Ileostomy retraction - Tips for fitting flange with pancaking issues

I've noticed 2 or 3 times my husband's ostomy seemed to retract, which of course makes it harder to fit the flange as snug as we'd like.

This seems to happen when there was pancaking. And it always returns to its normal slight protrusion.

It sure is a frustrating game trying to figure out what works best. We think we have it figured out and then oops, no we don't. Or I guess what he ate or drank changed things. He does sometimes eat heavier meals, which I'm trying to curb. But it is nice to see him finally enjoying food again.

Hello Doe1mama.

Thanks for your post as it gives us an opportunity to simply say that you and your husband are not alone in this predicament.

There seem to be a few reasons why stomas retract and pancaking is just one. (Mine retracts when any pressure is put upon it (or when it gets cold).

The pancaking is possibly exerting some minor pressure on the stoma so it might be an idea to try things to prevent that happening.

I would suggest asking for samples of Salts Healthcare - 'Dermacol' stoma collar, which are in various sizes to fit various stomas, so you would need to give them the size.

These are super-soft and fit snuggly round the stoma, guiding the output away and into the bag.

I used this concept to make my own bespoke device which includes a baseplate and a 90' waste bend elbow, which not only guides it away from the stoma but makes sure it goes in a downward direction into the bag/sleeve. However, not everyone is adept at DIY, so the Demacol stoma collars are the next best thing (in my opinion)!

PS: I did try to make a silicone mold of my stoma, but every time I put any silicone on, or near it - the stoma shrank, so that idea was shelved in favour of the sleeve and bend approach.

Best wishes

Bill

I notice too that bigger meals tend to cause bigger output and pancaking - especially if there is no air in the bag. Some appliances tend to eliminate air - not sure this is a good thing? I believe a little bit of air helps the output head downward. Hmm, there may be a song in that last sentence...a spoonful of sugar oh never mind.

Hi Doemama, have you tried using a flange that is convex so as to force the stoma to stick out more, helping the output to drop into the pouch.

Because of prior suggestions, we have been using a cover over the filter and the air in the bag certainly helps prevent pancaking. However, at night, we discovered it might be best to leave the filter open. Because if we don't, all the air pressure in the bag (again, the amount of air pressure is likely due to what he ate) seems to cause a break in the seal and it leaks for that reason. Catch 22. BTW, love your name. That's what I was saying last night when I had to change the whole apparatus, "Just breathe, take deep breaths."

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Glad to know it's something that happens. I'll check out the Dermacol.

I haven't. Last night I used paste with the flange and it did hold it for the night. But the seal broke on the side where the stoma hadn't yet protruded to its normal position yet and started oozing out when he got up in the AM. Sounds like it would be a good idea to have some of these on hand for when the stoma "hides". Thanks for the suggestion.

Yes, I also recommend trying the convex flange. It is especially good for people whose abdomen is not flat around the stoma area, or if the stoma doesn't stick out very much. It can make a huge difference.

Terry

Thanks! The appliance I use doesn't have any filter system and I am not sure why it is needed? Many on this site use the type with charcoal, etc. I am guessing to reduce odor...not saying that "my shizz don't stink" but I haven't had any comments from my closest peeps and again a slightly inflated bag helps gravity do its job. Now I know we must address overinflation as well - this would not be a good thing and I have experienced it. Most notably when I am shopping and look down at my belly and realize I look at least 8 months pregnant. This is not a good look for a woman in her 70's - - - just sayin'

I have found that if I eat big meals, my bag fills with a lot of air. I use salt bags; they come with a vent built in but get blocked, so I end up with a whoopee cushion. I have found from my supplier, Bullens Health Care, a device called EZ Vents. Brilliant! They attach via pulling tape off and sticking to my bag. You pierce a small hole; when the bag fills, pop the valve, and the air is gone. There is a downside: you do get a bit of discharge, about the size of half a garden pea. I wipe it off, close the vent, and all done. Before these, I was changing the bag so often. I can only share my routine, but there are a lot of fantastic guys on here with such great advice.