

They can examine the stoma, assess the surrounding skin and determine whether the retraction is affecting the seal of your stoma bag.

2. Review the Fit of Your Stoma Bag

A pouching system that worked well before may not work as effectively after your stoma changes shape.

Your stoma nurse may recommend changing the type of appliance or adjusting how it is fitted. Convex appliances, for example, may sometimes be considered when a stoma is recessed, but they are not suitable for everyone and should be selected with professional guidance.

3. Consider Accessories for Uneven Skin

If the skin around the stoma has dips, folds or scars, products designed to fill uneven areas may help create a more secure seal.

These can include barrier rings or other accessories recommended by your stoma care team. The goal is to create a smoother surface around the stoma so that the adhesive can sit securely.

4. Protect the Skin

Keeping the skin around your stoma as healthy as possible is particularly important when leakage is occurring.

If output repeatedly comes into contact with the skin, ask your stoma nurse about appropriate skin-care products and pouching techniques. Avoid experimenting with large numbers of products at once, as this can make it difficult to identify what is helping or causing irritation.

5. Monitor Changes

Once your appliance has been adjusted, keep an eye on how well it is working.

Notice whether leakage becomes less frequent, whether the surrounding skin is improving and whether the stoma’s appearance changes further. Sharing these observations with your stoma nurse can make future adjustments easier.

When Should You Contact Your Stoma Nurse or GP?

A retracted stoma does not automatically mean that you need emergency treatment, but new or worsening changes should be discussed with a healthcare professional.

Contact your stoma nurse or GP if you notice persistent leakage, worsening skin irritation, significant changes in the appearance of your stoma, or difficulty keeping your appliance securely attached.

Seek urgent medical advice if you become significantly unwell or have concerning symptoms such as severe abdominal pain, persistent vomiting, marked abdominal swelling, or a major change in stoma output. If you are unsure whether your symptoms are urgent, contact NHS 111 or your local healthcare service for guidance.

Your own clinical team can advise you based on your medical history and type of stoma.

Can a Retracted Stoma Be Prevented?

Not every case of stoma retraction can be prevented. Some of the factors involved relate to surgery, tissue healing or changes in the abdominal wall.

However, getting the stoma positioned and assessed properly, attending follow-up appointments and addressing changes early can help reduce some of the practical problems associated with retraction.

If your body shape changes, your stoma changes position, or your usual stoma bag suddenly starts leaking, let your stoma nurse know rather than simply putting up with it.

Living With Stoma Retraction: You Do Not Have to Manage It Alone

A change in your stoma can feel unsettling, particularly when it affects something as personal and important as keeping your stoma bag secure.

But stoma retraction is a recognised stoma complication, and there are different ways your care team may be able to improve comfort, skin protection and appliance performance.

If you are experiencing repeated leaks or skin irritation, speak with your stoma nurse, GP or other member of your NHS care team. A small change in appliance fit or technique can sometimes make a meaningful difference.

For additional practical support, organisations such as Colostomy UK and IA (The Ileostomy and Internal Pouch Association) also provide information and support for people living with a stoma.

A Little More Confidence in Everyday Stoma Care

You should not feel embarrassed about asking for help with leakage, skin irritation or changes in your stoma. These are important parts of stoma care, and your healthcare team is there to help you find a solution that works for your body.

Colo-Majic’s biodegradable ostomy liners can also be part of a more convenient stoma-care routine, helping make pouch management easier and supporting a more eco-conscious approach to everyday care. If you would like to try them, you can also look into Colo-Majic’s free sample option.

Internal link opportunity: Link the phrase “biodegradable ostomy liners” to Colo-Majic’s relevant product page, or link to an existing article about preventing leaks or protecting skin around a stoma.