Help with skin breakdown around loop ileostomy? (Takedown for j-pouch in a couple of months)

Hi Morgan,

Sorry you are going through this.  Yes - there could be help out there.  Coloplast makes a skin barrier sheet that you can cut a hole for your stoma and apply it directly to your skin and then put the wafer on top of it.  Some swear by it.  Also - I found that Coloplast wafers last longer that Hollister.  Give Coloplast a call.  They will help.

I had an awful time with my loop ileostomy as well.  I had myself declared 'housebound' by the visiting nurse who came every other day for a while.  It meant I was allowed to work from home, which also helped me cope.  Don't try and get longer out of a wafer, it's better to just change it than to have any leakage.  Once you get some skin healing you may get a better seal.  Too much stoma powder can make a bad seal - just a dusting at a time.  I also found that when I slept on my back the leaking was worse.  On my side with the pouch rotated to the side was better since nothing pooled around the seal.  

I had trouble too. I found a local stoma nurse & she worked with me & products to get it healthy & healed. I am allergic to zinc & latex & so many products have those it which only caused more break down. Perhaps you can find a nurse that will help you. I wish you t h e best. Take care. 

United osteomy & wound organization i think you can Google them. Or try your local wound clinic. I hope this helps you. 

Im going through the same thing right now. I had my loop created 8/27. I am getting better at it though. I change it just about every day. Once in a while i go 2 days. 

Heres the process that works for me or at least kind of works.

I take my appliance off and shower to clean it up.

After i dry it up very good i put stoma powder on. Then i use the skin barrier wipe over the stoma powder and over every area that is covered by the appliance. Then i use something to fan it until its totally dry

I use a barrier ring. I also use the convex pouch.

I take the sticker off of the pouch and i apply the barrier ring around it while its on the counter. I open the barrier ring up so its a little bigger than the opening in the bag. I put it on the bag and leave about an 1/8" all the way around the opening. That way when it heats up and expands it doesnt expand past the opening in the bag. I stick it on then i take a heating pad and put it over it for 20 seconds or so to melt it on.

That seems to work for me. Just keep trying different things. Dec will be here before you know it.

I am not sure what your emptying habits are but something that I learned this year is when you let the bag get too full, the poop starts to collect under the wafer, irritating the skin more greatly. Its better and perfect to empty the bag more often, try emptying the bag before it gets full around the stoma if you are not doing so already. 

Emptying tips: Each time you want to wash your hands, empty the bag. Before eating, empty the bag and then wash hands. Since we are suppose to wash our hands more often due to the Covid, emptying the bag before having to hands anyways helps a lot, its also a good way to get two things done at once. 

In conclusion, I follow those tips and I find that it helps me greatly. Each time I have to wash my hands for any reason, I try to empty the pouch before I wash my hands to get everything done at once. I hope my tips help, keeping everything empty reduces irritation in my experience with the bags. 

If it does not help, I would recommend woundcare doctors/clinics. 

Thanks to everyone who's replied here—I think I've got some leads on what I'm doing wrong. (I think I'm doing too much powder which gives me a poor seal, and I think I'm putting the ring too close to the stoma which gives me granulomas and lets the output leak a little and causes more skin breakdown.) Off to try a modified routine and get this skin healing! One nice thing about all this is how quickly the skin heals—pretty amazing. 

I also had a very bad time with my temp loop....I found that my skin reacted poorly to the barrier “donut” and was having bad reactions and leakage due to skin break down. What finally worked like a miracle for me was not using the donut ring and building a “gasket” with stoma paste...stopped all leaks and allowed my skin to heal. I hope you find a solution fast and heal up quick...bad stoma skin is painful.

This is what I found and used...my wound care nurse never told me of this product and said they prefer to find the best appliance to stop leaks from happening. I suffered for 2 months and this stuff worked great.

@Morgan Hubbard posted:

Thanks to everyone who's replied here—I think I've got some leads on what I'm doing wrong. (I think I'm doing too much powder which gives me a poor seal, and I think I'm putting the ring too close to the stoma which gives me granulomas and lets the output leak a little and causes more skin breakdown.) Off to try a modified routine and get this skin healing! One nice thing about all this is how quickly the skin heals—pretty amazing. 

You are welcome! I hope the problem gets solved! Let us know how it goes

Find a good stoma nurse. It saved me.