What color of stool should the nurse expect to find in a patient with a stoma (surgically created opening) initially?

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Expected Stoma Color Immediately Post-Surgery

A healthy stoma should appear bright red (beefy red) initially after surgery, which indicates adequate blood supply and viable tissue.

Normal Stoma Appearance

The correct answer is A. Bright red. A newly created stoma should have the following characteristics:

  • The stoma tissue should be bright red (similar to the color of healthy oral mucosa), indicating proper vascularization and tissue viability 1
  • This bright red color reflects adequate blood perfusion to the intestinal mucosa that has been brought to the abdominal surface 1
  • The tissue should appear moist and shiny, as it is intestinal mucosa 1

Critical Warning Signs

Purple or dark discoloration of the stoma is a medical emergency requiring immediate surgical evaluation:

  • Purple/black discoloration indicates stomal ischemia from compromised blood supply, which requires emergency surgery 2
  • This can occur with acute stomal prolapse leading to incarceration and ischemia, presenting with pain, obstipation, and purple/black discoloration 2
  • Dark red or purple coloration is never normal and suggests tissue compromise 2

Clinical Pitfalls to Avoid

Do not confuse normal bright red stoma tissue with abnormal darker colors:

  • Dry, dark red stoma tissue suggests inadequate moisture or potential vascular compromise 1
  • Purple discoloration specifically indicates severe ischemia and impending tissue necrosis 2
  • Any deviation from bright red, moist appearance warrants immediate assessment by the surgical team 1

The nurse should immediately report any stoma that appears purple, dark red, or black, as these findings indicate compromised blood flow requiring urgent surgical intervention to prevent tissue death and systemic complications 2.

References

Research

CE: Stoma and Peristomal Skin Care: A Clinical Review.

The American journal of nursing, 2019

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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