Hey guys. Its been about 2.5 weeks since my surgery and I've had a consistent skin irritation for about a quarter of an inch all around my stoma. Sometimes there would be less irritation one one or two sides, but its still there and causes some itching and occasional slight pain. I have this innie stoma (I should count myself lucky though... I almost had to have a permanent stoma! better innie than none) so its hard to fit it and my stoma nurse and I have been trying to figure out how to stop this irritation. We have put the powder and skin barrier on it each time we changed the bag and tried this stick of putty stuff, we've tried eakin rings, and lastly we tried stoma paste this morning when we changed it (also switched from a one piece to a two piece). Well my stoma nurse wasnt there to help, but my mom helped me - and I think she put it a bit too close to the edge of the wafer opening (its a kind that you dont cut, just mold to the size of the stoma - its convex too like my previous 1 piece bags). So the wafer opening is a bit smaller than the stoma, but I think it has a good barrier against the skin to hopefully stop the irritation. Actually it feels better now, not NEARLY as much itching. But it feels weird when I walk (and has these last 2.5 weeks) even when the bag is empty. So for those with innies - is it ok to have the wafer opening a bit smaller than the stoma? And if my irritation doesn't go away, any ideas to help that?



P.S. Is it normal to sometimes "feel" the stoma when it makes noises? Lately with this new 2 piece that I talked about above, I don't feel it as much but it does kind of tickle. Previously I think I might have felt it on my skin (the warm output). Basically it kind of tickles and I'm wondering if that is normal.


SORRY for the long story and question and stuff! THANKS for any help!!!

Hmmm... if you have already tried the powder and the "putty" I'm not sure I'm going to have much in the way of suggestions. The only additional thing to possibly try is a breathable pad made to soak up but breathe (I think I used something ?Aquaphor? made). I had a pressure sore that was killer, and my ET nurse used the pad over the bad spot, then putty, then the wafer. Surprisingly, she also put on a flat wafer instead of convex and it actually helped. I know that's contrary to logic, but it did help. Not sure I'd recommend it to you - but something to try if all else fails. You can also change the wafer more often - if you are able.

Your sensations regarding your stoma are perfectly normal. I would NOT cut that wafer too small either. When peristalsis starts and it begins moving in and out, getting bigger in the process, it will rub on the wafer and that can cause irritation or even cuts. It's pretty delicate.

The other odd thing about what my ET nurse did - she cut that wafer larger than I had been. And yet, it didn't leak or cause me problems. I started making mine a little larger after that too.

I hope that helps some.

Steve

My end ileostomy caused me many problems similar to the ones you are experiencing as it was in a dip.

So, here is my advice based on 16 years of experimentation.

Don't ever allow the ring of the bag even make contact with your stoma. If it cuts in to the stoma it was cause permanent trauma which externally may heal and look normal but benath the surface it will damage blood vessels and spoil blood flow which could lead to stenosis (narrowing) of the bowel which will lead to increasted risk of blockages now and after takedown. I was told sleeping on my belly would be okay with a stoma, in practice though it caused more trauma too which is why I would never do that with my temporary loop.

The way I managed to cope/overcome the problem you have was with Stomahesive paste. What I did was look at the engineering behind the seal that needs to be made. Firstly squirt a ring of the paste on to the peristomal skin also so that it actually makes contact with the stoma. Ensure the skin is as dry as possible (I accept it may be weeping and sore so dab it dry with tissue and blow in it) the paste contains alcohol so it will probably sting like hell but for me I realised it would have cleansing effect, grit your teeth for about 30 seconds, the pain subsides. Next wet the end of your finger under the tap and dab the paste (the water stops it sticking to your finger) to shape the out edge to that it is flush with you skin and gradually inclines to meet your stoma. You end up with what looks like a ring with a seamless seal protecting your skin. Blow on or air dry the surface of the paste then apply your bag, ensuring your gently press down the edges around the paste and stoma without displacing the paste too much.

Once the skin has healed, the stinging will not happen.

I learned that changing the bag just before bed meant that it was less likely to get dislodged and the paste got time to set for the following days activities. Also apply the paste and bag while you are standing so that your abdominal skin as stretched and do not sit or crouch for a couple of hours. I did have to change it daily and this was not the perfect solution but it was the best solution I could find after 16 years of trying. After a day or so, the skin would clear up, i'd continue with this as it consistently protected my skin from the dreaded burn. Also, its not essential to remove all the paste between changes.

Good luck, if you try this let me know how you get on.

Yes its normal to have a sensation when the stoma is active.

Dan

I have an innie too. I use a hollister flat wafer and cut it slightly bigger than my stoma to allow the eakin seal room to expand. I also use a hair drier to help with adhesiveness.

Is it leaking, or just getting irritated? I had a very sunken stoma after my 2nd surgery. It was very irritated, and leaked constantly. I was eventaly able to get a convatec wafer to stick for about 48hrs at a time, but the whole experience was maddening. My skin never did heal up the whole time with the wafer, but after 6 weeks we got me hooked back up and everything was peachy. Basically, my advice is try some different companies wafers, that might be your ticket to a better fit.

I lost my ostomy a long time ago but I do remember that if I put my hand over the stoma, after changing the bag, it helped the adhesivness a ton and then some. I would lay down for about 5 min with my hand on the stoma.
One other suggestion is that you could try Shaz's Ostomy board...It's much like this one and while it also talks about j-pouchs and all the other things as here, it is more directed towards ostomies
Julie
www.ostomates.org

I agree that you should never cut or mold your wafer too small. This can damage the stoma and cut off vital blood supply when the gut is in peristalsis.

