September 2008
Page 5


Narrow!

Stomal Stenosis

Stomal Stenosis is a narrowing of the lumen of the stoma as it passes through what is referred to as the fascia (located an inch or so below the ostomy opening) or a narrowing of the ostomy opening due to a tightening of tissue about the ileum or ostomy. The peristomal hernia is a widening of the defect of the abdominal wall through which the ileum passes to reach the surface. If this defect becomes too large, then more ileum can move into the space between the skin and the lining of the abdominal cavity. The ileum in this space can then twist or kink on itself and cause a blockage. Any type ostomy can become stenosed. Your doctor can help resolve this by several methods. Stenosis that develops right after surgery is usually attributed to mucocutaneous separation - the stoma separating from the skin to which it is sutured.

Stenosis that develops later may be caused by disease (Crohn's or tumor), excessive scar tissue formation at the skin or fascial level, trauma resulting from improperly fitting equipment, hyperplasia or chronic irritant dermatitis or peristomal skin.

Preventive measures include maintenance of a secure pouch seal to prevent peristomal skin breakdown, urine acidification measures, prompt treatment of Hyperplasia and awareness of signs and symptoms of partial stoma obstructions.

SOURCE: Ralph Kaye Chapter, San Antonio, TX; The Re-Route on-line, Evansville, IN, July 2008, via Inside Out On-line Sept. 2008.

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