Granulomas are small, red, raised areas on or around the stoma. Although in my experience they tend to have a whiteish, blister/ulcerous appearance.
They can develop as a result of over-healing of damaged skin on the stoma surface, possibly due to friction from the bag or by the stoma retracting and contracting throughout the day causing it to rub.
An infection may also cause granulation formation in some cases, problems with the skin’s healing process following surgery can lead to granulomas. A nurse will assess if this is the case which is why it’s always best to check with them first! Inflammation can also be a cause but rarely on stoma granulomas.
This blog contains images of my stoma and a video of me treating the granulomas at home, so caution if you are not wanting to see this!
Granulomas can cause bleeding, itching and patches of soreness or may cause no problems at all.
I have had many issues with granulomas, but a few months ago I was very worried about an extremely large, unsightly lump on my stoma, not at the base but at the head, near the output area.
Below is a picture of it at the time, sorry its fairly awful but I wanted to share it as I struggled to find examples like mine when I was looking onto what it was.
I was referred initially to a dermatologist which threw me as I had no idea they dealt with this type of thing, I thought they were just for external skin problems like eczema…
They were concerned as it was so large and looked ulcerated, so a tissue sample was taken, and my bowel specialist was consulted. It was a worrying time whilst I waited for the biopsy results but thankfully it was benign. It was in fact ‘just’ a granuloma and overgrowth!
The consultant cut some of it away during the biopsy which caused excessive bleeding for a short while, but I felt nothing.
I had to chuckle when the nurse looking after me went into how important it was to keep the biopsy site clean and sterile whilst it healed! It lived in my poop, so we all know that wasn’t going to happen.
I did clean it daily with sterile water and checked it looked healthy, no sign of infection etc. The remaining area was to be treated with Silver Nitrate.
At this time, I also had numerous lumps around my stoma and the base where it joined my skin, these were also carefully treated.
The stoma nurse repeated the treatment in clinic once more and then handed me several packs of silver nitrate and sent me on my way!
I treated them all every 3-4 days for a few weeks and finally they cleared. The raised area of overgrowth at the tip remains still and apart from bleeding occasionally, causes little issues.
After treatment, you can see there is still a strange overgrowth, but that's just Fred now being unique!
I still get granulomas regularly, and now treat them myself a needed, however, I would still get them checked out if any looked different or concerned me in any way. Normally when bleeding and soreness becomes an issue. Bleeding from the granulomas causes me soreness where they interfere with my seal and allow blood/stool onto my skin.
And wow can they bleed!
The video I have shared is me treating them recently at home. I hope by sharing this it helps give some peace of mind that they can occur without any sinister things going on. They often appear when I am run down but mostly with no rhyme or reason.
Treatment with the Silver Nitrate is totally painless, but care MUST be taken to ensure you don’t touch your skin with the tip as it will burn you.
Thank you for reading this and please remember this is just my experience and I am not a nurse, so always check, its never too much trouble for them and its not something to ignore as they will not clear on their own.
Take care and thank you for helping me to raise awareness of IBD, living with a stoma and help to break the taboo of poo!