Retracted Stoma: What It Is, Why Your Bag Keeps Leaking and What Helps (UK)

What is a retracted stoma?

A retracted stoma is one that has sunk down so that it sits level with your skin, or below it in a little dip, instead of sticking out slightly. Because the opening is no longer above the skin, output can run under the flange instead of dropping into the bag.

Stomas are usually made to stand out about 1–2 cm for an ileostomy and a little less for a colostomy, so that output lands straight in the bag. When a stoma retracts, the main thing you notice is leaks. They are often at the same spot, often soon after changing, and the skin around the stoma gets sore. If that sounds familiar, our guide my stoma bag keeps leaking walks through every cause. A retracted stoma is one of the most common.

Why does a stoma retract?

• Weight gain. More tummy fat around the stoma can pull it inwards. It is the most common reason a stoma that used to be fine starts to sink years later.
• In the first weeks after surgery, while the bowel settles and the swelling goes down.
• Tension on the bowel, when the bowel was short or under some pull at the time of surgery.
• Scar tissue or a hernia changing the shape of the tummy around the stoma.
• Sitting or bending. Some stomas look fine standing up and only sink into a skin fold when you sit. That is why leaks can happen mainly at your desk or in the car.

When to call your stoma nurse

Call your stoma nurse if your bags have started leaking when they did not before, if the skin around the stoma is sore, or if the stoma looks flatter than it did. They can check it lying, sitting and standing, re-measure it and change your products, usually to a convex flange.

Call your hospital or NHS 111 straight away if the stoma turns dark red, purple or black. Do the same if it has pulled right back so you cannot see it, if you have strong tummy pain, or if nothing comes out of the stoma and you feel sick or bloated.

What helps with a retracted stoma

A convex flange

A convex flange has a gentle dome on the back. It presses lightly on the skin around the stoma so the stoma pushes up into the bag. It is the first thing most stoma nurses try for a flat or retracted stoma, and there are soft, medium and firm options. It is available on NHS prescription. Always start convexity with your stoma nurse, because the right firmness depends on your tummy.

Seals, rings and paste

A mouldable seal or ring fills the dip around the stoma and makes a flatter surface for the flange to stick to. Some people use a little stoma paste in a crease. Our guide to stoma barriers, rings and powders explains each one.

A support belt

A stoma belt adds gentle, even pressure over a convex flange and keeps it close to the body when you move. Many people with a retracted stoma wear one most of the day. A soft, wide stoma belt worn under clothes does this without showing.

Cut it to fit, every time

Measure your stoma again whenever leaks start, and cut the flange so it sits 1–2 mm bigger than the stoma. Sore skin around the edge usually means the hole is too big. Our guide to skin problems around a stoma covers how to settle it.

A bag routine that holds

1. Change at a quiet time

   First thing in the morning, before eating, the stoma is usually at its quietest.

2. Clean and dry the skin

   Use warm water and dry completely. Any moisture under the flange shortens wear time.

3. Seal first

   Shape the ring or seal snugly around the stoma, so the dip is filled.

4. Convex flange on

   Place it from the bottom up and hold your hand over it for 30–60 seconds, so the warmth helps it stick.

5. Belt on

   Put on your support belt, snug but not tight, before you sit down or bend.

When surgery is considered

Most retracted stomas are managed with products and a good routine, without more surgery. If leaks keep coming back despite everything, or the stoma has pulled back very deeply, your surgeon may suggest an operation to re-make the stoma, sometimes in a different place. If your stoma is temporary and a reversal is already planned, your team may simply help you manage until then. See temporary vs permanent stomas.

Retracted stoma: your questions