Prolapse Stoma! When it goes wrong and how to treat it early to avoid surgical intervention!

Warning - includes pictures not for the faint hearted!

Firstly, I will share my diary of the prolapse, then follow with how to avoid prolapses happening and what to do immediately if they do.

3 weeks post op following surgery to remove my failed JPouch, remove and close all areas of my anus and creation of a permanent ileostomy stoma, something horrendous happened! My first stoma prolapse, and it went very wrong!

Surgery technical name: SILS (Single Incision laparoscopic Surgery) and ~TATME (Trans Anal Total Mesorectal Excision) excision of ileoanal pouch with formation or end ileostomy in left iliac fossa.

(Please always seek medical advice in the event of a prolapse – I am writing from experience, not giving professional advice).

Diary 23rd February 2020

It was Sunday and I was having a relaxed day at home; Stuart was sorting out the eves storage and I was watching. About 4pm I went into the eves to look at something and bumped my head, hard, on the beams, it caused me to jump/fall backwards and down.

I felt a few sharp pains in my stoma, unusual but not severe, so I assumed it was all normal and carried on.

At 7pm, whilst eating dinner, I noticed my bag felt odd, full and heavy. Odd enough to cause me to go to the bathroom and take off the bag to check it.

I removed my bag and OMG, I shouted to Stuart ‘help!’ I was standing there holding about 3-4 inches of my small bowel. It was protruding out of the end of my stoma and looked swollen and purple.

Picture 1 prolapse Picture 2 normal stoma

I had no clue what to do so called the hospital ward I was on post op. I had to ask Stuart to hold the bag under my bowel so I could call, he was amazing and held my bowel and stayed calm.

The ward nurse told me not to panic but to go to A&E as I was just 3 weeks post op and still had stitches round the base of my stoma. I had to put on another bag over the prolapse, it was weird wiggling it into it. I started to collect medications and get ready to go just as my boys arrived home from their dads’ weekend. I had to turn them around, back to his with the dog, all whilst trying to be calm and not scare them.

After a 30-minute drive we arrived at A&E and after a short wait, I was taken to a side bay so I could lie down. My stoma now felt very hot and was swelling yet still functioning throughout.

The emergency nurse came and registered me, she was in a rush so didn’t take my full medication list and said not to worry, that we could do it later… this caused me huge issues later that night!

It was 4 hours before the surgical team came to see me. By now my stoma had swollen further and was very painful and sore. I was lying flat to see if it would go back in by itself, but no luck. I asked for pain relief but as I was already on Oxynorm post op, all they could give me was a paracetamol drip; they also gave me liquids. (I can not have ibuprofen due to IBD and I am allergic to Morphine).

Stuart researched the internet and read the NHS guidelines for a prolapse stoma, it recommended I lie flat and poor sugar on it. The surgeon had not heard of this for stomas, but his assistant had, so she poured 2-4 sachets of sugar on and monitored it.

They also placed ice round the stoma (which was now out of the bag and just lying there,