Which is a major long-term complication caused by coughing in a patient with a colostomy?

Rationale: A. A stoma prolapse occurs when a portion of the intestine protrudes excessively through the stoma site. Increased intra-abdominal pressure from chronic coughing, straining, or heavy lifting can contribute to prolapse, making it a major long-term complication for colostomy patients. It can lead to discomfort, impaired appliance fit, and potential ischemia if severe. B. While the skin around the stoma can become irritated or inflamed due to poor hygiene, leakage, or allergic reactions, coughing is not a primary cause of long-term inflammation at the stoma site. C. Obstruction of the stoma usually results from scar tissue, adhesions, or impacted stool, not from coughing. While increased intra-abdominal pressure may transiently affect output, it does not typically cause long-term obstruction. D. Stenosis (narrowing of the stoma) generally develops from scarring or poor healing, not from repetitive coughing. Coughing primarily contributes to prolapse rather than narrowing.