Also, I am a great believer in the less is more theory. I only use a no-sting barrier wipe before applying my convex moldable wafer. I have a lot of scarring and dips around my stoma and the moldable wafers really do mold to every contour so there is no need for pastes and seals.

Another thing is to make sure that your appliance is well supported. I wear good quality lycra underwear which helps to keep everything close to my body. Others prefer to wear an ostomy belt. Either way it's important to try to keep everything well supported and to help the convex wafer push out your stoma.

You are still very early in the game. Make sure you measure your stoma every time you change your wafer because it will continue to shrink for several months.

If I get any irritation (very rare now I use the moldable wafers) I dust with stoma powder and then dab over with the no-stin barrier wipe before applying my wafer and usually things ahve healed up nicely by the next wafer change. Also, I like to shower without my appliance on the days that I change my wafer. I aim the shower head at the skin around (not on) my stoma for 5-10 minutes. This not only feels really soothing but helps to stimulate the blood supply and therefore speeds up the healing process.

I hope this helps.

Good luck.

Shell

Hi

I had awful leakage, very uneven craggy area around an innie, less than flush stoma..
I use Keraya powder (solidifies leakage, seeping), then cement (perma-type is 1 good brand) layering wafer and corresponding area around stoma with a liberal coating, then Eakins seal (Eakins rules!!), then wafer then belt.
Stoma powder was a big help as was the belt.

I will say the last/BEST surgeon told me my stoma would come out more / protrude teh longer I was 'out' from surgery. From a recessed/innie, it is now out maybe 1/2 inch and to me, that is like a telephone pole after all the problems....

On diet, Bananas every morning and a rice/egg fritatta bind me up pretty good. No soda.

Rice cakes are good now too-Ranch flavor especially, Not like Mom's rice cakes.

And I have 2 Pectin capsules 3x's a day with water-helps solidfy stool.

Good luck

I also have an innie. I had my first surgery on May 2nd and until last week have had terrible problems with burning pain from the irritation. Last week we accidentally found the perfect fit, size, and location. That was all it took. 3 days later when we took off the wafer, after 3 days of zero pain, the skin looked beautiful. Here is our routine.

Don't eat after 8 pm when I'm going to change it the next morning.
Take off appliance
Get in shower and let water run over the stoma to get it good and clean. I will cup my hand under it to let water pool up on the stoma.
Sometimes I use adhesive remover in the shower.
I wash with soap and water right up to the raw areas then rinse thoroughly.
Lay down on bed
Dry stoma and skin with blow dryer on cool
stoma powder thickly on all raw areas
Barrier wipe around and up to powder
Dab powder with fresh barrier wipe to set the powder
Add more powder
Another barrier wipe around and up to powder
All that dries while hubby cuts hole just big enough for the stoma. He cuts it out just a little on the top where the output hole is.
Apply Eakin seal to wafer and make sure it is thoroughly stuck
Apply wafer carefully to body to make sure it is perfectly placed. Hubby does this by looking through the hole as he does it.
As soon as he puts it on, I press down on the ring to help set and mold the eakin seal while he secures the bandage part of the wafer.
Attach bag
Attach belt
Keep laying there and putting pressure on the ring for probably 30 minutes.

I think the belt was what made the biggest difference. It helps to hold the bag down and close to my body so the stoma can "spew" into the bag instead of under the ring. I hate wearing the belt, but I hate the burning pain more.

I am counting the days to take down, 19 now!!!! I can't wait to get rid of this bag.

Good luck. I believe the key is the stoma powder thickly, careful sizing and placement of the wafer, and wearing the belt which hooks to the sides of the bag ring.

Thanks for the input

My stomas been better - I forget if I mentinoed it in this thread, but last Sunday, the last time I changed my bag, the irritation looked to be healing a bit. I've had this bag on for a week (nearly - gonna change it tomorrow - sunday - morning) and its not too bad. I had some problem with food passing earlier, but thats my own fault. I didn't drink enough water nor did I chew enough. I also think that SOMEHOW my eakin ring is swelling up a lot and causing pain when thick food passes. I thought last time it was because I tended to hold my hand over my wafer area and I thought that maybe it flattened it out and caused the small hole, but I havent done that this bag and I STILL have that problem! Right now the opening is maybe a half an inch when my stoma is about .75/1 inch (oval). I just hope tomorrow my irritation is healing more!

On a sidenote, Gail, you had your surgery on my birthday AND you're going to have your takedown a day after me! Haha. Good luck!

A week??? That may be part of your problem. My stoma nurse said no more than 3-4 days, especially with irritation. I do much better on a 3 day schedule and if it hurts really badly, we change it in 2 days. Don't take chances and stretch the use of the bag. It isn't worth it. Most insurances pay for 2 a week, so you should have enough to change more than once a week.

I have 19 days to take down and am almost counting the hours. Although it will be worth it ultimately, I am SO ready to get rid of this bag!!

Have your tried any stoma powder? I also liked eakin seals. They are like rings and helped me a ton. Edgepark.com has them. Hope things get easier.

I'm laughing because we use tons of stoma powder every time we change. I think the biggest thing that helped was wearing the belt that actually hooks to clips on the bag. I HATE it, but it beats the burning from the acids on my skin.

We had a setback last night. I have a place on my incision that reacted to the stitches and has a hole at least 1 1/2 inches deep. We have been packing it daily for about 2 1/2 weeks.

Last night, late, it began to really hurt below it. When hubby looked, it was angry red, so we immediately took off for the ER. They put me on antibiotics and some powerful painkillers. Today when hubby took the packing out, it drained and drained pus and blood. I'm hoping that means the infection is coming out and I'm beginning to fight the infection. I'm 18 days from takedown and don't want anything to stand in my way!