I recently had the opportunity to help a patient with an interesting pain syndrome in his abdominal wall, and I couldn’t help but think that there must be other patients in the world who have this same problem.
This patient had a previous large bowel problem that led to a surgical procedure requiring the removal of a large portion of the colon (the large bowel). While every single one of us would rather have the bowel put back together again so that we can have normal bowel movements immediately, sometimes that is just not possible. A surgeon will often have to create either a temporary or permanent opening in the abdominal wall to bring the colon or small bowel out to the skin, creating what is called a colostomy. This allows stool to pass out of the body when it is not able to pass in the usual way.
This is typically done when a portion of the large intestine (colon) or rectum is removed or damaged, preventing normal bowel function. The stoma is created by bringing the end of the colon through the abdominal wall and attaching it to the skin. A colostomy bag is placed over the stoma to collect waste, which can be emptied as needed.
If the challenges of a colostomy were not hard enough, this patient that presented to my office had previously had the colostomy reversed but in the process, developed severe abdominal wall pain in his scar. He had pain 24/7 that he described as “electrical”—severe, stabbing pain that became worse with movement. It radiated around the surgical site and caused him tremendous challenges.
He had taken many kinds of medications and was never able to get the pain under control. Fortunately, after seeing this patient and identifying a nerve in the abdominal wall caught up in his scar, we were able to help him put an end to several years of misery and struggle.
Colostomies are common enough that this patient’s story is not unique. Persistent colostomy site pain is not normal, and nerve surgery may be able to help you get the relief you deserve.
What Is Colostomy Site Pain?
A variety of factors can cause colostomy site pain. Some of the most common stoma complications, such as infection or sore skin, only result in temporary discomfort that is easily treated. Others, such as nerve damage, can result in persistent abdominal pain.
Every surgical procedure carries risks. One of the risks of colostomy surgery is nerve injury. During the surgery, the nerves in the surrounding area can be damaged or severed. The pain may be temporary in some cases, but in others, it may be permanent. The risk of nerve injury can vary depending on the individual's health, the extent of the surgery, and the surgeon's skill and experience.
How Do I Know if I Need to See a Nerve Surgeon?
Signs of colostomy site nerve pain can vary from person to person, but some common symptoms include:
- Persistent pain around your stoma or in the abdomen or in a previous scar in the case that the colostomy was reversed or closed
- Numbness or tingling in the area around the stoma bag or scar
- Burning or shooting pain in the abdominal wall near the colostomy site or previous site
- Pain that radiates to other areas of the abdomen
- Pain that worsens when the colostomy bag is changed or emptied
- Pain that interferes with daily activities and quality of life
If you're experiencing persistent pain around a colostomy site or a previous site that has been reversed that doesn't improve with over-the-counter pain relievers or other non-surgical treatments, it may be time to consult a Baltimore nerve surgeon. Your surgeon can evaluate the cause of your pain and recommend an appropriate treatment plan.
How Can I Find a Surgeon to Treat My Nerve Injury?
You can start searching for a nerve surgeon by requesting a referral from your primary care physician, gastroenterologist, or ostomy nurse. Then, consider each surgeon's experience, certifications, and history of positive patient outcomes.
Experience With Colostomy Surgery Complications
Choose a surgeon who has experience in performing surgeries to treat nerve damage from colostomy surgeries. In the Baltimore area, I’ve been able to help a number of patients with pain after previous colostomy complications, including a man who had severe pain from the anterior cutaneous branch of the intercostal nerve that was trapped in the scar tissue around his surgical site.
Check that the surgeon is board-certified in their specialty. This certification ensures that the surgeon has met rigorous training and education requirements. I am board-certified in Plastic and Reconstructive Surgery. I am also a member of the American Society for Peripheral Nerve, the American Society of Reconstructive Microsurgery, and the Association of Extremity Nerve Surgeons.
Positive Patient Outcomes
Look for a surgeon with a track record of successful patient outcomes, including pain relief and improved quality of life after surgical care. For your convenience, I’ve provided several patient testimonials showcasing my ability to help patients identify and treat their nerve pain.
What Should I Expect During My First Appointment?
During your first appointment, I will review your medical history, perform a physical exam, and ask questions about your symptoms. I may also order imaging tests or nerve studies to assist in making an accurate diagnosis.The treatment for colostomy site pain will depend on the underlying cause of the pain. For example, a nerve reconstruction for colostomy site pain removes the sensory nerves stuck in scar tissue and relocates them to a surgical site far from the previous one. I will explain your options and help you decide what course of treatment you wish to pursue.