Which of the following is a contributing factor for stomal prolapse that involves increased abdominal pressure?

• A. Obesity
• B. Increased abdominal pressure with tumors, coughing, crying
• C. Large abdominal wall opening
• D. Pregnancy

Answer: (B)

Stomal prolapse happens when a loop of bowel telescopes out through the stoma, and a major driver is a rise in intra-abdominal pressure. When pressure inside the abdomen increases—such as during coughing or crying—or when an abdominal mass like a tumor is present, the mobile bowel can be pushed outward through the stomal opening, leading to prolapse. The option that explicitly describes these pressure spikes, including the effect of a tumor and the transient increases from coughing and crying, aligns most directly with this mechanism. While factors like obesity or pregnancy can raise overall abdominal pressure or contribute to prolapse, they’re not as specifically tied to the pressure- spike mechanism described here.