Reasons Stomas Change Their Sizes

Sometimes, your stoma may start acting like it has a mind of its own. In this article, we will briefly explain why stomas shrink, move, or grow.

There are many reasons why a stoma may move around and changes size. Some of these reasons are not quite bothersome, while some may require medical or even surgical intervention.

Reduction in swelling after surgery

Due to the traumatic effects of surgery, your stoma may look swollen afterward. However, this swelling subsides over time. The stoma settles to a permanent shape and size after six to eight weeks of surgery. That is why doctors ask all patients to measure their stomas regularly after surgery.

Remember, it is not wise to keep your ostomy appliance on for more than a few days. Because your stoma will shrink, you do not want more of your peristomal skin to get exposed to bodily wastes. Removing the old ostomy appliance after every 2-3 days to measure the stoma is recommended.


Peristalsis is another reason why your stoma would change its shape and size. It is a natural movement of the intestines caused by the contraction of muscles in the gut. This function is very useful to get stools out of your system. Without peristalsis, you will develop motility issues.

It may be worth mentioning here that peristalsis is natural, much like a heartbeat. So, there is no way you can control it. You see it only because you have the stoma sticking out on your abdomen.

Weight loss and weight gain

Whether your weight loss/gain is intentional or due to an illness, you will experience a change in the shape and size of your stoma. Most people experience dramatic changes in their body weight after ostomy surgery, so it goes without saying that their stomas change with the rest of their bodies.

If you are using pre-cut ostomy pouches and are planning to adopt some dietary changes, be sure to keep it in mind because the hole in your skin barrier may no longer fit around the stoma.

Flush or retracted stoma

An average stoma sticks out a little bit, but some people have a flush or retracted stoma. A flush stoma has a tiny bump. In some cases, it may become flat with the abdominal skin.

In most cases, a retracted stoma points inwards, which can be a cause of concern for ostomates. It can be a result of poor placement of the stoma.

The most significant impact of a retracted or flush stoma is that it makes stoma management more challenging.

Prolapsed stoma

It is the opposite of a retracted or flush stoma. The two types of stoma prolapse are fixed and sliding prolapse. A fixed prolapse is when the stoma is not created properly. A sliding prolapse might happen for several reasons.

Although this problem seems more alarming, its surgical correction is usually not urgent.


Parastomal hernias occur as a result of your bowel pushing through the abdominal muscles. This problem is prevalent among a large percentage of people with ostomies.

This problem results in the formation of bulges under the skin, changing the appearance or size of the stoma. Many patients use hernia belts or undergo surgery to treat this problem.

The best solution to any problem that changes the shape and size of your stoma is to speak to your doctor or ostomy care nurse. Moreover, it is necessary to remain committed to a healthy lifestyle. You will be able to reduce the likelihood of most of the stoma problems this way.