Medical Oncologist
CION Cancer Clinics
When the stoma sticks out or sinks in: prolapse and retraction | CION Cancer Clinics
If your stoma suddenly sticks out much further, lie flat and check its colour. Pink, soft and moist is not an emergency, and it often slides back on its own. Dark, cold, hard or very painful, or a stoma that stops working, needs hospital the same day. If the stoma has sunk into the skin instead, the fix is usually a different bag. This page explains both problems and what to do about each. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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The short answer
What do you do if the stoma sticks out or sinks in?
If the stoma has suddenly become much longer and is hanging out of the bag, lie flat, stay calm and check its colour. A prolapsed stoma that is still pink, soft and moist is not an emergency, and it will often slide back on its own while you lie down. If the stoma has sunk below the level of the skin, the urgent job is stopping leaks and protecting the skin.
Prolapse: the stoma telescopes outwards
The bowel behind the stoma slides forward through the opening, so a stoma that was the size of a coin becomes a long pink tube. It happens most often with coughing, straining or heavy lifting, and it is more common when the opening in the muscle is a little loose or when there is a hernia beside the stoma.
Retraction: the stoma sinks below the skin
The opposite problem. The stoma pulls inwards until it sits level with the skin or in a dip. Stool then runs under the baseplate instead of into the bag, the skin becomes sore, and the bag fails again and again. Weight gain, tension on the bowel from the operation and early scarring are the usual causes.
Neither problem means the cancer has returned. Both are mechanical, and both have well-worn solutions.
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When a prolapsed stoma cannot wait
Go to the nearest emergency department the same day if the stoma turns dark red, purple or black, feels cold or hard, is very painful, will not go back after lying flat, or stops passing stool and wind while the tummy swells. Those signs mean the blood supply to the bowel may be squeezed. Do not keep trying to push it in, and do not wait for the morning clinic.
Not sure whether this applies to you?
Ask an oncologistProlapse
What to do at home when the stoma prolapses
Lie flat and wait
Lie on your back with your knees bent and breathe slowly. Gravity and a relaxed tummy are often enough for the stoma to slide back in on its own.
Check the colour
Pink and moist is healthy bowel, even if there is a lot of it. Dark red, purple or black, or a stoma that is cold to touch, is the red flag above. Colour is the single most useful thing to note.
Cool it, and reduce the swelling
A cloth wrung out in cold water laid over the stoma reduces the swelling that stops it going back.
Guide it back only if you have been taught
With a clean, lubricated hand a nurse can gently ease the bowel back through the opening. Do not attempt this yourself unless your stoma nurse has taught you and told you it is safe for your stoma.
Change to a bag that fits the new size
A prolapsed stoma needs a bag with a larger opening and more room, so that the edge of the flange does not cut into it. Ask the nurse for the right size, and for a support belt to wear during the day.
Retraction
How a sunken stoma is managed
The goal is to lift the stoma up into the bag, protect the skin and get a full day out of each seal. Most of this is done by a stoma nurse changing what you wear, not by surgery.
A convex bag
The baseplate is curved outwards, so it presses gently around the stoma and pushes it up above the skin. This is the main answer to retraction. It comes in soft and firm versions, and the nurse chooses the depth to match how far the stoma has sunk.
Barrier rings and paste
A soft ring or a strip of paste fills the dip around the stoma so stool cannot creep underneath. It is moulded by hand and sits between the skin and the flange.
Also used
- Barrier powder on damp, broken skin
- A stoma belt clipped to the flange to add pressure
Skin care between changes
Retraction makes the skin sore because stool sits on it. Wash with plain water, pat dry fully, avoid soaps and oils, and let the nurse see any redness early.
Weight and posture
A stoma sinks further as the tummy grows and when you sit slumped. Keeping weight steady and sitting upright with a small cushion behind the back both make a real difference to how the bag lies.
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Commonly believed
Four things people believe when the stoma changes shape
"A stoma hanging out means something has burst inside."
A prolapse is bowel sliding forward through the opening, the way a sleeve pulls through a cuff. Nothing has burst. What matters is the colour and whether it goes back, not the length.
"If it has prolapsed once, it needs an operation."
Many prolapses are managed for years with a belt, the right bag and care with lifting. Surgery is offered when the prolapse keeps happening, will not go back, damages the bowel or makes the bag impossible to keep on.
"A sunken stoma is my fault for putting on weight."
