How Common is Peristomal Pruritus in the Absence of Visible Skin Problems?

Adjustment to an ostomy may be difficult if wearing the pouching system creates discomfort.  Pruritus, especially when chronic, may be distressing and difficult to treat (Bautista, Wilson & Hoon, 2014).  Little is published in the stoma care literature about pruritus except in relationship to certain skin conditions such as candidiasis and dermatitis. We explored peristomal itch to learn how ostomy nurses and individuals with stoma compared in their experiences with this issue.

Aims:

Explore peristomal itch reported by individuals with stomas

Assess stoma care nurse opinions about peristomal itch

Identify similarities and differences in the responses of the two groups

Methods:

Participants responded to questions posed in an electronic survey which was created by the authors and reviewed and approved by an Independent Review Board.

Results:

Over 57% of the 164 respondents with stomas reported experiencing itching around their stoma and 35% of them said the skin most often or always appeared healthy when itchy.  The majority (74%) of these respondents did not discuss the problem with a healthcare provider. About 71% of the 259 nurse respondents have evaluated patients with pruritus and healthy appearing skin.  The most common causes identified by nurses were dry skin, sensitivity to adhesives or products, and leakage. Individuals with stomas identified the most common causes as leaving the pouching system on too long, leakage, moisture, and product sensitivities.

Conclusions:

Peristomal pruritus is common, and occurs even in the absence of visible skin redness or irritation.  Ostomy nurses should include questions about pruritus as a routine part of their assessment of individuals with stomas. Further study is needed to investigate causes and treatment for this peristomal skin problem.