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Hi,

Does anyone have experience with a flush or retracted stoma?

I have a loop ileostomy, and my stoma has retracted (and is almost flush with my skin). This is causing a lot of discomfort, irritated and denuded skin, as well as frequent pouch changes. These problems are also preventing me from being active in sports. Activity also reduces the life of the pouch. I have yet to last longer than 4 days with a pouch, and it is already quite painful (skin) at pouch change.

Does anyone have any suggestions or advice on how to cope with this problem? Are there possible resolutions outside of surgery? I have tried some convex products, but they have still failed and do not last.

I had my surgery to create the ileostomy on April 23, and have already been hospitalized a second time due to surgical complications (obstruction due to scar tissue).

Any advice on this matter would be greatly appreciated.

Thanks,

Solomin

Replies sorted oldest to newest

I also have issues with retraction and this is even after a stoma revision. Somehow my body just wants to make the loop experience as miserable as possible. The only thing that sort of keeps this manageable is using Convatec pre-cut convex wafers (I think these have the most convexity and are as firm as wafers come) and changing about every 1 1/2 days. Good luck to you! I know it is frustrating.
V
Definitely use a convex wafer. Have you consulted with your ostomy nurse?

Four days is too long to try to go between wafer changes if you're having issues like this. I know some veteran ostomates will go 7-10 days between changes but twice/week (three or four days per appliance) is the standard recommendation. I know it can be painful to change so you want to do it less frequently but your skin will heal more quickly if you change more frequently. Two-three days would make more sense. Personally I would rather change every day than try to stretch the life of a wafer and deal with skin damage...

Do you know how to "crust" over damaged skin using prep wipes and powder? Basically you want to apply a small amount of powder over the irritated skin, then dab on no-sting skin prep, then add a bit more powder, etc alternating for three layers or so. This will protect the damaged skin while still allowing a good seal.

Are both openings on your loop flush, or just the mucus opening? Make sure you aren't pouching OVER the mucus opening -- this is a common issue with loop ileos where the mucus opening can be flush or hard to see. The mucus won't break down skin so it's often helpful to cut your wafer a little larger around the bottom/where the mucus opening is to make sure it isn't outputting underneath the wafer, leading to much faster breakdown.
P
I had this same problem with my second surgery. There were days that I was having to change my ostomy system 2-3/day because of leakage issues. I went to a convex system with a belt. Remember that some may work better with your stoma than others, so you have to be patient. I know that's not the best advice to hear, what with the irritation at the site and all, but it will get better. There are a lot of products out there. You just have to find the one that works best with your pouching system. I would speak to your ostomy nurse and ask for samples from other companies such as Hollister, etc. That way you can try them out and decide which one works best for you.
A

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