My skin is sore and the bag keeps leaking — what is wrong?

Usually a poor fit is letting output reach the skin. Get the stoma re-measured (it changes size after surgery) and check the fit with your stoma nurse; barrier products can help.

Is it normal for my stoma to bleed?

A little surface bleeding, such as after cleaning, is common and settles, because stomas are very vascular. Blood from inside the stoma, or a lot of blood in the bag, is not normal — seek urgent help.

There is a bulge around my stoma — is that a hernia?

Often yes — a parastomal hernia. Support belts help and avoiding heavy lifting reduces strain; surgery is considered mainly if it causes problems. Ask your stoma nurse.

How do I know if it is a blockage, and what do I do?

Output slows or stops with cramping, a swollen tummy and vomiting. Stop solids, take fluids, try a warm bath and gentle movement; call 995 if it does not clear, cramps worsen or vomiting persists.

What does a healthy stoma look like, and when is a colour change an emergency?

Healthy is pink or red and moist. A stoma turning dark, dusky, purple or black, or pulling in and going pale, can mean the blood supply is failing — call 995.

Managing Stoma Problems: Common Issues & Red Flags

Written & reviewed by the BestDoctors.sg editorial team · Last updated 25 Aug 2026 · General information, not medical advice

Everyday stoma problems — sore skin, leaks, wind — are common and usually fixable with your stoma nurse, while a few situations are genuine emergencies. The aim of this guide is to help you tell a routine problem, which means calling the stoma nurse, apart from a red flag, which means seeking urgent help or calling 995. Knowing the difference means you neither worry unnecessarily over the ordinary nor delay over the serious. This guide covers the common problems and how to handle them, and makes the emergencies unmissable.

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In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.

Call 995 or go to A&E now if your stoma turns dark, dusky, purple or black, or pulls in and goes pale (a possible loss of blood supply); or if you have a blockage that will not clear — no output of stool or wind, cramping pain, a swollen tummy, and vomiting. Also seek urgent care for heavy bleeding or blood from inside the stoma, and for severe dehydration from high output. For sore skin, leaks or a new bulge, call your stoma nurse.

Sore skin and leaks — the most common problem

Irritated skin around the stoma is the most common issue, usually caused by output reaching the skin from a poorly fitting or leaking appliance, or occasionally a reaction to a product. Because sore skin and leaks tend to go together and share the same cause, the fix is usually the same: get the stoma re-measured, since it changes size in the months after surgery, and check the fit with your stoma nurse. Special barrier sprays or wipes and measuring your stoma regularly can help, and treating soreness early stops it becoming a bigger problem.

Parastomal hernia

A parastomal hernia is a bulge around the stoma, caused by loops of bowel pushing through the weakened abdominal muscle. It is common and often managed without surgery — a hernia support garment or belt can help, and avoiding heavy lifting and straining reduces the strain that makes it worse. Your stoma nurse can advise, and surgery is considered mainly when a hernia is causing symptoms or problems. If you notice a new bulge developing around your stoma, it is worth getting it checked.

Blockage or obstruction — the key emergency

A blockage is the problem to know best. The signs are that the stoma output slows down or stops, with cramping abdominal pain, a swollen tummy or stoma, reduced or dark urine, and nausea or vomiting. As first steps at home, stop eating solid food and take only fluids, change to a larger or new pouch if the stoma swells, try gentle massage around the stoma, a warm bath and short walks, and some people find a knee-to-chest position helps. Seek urgent help — call 995 — if there is no output for many hours (some sources suggest around twelve), if the cramps worsen, if you become dehydrated, or if vomiting persists, because an untreated blockage can be dangerous.

High output and dehydration

A high-output stoma — described by some sources as generally more than about a litre a day — can leave you dehydrated, short of salts and, over time, poorly nourished, so it is important to seek help to manage it rather than pushing through. Watch for thirst, dark and scanty urine, dizziness, fatigue and a dry mouth. Our stoma diet and nutrition guide covers hydration and rehydration, and your stoma team can advise on managing a persistently high output.

Stoma bleeding — surface versus inside

Stomas contain many small blood vessels near the surface and can bleed easily, so a little surface bleeding — for example after cleaning — is common and usually settles on its own. What is not normal is blood coming from inside the stoma, or a lot of blood in the bag, which should be treated as a reason to seek urgent help. Knowing this distinction saves needless worry over minor spotting while ensuring you act on the bleeding that matters.

Other changes: retraction, prolapse, stenosis and granulomas

Several other changes can occur and are usually managed by your stoma nurse. Retraction is the stoma sinking back below the skin instead of sticking out, which different appliances can help with. A prolapse is the stoma coming out further than usual — keep an eye on its size and colour, because the blood supply can become compromised. Stenosis is the opening narrowing over time, which may affect output. Granulomas are small red overgrowths of tissue at the skin junction that can bleed or weep and which the nurse can treat. These are generally non-urgent — unless the colour changes or a prolapse turns dusky, which is an emergency.

Reading the colour, and when to call whom

The colour of your stoma is a useful daily check. A healthy stoma is pink or red and moist; a stoma that turns dark, dusky, purple or black, or that pulls in and goes pale, can mean the blood supply is failing and is an emergency. As a simple rule of thumb: call your stoma nurse, the same or next day, for sore or leaking skin, a poor-fitting pouch, a new bulge, a granuloma, minor surface bleeding, or persistently high or loose output; and call 995 or go to A&E now for a dark or pale stoma, a blockage that will not clear, heavy or internal bleeding, or severe dehydration. In Singapore, your hospital stoma care nurse or stoma clinic is your first contact for everyday problems, and the emergency number is 995. The reassuring bottom line is that most stoma problems are minor and fixable with your nurse’s help — and knowing the handful of true red flags means you can act fast on the rare occasions it matters.

Sources

NHS — Complications of a colostomy: nhs.uk
Colostomy UK — Stoma problems: colostomyuk.org
Bladder & Bowel Community — Stoma complications: bladderandbowel.org

General information only. This guide supports — but does not replace — the advice of your surgical team and stoma nurse (stomal therapist), who tailor stoma care to you. Seek urgent help — call 995 — if your stoma turns dark, dusky or black or pulls in and goes pale (a possible loss of blood supply), or if you have no output of stool or wind with cramping tummy pain, a swollen abdomen and vomiting (a possible blockage). Also seek care for heavy bleeding from inside the stoma or signs of severe dehydration. If you are struggling emotionally, you are not alone — the Samaritans of Singapore (SOS) are on 1767 and mindline.sg on 1771.

Managing Stoma Problems (Singapore)