Need tips for using stoma collars with loop ileostomy?

Hi all, I have been trying the Dermacol stoma collars as I have constant bleeding and soreness on the skin at the bottom of the stoma and thought it might stop that! The trouble I have is that I have a loop ileostomy and have a small opening at the left side of the stoma and the adhesive base of the collar covers it! I don't know if it's my imagination but I seem to build up a lot of gas almost as if I'm plugging the hole! Sorry to be so graphic but I wondered if anyone had a tip for a way round this as I think the collar would stop the soreness I get! Thanks! Marilyn.

In this place if you aren't graphic, you're wasting time. No one here is shocked by a stoma or output. This is our life....

So if I read your post correctly...

When they established your loop, the opening where they turned your intestine inside/out extends down to the base of your stoma. The "outbound" opening is higher up the stoma, and the opening to your "unused" bowel is at the bottom of your stoma, and that hole gets covered by the stoma collar.

I think that you're partially right about the gas. Just because that part of the bowel is out of the processing loop doesn't mean it doesn't do anything. I'm sure that since it has nothing to really work with, it does produce some gas. When you're working on your stoma, I could see some of that slipping out. Do you get distended or do you feel pressure? Do you occasionally pass gas through the rectum?

Back in '81, I had a temporary loop ostomy. In a few months, my outie turned into an innie, and at some point, a little fecal matter actually made it down the resting side, so for the last month or so, I passed fecal matter through both my stoma and my rectum.

I'm thinking that you probably aren't in any danger, but I'd show it to an ostomy nurse because they've seen many, and I've only seen my own stoma! LOL

Dave

Hi Dave, yes you've more or less got the picture! I get a bit distended and just feel kinda blown up and when I take the stoma collar off it all settles down! I do get gas from my rectum now and again but that's just a build up of mucus that causes that and goes as soon as I pass the mucus! I wondered if anyone had heard of a stoma collar that might fit over both 'holes', probably a long shot! Thanks for your interest in helping, cheers!

Hello

With my first loop ileostomy, I wasn't aware of the second opening and was placing the bag straight over this opening, accidentally sealing it, thinking there was only one opening to be dealt with.

There is mucus that exits from this opening, also a small amount of gas. This mucus caused the adhesive on my bags to fail and leak. It wasn't until I visited the stoma nurse that I learned of the second opening and not to block it off. I have an "end ileostomy" now, but for the record, I used a "Salts" mouldable seal around the perimeter of the stoma site, slam the bag on, and all is good.

Hello Marilyn. I do not have this problem , so I can only guess at what I might try to resolve it.

Were you aware that the Dermacol collars come in different sizes?   It might be that a size bigger would allow enough room for the hole to remain uncovered and still give protection around the rest of the stoma. (ask for samples)

Another option might be to punch a small hole in the collar (with a hole punch, or a pair of small scissors)  and locate that hole where the hole in your stoma is.

I hope this helps

Best wishes

Bill

Stories of Living Life to the Fullest from Ostomy Advocates I Hollister

Hello Axl,

What you are describing is exactly my situation and the mucus coming from the opening did cause the adhesive to fail so definitely wasn't suitable! Bill below has suggested making a hole in the adhesive part of the stoma collar but it isn't big enough to cover over and go beyond the small opening to stick properly so looks as if the collars won't work for me! It would be great if Salts would devise something similar for loop ileostomies! Thanks for your help! Take care!

Hi Bill,

Thanks for trying to help. I know the collars come in different sizes, but to make them work properly, they have to be a snug fit around the stoma! Your idea of punching a hole is good, but the trouble is the collar isn't big enough to cover far enough over the small opening for the adhesive to stick! If the adhesive base of the collar was bigger, that would have been a great way to resolve the problem! Maybe I should contact Salts and ask if they would consider that idea, as there must be lots of people with a loop ileostomy who would benefit from these collars! Thanks for your suggestions. Your ideas for people are always excellent! Hope you are keeping well, take care!

Hello Marilyn.

Sorry my suggestions were not sufficient for your needs. I am having difficulty envisaging precisely what you need, but what I can say is that virtually nothing I tried that was 'off-the-shelf' was appropriate for my own needs. In the end, I started making my own baseplates until I created one that was just right. It is made of plastic and wastepipes and sticks on with medical adhesive. Now! if you simply need to extend the area of adhesive, then I would recommend trying the medical adhesive (on the collar) as it is just as good as the stuff they put on the flanges. It simply sprays on and you can then spread it around with your finger to get it where you want it to be. 

I hope that helps

Best wishes

Bill

I didn't get on well with collars myself. In my case, they caused more leaks. But yes, I know what you mean about them. Have you tried ConvaTec mouldable? I can't remember their proper name for the life of me, lol. I was at the launch event for them about 6 years ago in the UK. The ring moulds itself to the shape of your stoma, so you get a very good seal. I see you're from the UK. The best option is to speak to your stoma nurse or one of the home delivery company nurses. They can give you various samples to try.

Hello again Bill,

If I knew how to put a drawing on here, I would think that would be easier to understand than explaining the situation! What I'm trying to achieve is exactly what the collar would do. I keep getting raw and bleeding right at the bottom of the stoma where it meets the skin! I do use the moldable seals, but the output still manages to get under it! That's where I think the collar would help as it's sealed at the part where I'm having the problem! Sorry, not easy to explain this! If the adhesive baseplate of the collar was just another half inch in diameter bigger, then your idea of making a hole in it where I need it would have worked a treat! Hey ho, think I'm beat!!

Hi Panther,

I do use the mouldable seals but it doesn't matter how hard I try to get it bang up against the bottom of the stoma, the output still manages to get underneath it and cause sores and bleeding! If the adhesive base plate of the collar had just been a wee bit bigger, say half an inch in diameter, I could have cut a small hole in it to expose the small hole of the loop part of my ileostomy! Because the adhesive plate is covering that hole when it's on, it's causing a lot of gas and bloating but the collar part is solving the bleeding!  Help one thing and get another problem, was just hoping there was something else out there that I hadn't discovered!  Thanks for trying to help! Take care!

I've never used a collar. I'm wondering if you used a ring (mouldable barrier material) that might solve the problem.

I have both Hollister and Convatec rings if you'd like to give it a try.

Dave