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Bleeding from a stoma: when it is normal and when it is not | CION Cancer Clinics
A few spots of blood when you clean a stoma are common and usually harmless, because the stoma has a rich blood supply close to its surface. Bleeding that does not stop with gentle pressure, blood mixed into the output, black output, or bleeding with dizziness needs a doctor. This page explains the usual causes, how to handle a small bleed, and when to go in. 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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On this page
- Is bleeding from a stoma normal?
- Which bleeding is usually fine, and which needs checking?
- What makes a stoma bleed?
- What should you do for a small bleed?
- What do families believe about stoma bleeding that is not true?
- What happens when you are checked, and what can this page not tell you?
- Common questions about bleeding from a stoma
The short answer
Is bleeding from a stoma normal?
A few spots of blood on the wipe when you clean the stoma are common and usually harmless. Bleeding that does not stop with gentle pressure, blood mixed into the output, or black output needs a doctor's attention.
Why a stoma bleeds so easily
The stoma is the inside lining of the bowel, and it has a rich blood supply close to the surface. It has no nerve endings that feel pain, so it can be rubbed or nicked without you feeling it. A small bleed from the surface usually stops quickly on its own.
Where the blood is coming from matters
Blood on the outside of the stoma, seen when you clean it, is usually from the surface. Blood mixed into the output, or output that turns dark and sticky like tar, is more likely to come from inside the bowel. That needs a different kind of check.
When the stoma is new
In the first days after surgery, a little oozing around the stitches where the stoma meets the skin is common. The ward nurses check it. Once you are home, any new or increasing bleeding is worth a call.
This page describes common patterns. It cannot tell you whether your own bleeding is harmless. If you are unsure, ask.Side by side
Which bleeding is usually fine, and which needs checking?
Usually not a worry
Call your team or be seen
A few spots on the wipe when cleaning
Bleeding that keeps soaking through gauze
A tiny red mark where the baseplate rubbed
A sore or cut on the stoma that does not heal
Stops within a few minutes of gentle pressure
Blood mixed through the output, or clots in the bag
Happens now and then, with no other symptoms
Black, tarry output, or blood in a urostomy bag
The stoma stays red, moist and a normal size
Bleeding with dizziness, paleness or breathlessness
Not sure whether this applies to you?
Ask an oncologistCommon causes
What makes a stoma bleed?
Most causes are simple and easy to fix. A few need your medical team to look at your medicines or blood tests.
Rubbing and cleaning
Scrubbing the stoma, using rough tissue or wiping too firmly. Soft cloth and warm water are enough. Pat, do not rub.
A baseplate cut too small
An opening that is too tight or has a sharp edge can cut into the stoma each time you move. Measure again and recut with smooth edges.
Blood-thinning medicines
Medicines such as aspirin, clopidogrel, warfarin or apixaban make small bleeds last longer. Do not stop them on your own. Tell the doctor who prescribed them.
Chemotherapy
Some treatment lowers the platelets, the blood cells that help clotting. A low platelet count can make the stoma bleed more easily.
Something inside or around the stoma
Less often, bleeding comes from small raised growths on the stoma, from swollen veins linked to liver disease, or from inside the bowel. These need a doctor to examine you.
!
When bleeding cannot wait
Go to the nearest emergency department today if bleeding does not stop after firm, steady pressure, if the bag is filling with blood or clots, if the output turns black and tarry, or if the person becomes dizzy, pale or breathless. Say that they have a stoma and list any blood-thinning medicines or recent chemotherapy.
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At home
What should you do for a small bleed?
Press gently
Hold a clean, soft, damp cloth or gauze against the spot that is bleeding. Keep steady pressure for a few minutes without lifting to check.
Try something cool
If it keeps oozing, a cool, damp cloth can help the small vessels close. Do not put ice directly on the stoma.
Find the cause
Look at the old baseplate. Is there blood where the edge sat? Is the opening too tight? Recut the new one to fit and smooth the edges.
