Stoma Bleeding

Stoma bleeding can be alarming, but it is not always a sign of a serious problem. This guide explains the common causes of stoma bleeding, what you should do when you notice blood, and when to seek urgent medical help. It also covers how to care for your stoma day to day to help reduce the risk of irritation and bleeding.

Why is my stoma bleeding?

The bowel is pink or red in colour due to its healthy blood supply. When cleaning your stoma, a small amount of bleeding on the cloth or wipe is normal and is called contact bleeding.

Contact bleeding usually stops on its own within a minute or two. The surface of a stoma is made of mucosa—the same delicate tissue found inside your mouth—which can bleed easily even with gentle wiping. This is nothing to worry about as long as the bleeding is minor and short-lived.

 

Is it normal for a stoma to bleed?

Some bleeding during cleaning or bag changes is normal. However, heavy bleeding is not normal and requires urgent medical attention.

If your stoma bleeds heavily, bleeds without being touched, or produces a large amount of blood in the bag regularly, attend your local A&E department or call an ambulance.

 

What causes a stoma to bleed?

Stoma bleeding can happen for different reasons. If you are unsure about any bleeding, contact your stoma nurse or GP. If bleeding is heavy, attend your local A&E department or call an ambulance.

Minor bleeding can be caused by:

• Contact bleeding – minor bleeding during cleaning or bag changes is the most common cause and is usually harmless
• Granulomas – small, raised lumps of tissue that can form on or around the stoma and bleed easily when touched
• Skin irritation – if the skin around your stoma becomes sore or broken, this can sometimes cause minor bleeding
• Trauma – an accidental knock to the stoma can cause minor bleeding

If you notice blood mixed into your stoma output regularly, or if bleeding is heavy or persistent, speak to your GP immediately, or attend A&E.

 

How do you treat a bleeding stoma?

Treatment for a bleeding stoma depends on the cause and how severe the bleeding is. For most cases of minor surface bleeding, simple first aid at home is all that is needed:

• Apply gentle, direct pressure to the bleeding area using a clean, soft wipe or cloth for 1 to 2 minutes.
• Avoid scrubbing or rubbing the stoma, as this can make the bleeding worse.
• Once the bleeding has stopped, carry on with your bag change as normal.

If bleeding is caused by granulomas, your stoma nurse may recommend treatment. Depending on the size and extent of the granulomas, this may involve silver nitrate application in a clinic or at home. Your stoma nurse will discuss the best option for you.

Salts Healthcare offers a range of stoma care products including skin barrier wipes and seals designed to protect the peristomal skin. If you are experiencing repeated bleeding and are unsure which products may help, seek advice from your Stoma Care Nurse.

If the bleeding does not stop after applying direct pressure, seek advice from a medical professional. This may include your GP, the 111 service, or attend your local A&E department.

 

How to reduce the risk of stoma bleeding during bag changes?

A few simple habits can help to reduce the chance of irritation or contact bleeding when changing your stoma bag:

• Use water and a soft, non-woven wipe to clean around your stoma. Avoid using products that contain alcohol or strong fragrances, as these can dry out the skin.
• Pat the skin dry gently rather than rubbing it.
• Make sure your stoma bag aperture is the correct size. If the hole cut in the bag is too small for your stoma, the edge of the cut can rub against the stoma with friction, causing irritation and bleeding. If it is too large, output can leak onto the surrounding skin and cause soreness.
• Use a skin barrier or protective wipe around the peristomal skin to help maintain a healthy skin barrier.

If you are unsure whether your bag is fitting correctly, contact your stoma nurse or speak to the team at Salts Healthcare for advice on the right products for your stoma.

 

What if there is blood in your stoma bag?

If there is an excessive amount of blood in your bag, seek urgent medical attention by contacting your GP, the 111 service, or attending your local A&E department.

A small streak of blood in the output can sometimes occur, for example if you have recently had a difficult bag change. However, you should always monitor the situation closely.

Seek medical advice if:

• There is a large or increasing amount of blood in your bag.
• The bleeding happens repeatedly over several bag changes.
• You feel unwell, dizzy, or notice other symptoms alongside the bleeding.
• The blood is dark in colour or looks like tar, which can be a sign of bleeding higher in the digestive system.

 

When should I call 999 or go to A&E?

In most cases, stoma bleeding is minor and can be managed at home or with advice from a medical professional. However, you should call 999 or go to your nearest A&E department immediately if:

• Bleeding from the stoma is heavy and does not stop with direct pressure.
• You are losing a large amount of blood and feel faint or unwell.
• You have other symptoms such as severe abdominal pain alongside bleeding.

Always trust your instincts. If something does not feel right, seek help straight away.