Peristomal caput medusae: a patient’s journey

Considering that around 205 000 people in the UK have a stoma (Hodges, 2022), the Stoma Care Nurse Specialist’s (SCNS) role remains vital. Not only does the SCNS need to show compassion, but also provide individualised patient care from pre-operative counselling, to continuing long-term community support.

An experienced SCNS will have the knowledge to recognise stomal complications and the expertise to resolve the issues, while supporting the ostomate with what may be a painful or distressing issue.

The ostomate may encounter many complications during their journey with a stoma, including sore skin, high output, prolapse, parastomal hernia, granulomas, stenosis and retraction, to name a few. Sore peristomal skin can result in a diminished adherence of the stoma appliance, resulting in leakages. Experiencing complications can affect the ostomate’s quality of life (Salvadalena et al, 2020). Although it is normal for an ostomate to see some blood when cleaning the stoma, this should be minimal. Hill (2020) describes luminal bleeding as a potential result of inflammatory bowel disease (IBD), or portal hypertension in patients with liver disease, which may result in caput medusae around the stoma. Caput medusae is a term derived from the Greek myth of Medusa, whose head of hair was made of snakes.