Note it and tell your nurse
Write down when it happened, how much and what stopped it. If it happens often, or you take blood thinners, tell your team.
Commonly believed
What do families believe about stoma bleeding that is not true?
"Any blood from the stoma means the cancer is back."
Almost all bleeding from the surface of a stoma comes from rubbing, cleaning or a baseplate that is too tight. If your team is concerned about anything more, they will explain what they want to check and why.
"He is bleeding, so we should stop his blood thinner."
Stopping a blood thinner suddenly can cause a stroke or a clot, which can be far more dangerous. Call the doctor who prescribed it and let them decide.
"It does not hurt, so it cannot be serious."
The stoma has no pain nerves. Serious bleeding can happen without pain. Judge by how much blood there is, whether it stops, and how the person feels.
"Turmeric or home powder will stop the bleeding."
Powders and pastes on the stoma can irritate it and stop the bag from sticking. Use gentle pressure instead, and ask your stoma nurse before putting anything on the stoma.
Being straight with you
What happens when you are checked, and what can this page not tell you?
A doctor or stoma nurse will look closely at the stoma and the skin around it. They will ask about your medicines, your treatment and what the output has looked like. Blood tests can show your blood count and how well your blood clots.
If bleeding seems to come from inside
The team may suggest a camera test through the stoma to look at the bowel lining. They will explain why and what it involves before you agree. The test itself is not a treatment decision.
What this page cannot tell you
It cannot tell you the cause of your own bleeding, whether your medicines need changing, or whether you need further tests. Those decisions belong to the people treating you.
If you are on cancer treatment
Tell your oncology team about any new bleeding, even small amounts, while you are having chemotherapy. It can change what they check before your next cycle.
Before you go to any appointment about bleeding, write down every medicine you take, including ones bought without a prescription and any herbal or Ayurvedic remedies. Some of these can affect bleeding, and the doctor needs the full list to judge what is happening.Questions we are asked
Common questions about bleeding from a stoma
Why is there blood on the tissue every time I change the bag?
Usually because the stoma is being rubbed. Clean with a soft, damp cloth and pat rather than wipe. Check that the baseplate opening is not too tight. If it still happens every time, ask your stoma nurse to look at the stoma.
Is blood in a urostomy bag the same thing?
Not always. A spot on the outside of the stoma is often from rubbing. Pink or red urine collecting in the bag can mean bleeding from the kidneys or urinary tract, or an infection. Tell your team the same day.
Can beetroot or food make the output look like blood?
Yes. Beetroot, red food colour and some fruits can turn output red, and iron tablets can make it very dark. Think about what was eaten. If you are not sure, or the colour does not change back, ask your team.
Is it safe to keep changing the bag if the stoma bleeds a little?
Yes. Stop the small bleed with gentle pressure first, then dry the skin and fit the new bag. A bag will not stick well to damp or bloody skin, so take your time.
My mother's platelets are low from chemotherapy. What should we watch for?
Watch for bleeding that takes longer to stop, new bruises, bleeding gums or blood in the output. Handle the stoma very gently. Call the chemotherapy team if you see any of these, rather than waiting for the next appointment.
There is a small raised lump on the stoma that bleeds. What is it?
It may be a small overgrowth of tissue, which is common where a bag rubs. It is usually harmless but can bleed easily. Show it to your stoma nurse, who can treat it or ask a doctor to look.
Should I stop aspirin before seeing the doctor?
No. Never stop a prescribed medicine on your own. Tell the doctor who prescribed it about the bleeding. They will weigh the bleeding against the reason you take it and decide whether anything should change.
Can bleeding from a stoma be a sign of a blockage or hernia?
Sometimes. A swollen stoma from a blockage, or a hernia that changes the fit of the bag, can make the baseplate rub and cause bleeding. If you also notice pain, swelling or less output, mention all of it together.
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Sources
- NHS — Colostomy
- NHS — Ileostomy
- American Cancer Society — Ostomies
- National Cancer Institute — Bleeding and bruising and cancer treatment
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.
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