Which of the following is a contributing factor for stomal prolapse?

• A. Obesity
• B. Weak muscle tone of abdomen
• C. Large abdominal wall opening
• D. Pregnancy

Answer: (D)

Stomal prolapse happens when more of the bowel slides out through the stoma, and anything that increases intra-abdominal pressure or reduces abdominal wall support can enable that to happen. Pregnancy is a particularly direct contributor because the growing uterus raises the pressure inside the abdomen and stretches the abdominal wall, making it easier for a loop of bowel to telescope through the stoma. Hormonal changes during pregnancy can also relax tissues, increasing susceptibility.

Obesity and a large abdominal wall opening can raise pressure or reduce support as well, but pregnancy uniquely combines a significant, dynamic rise in intra-abdominal pressure with tissue laxity, which explains why it’s the contributing factor listed here.