Weight gain is one cause, but retraction also happens because of tension on the bowel from the operation, early scarring, or a stoma made in a hurry. It is worth managing weight for other reasons, but the fix for leaks is a convex bag and a ring, not guilt.
"Leaking is just part of having a stoma."
It is not. A well-fitted bag on a well-sited stoma should stay sealed for its full wear time. Repeated leaks are a signal that the stoma has changed shape and the appliance needs to change with it. Ask for a review rather than buying more bags.
Being straight with you
When is surgery needed, and what this page cannot tell you
Most prolapses and most retractions are managed without another operation. Surgery is considered when a prolapse keeps recurring, will not go back, or has damaged the bowel, and when a retracted stoma leaks whatever appliance is tried. It is done as an emergency only if the bowel loses its blood supply.
What the operation involves
For a prolapse the surgeon trims the extra length of bowel and re-stitches the stoma, often through the stoma itself without opening the tummy. For a retraction the stoma is freed and refashioned so it stands proud of the skin, or moved to a new site if the old one cannot be used. Ask which is proposed for you, and what recovery looks like.
Who it does not suit
Any repair is another operation under anaesthetic, so it is weighed carefully in people with heart or lung disease, in anyone still having chemotherapy, and in anyone whose cancer needs treatment first. A stoma that looks wrong but works and stays sealed is usually left alone.
What this page cannot tell you
It cannot tell you whether your stoma needs repair, or which bag will fix your leaks. Take a photo when the problem is at its worst and bring it to the stoma nurse, because a stoma often looks normal again by the time you reach the clinic.
Questions we are asked
Common questions about stoma prolapse and retraction
The stoma has come out a long way. Is this an emergency?
Not on its own. Lie flat, check the colour and give it time to slide back. It becomes an emergency if the stoma turns dark or black, becomes hard or very painful, will not go back, or stops working while the tummy swells. If any of those are true, go to hospital the same day.
Can I push the stoma back in myself?
Only if a stoma nurse has taught you how and has said it is safe for your stoma. Done gently, with a clean lubricated hand and while lying flat, it is a standard technique. Done with force, or on a swollen or dark stoma, it can injure the bowel. If in doubt, do not.
Why does the bag keep leaking since the stoma sank?
Because a flat baseplate cannot seal around a stoma sitting in a dip, so stool runs underneath. The fix is a convex bag that presses the skin down and lifts the stoma up, usually with a barrier ring and sometimes a belt. Ask your nurse to refit you rather than adding more tape.
Will the prolapse keep happening?
Often, yes, once the opening has stretched. A support belt worn during the day, avoiding heavy lifting and treating any cough all reduce how often it happens. If it is happening daily, or is hard to get back each time, that is the point to ask your surgeon about repair.
Does a prolapsed stoma hurt?
Usually not, because the bowel has no pain nerves of the kind skin has. People describe a dragging or heavy feeling and worry about how it looks. A prolapse that is genuinely painful, especially with a colour change, is the exception and needs to be seen the same day.
What is the sugar trick I have read about?
Ordinary granulated sugar sprinkled on a swollen prolapsed stoma draws water out of the tissue and shrinks it, which can let it slide back. Stoma nurses and emergency doctors use it. It is safe on healthy pink bowel, but it is not a substitute for being seen if the stoma is dark or stuck.
Is a convex bag covered by Aarogyasri or insurance?
Bags and accessories are covered by some schemes and some policies and not by others, and convex bags cost more than flat ones. Ask your stoma nurse for the exact product code and call the helpline with your card details; we will check what your cover pays for before you buy.
Can I keep working and travelling with a prolapse?
Usually yes, with a belt and a larger bag. Heavy lifting is the thing to discuss with your surgeon, because it is what pushes the bowel out. Carry spare bags in the bigger size and lie down for a few minutes if it prolapses while you are out.
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Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Sources
- NHS — Colostomy: complications
- Cancer Research UK — Living with a colostomy
- Macmillan Cancer Support — Living with a stoma
- American Cancer Society — Colostomy guide
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Parastomal hernia after APRThe bulge beside the stoma that often comes with a prolapseStoma siting before APR: why it is markedHow the original site affects leaks and retractionComplications and red flagsEvery same-day warning sign after cancer surgeryFollow-up after APRWhen the stoma is checked and who to askAbdominoperineal Resection (APR)The operation this page follows on from
Talk to us
Stoma changed shape and the bag keeps failing?
Tell us what has been done so far and a CION stoma nurse or surgical oncologist will help you work out the next step. One helpline serves every CION centre.