Stomal constipation and obstruction of stomas in palliative care

For patients with a stoma who have constipation or obstruction of the stoma, seek advice from a stomal therapist.

The level of the bowel diversion dictates the consistency of the faeces and the type of treatment. Hard faeces require lubricants and stool softeners applied locally. Suppositories (eg glycerol) can be carefully inserted into the stoma. A sorbitol+sodium citrate+sodium lauryl sulfoacetate enema¹ can be given with a rectal tube inserted into a stoma. Soft faeces or mucus can be removed by inserting warm water via a catheter above the level of impaction.

Skin integrity around the stoma is critical—use a barrier cream (eg Comfeel Barrier Cream, Sudocrem, zinc and castor oil cream) to protect the surrounding skin from contact with faeces.