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Complications of Ostomy Surgery of the Bowel

What complications may occur after ostomy surgery of the bowel?

Talk with your doctor, surgeon, or ostomy nurse about possible complications that may occur after your surgery. Like any major surgery, ostomy surgery may lead to complications, such as bleeding and infection. Some risks depend on the type of ostomy surgery you have and the reasons you need surgery.

After ostomy surgery, talk with your ostomy nurse or doctor if you notice any unusual symptoms or problems. They may recommend at-home treatments for minor problems or complications. Doctors may recommend medicines, surgery, or other medical treatments for more serious complications.

Ileostomy or colostomy

Complications of ileostomy and colostomy may include stoma or skin complications, dehydration, problems absorbing nutrients, and intestinal obstruction.

Stoma complications

Complications that are more common within the first 30 days after surgery may include7,8

  • bleeding from the stoma
  • lack of blood supply to the stoma and death of stoma tissue
  • retraction, or when the stoma sinks below the level of the skin
  • separation of the stoma from the skin around it

Stoma complications that are more common 30 days or later after surgery may include7,8

  • hernia, or abdominal contents bulging through a weak area in the abdominal wall near the stoma. In rare cases, part of the intestine may become stuck in the hernia, which can lead to a blockage in the intestine or cause the intestine to lose its blood supply.
  • prolapse, or when part of the intestine pushes itself through the stoma. Rarely, the prolapsed intestine may become stuck in the stoma and lose its blood supply.
  • retraction.
  • stricture, or narrowing of the stoma, which makes it difficult for intestinal contents to pass.

Skin complications

Complications involving the skin around the stoma are common. Skin complications may include

  • irritation when intestinal contents that leak from the stoma touch the skin, which can happen if your ostomy pouch doesn’t fit properly
  • irritation or injury related to applying or changing your ostomy pouch
  • infection with bacteria or fungi

Other complications

After ileostomy or colostomy, other complications may include

  • dehydration, which is more common if all of your large intestine was removed or bypassed
  • problems absorbing nutrients, which may occur if part of your small intestine was removed or bypassed
  • intestinal obstruction, a partial or complete blockage of food, fluids, air, or stool moving through your intestines

Continent ileostomy

Complications of continent ileostomy may include

  • problems with the pouch, such as pouchitis
  • problems with the stoma, such as stricture or hernia
  • problems with the valve, which may make it hard to drain the pouch or cause incontinence
  • small intestinal obstruction

Ileoanal pouch surgery

Complications of ileoanal pouch surgery that are more common within the first 30 days after surgery may include9,10

Complications that are more common 30 days or later after surgery may include9,10

  • pouchitis, which is inflammation of the ileoanal pouch
  • cuffitis, which is inflammation of the area where surgeons attached the pouch to the anus
  • small intestinal obstruction
  • stricture, or narrowing of the area where the ileoanal pouch is connected to the anus

After ileoanal pouch surgery, more frequent bowel movements may cause the skin around your anus to become irritated. Your ostomy nurse will teach you how to prevent and treat irritated skin.

Patient talking with a doctor
Talk with your ostomy nurse or doctor if you notice any unusual symptoms or problems.

Seek medical help right away

Contact your doctor or ostomy nurse if you notice any unusual signs and symptoms any time after ostomy surgery.

Talk with your doctor and ostomy nurse about symptoms that could be signs of a serious complication and when you should contact a health care professional or seek emergency medical care.

Seek medical help right away if you have symptoms that could be related to a serious complication. Examples include1,2,5

  • problems with your stoma, such as changes in a stoma’s size, shape, color, or odor; bleeding from inside or around the stoma that is heavy or doesn’t stop; or an injury or deep cut to the stoma
  • cramping in the abdomen that lasts for more than 2 or 3 hours
  • nausea and vomiting that is severe or does not stop
  • passing no gas or stool from a stoma for more than 4 to 6 hours, along with cramping and nausea
  • severe diarrhea or watery output from a stoma, which could lead to dehydration


Last Reviewed June 2021
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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.