Seeking Advice for Chronic Ostomy Irritation

Replies
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knitter

Hello everyone:

Generally, I'm doing very well at 10 weeks after ileostomy surgery. But what's getting me down is redness and irritation on the underside of my ostomy. Try as I may, I can't find anything that helps. Powder, barrier spray, changing appliance more often, reducing the size of the hole on the appliance. So all day long, it stings like crazy, and I'm really anxious to be more active and engaged with other people. Emotionally, the chronic discomfort brings me down, and physically even I feel bedraggled and tired. Any thoughts from those of you that have had similar problems or those of you that say you're oblivious to your ostomy pouch because it doesn't bother you hardly at all?

Beth22

Hey there, I am really sorry to hear you are going through this. I have been there more times than I can count. I was leaking so my question is, are you leaking? If you're leaking, powders won't work or anything you put on due to the fact of the output hitting it and your skin. Few tips when cutting your wafer: you want to cut it to the size of your stoma so it fits snug but not tight where it squeezes or cuts into the stoma. You don't want to leave gaps as it will get on your skin and under the wafer, making your skin raw, weepy, red, and burning like crazy. Another question is, is your stoma retracted or does it stick out?

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IGGIE

G'day Knitters, after you have cut the hole in the wafer, do you put a seal washer on first? This helps to close any gaps between the hole you cut and your stoma. Also, you said you change it more often. This is not a good thing because each time you change, you're pulling on the skin as you're removing the wafer. Please talk to your stoma nurse. Regards, Iggie

JamesArnod

I also had stinging and redness. I found out it was like a baby rash. So I used a small hairdryer to make sure that the area was totally dry. In a few days, it cleared up and I have not had a problem in the last 12 years. I lied, I actually did have the problem twice when I got lax with the hairdryer, but other than that, I didn't lie...have a great day all!

Na_a

Sorry to hear you are going through this. I had an issue with really irritated skin as well. I have a loop ileostomy so my stoma opening faces down causing a lot of "pooling" at the base of the stoma. As well, it does not protrude very far. My OA advised that for a little while (until healed) I change my bag every other day. I use a convex bag and a barrier ring (highly recommend). I can't remember the name of the process but I would also use several layers of barrier spray and stoma powder (after making sure I was fully dry with a blow dryer). So I would dry, apply stoma powder, spray, dry, powder, spray, dry, powder, spray, dry, ring, bag.

I wish you the best of luck.

 
Staying Hydrated with an Ostomy with LeeAnne Hayden | Hollister
Justbreathe

Had this same issue at the beginning and still having it occasionally- being advised to cut hole too big...I now snug it up so close to stoma I almost squeeze it in - especially make sure it is snug on the bottom of stoma - in addition, I added a barrier ring (Convatec) as many on this site recommended- I use stoma powder around stoma and a barrier wipe... still occasionally the skin around stoma gets "raw". Recently I discovered that Vicks VapoRub on that skin has helped tremendously- almost immediate relief - I apply Vicks first (may not be good for everyone we are all different- but was a cure all when I was a kid) ;then stoma powder, then barrier wipe - really provides relief for me. Also, I change every other day... Good luck in finding what works for you. jb

gentlejohn

I too use a thin ring beside your ostomy. Yes, that might help. Otherwise, consult a stoma nurse.

Justbreathe
Reply to gentlejohn

Yes, the barrier ring was a game changer for me!

knitter
Reply to Beth22

It sticks out a little and aims downward. I've been using a convex appliance by Coloplast. My daughter attached it yesterday and it's doing better.
She has better eyesight and can cut the hole on the pouch more accurately. So after several horrible leaks in the past two days, I've calmed down. I see the surgeon on Monday and they're going to offer me different supplies by a different brand. I was getting very down after lying on my back for 48 hours and not being able to keep a bag on that didn't leak. So just mopping myself up with nothing on for hours and hours. How depressing. The nurse at the surgeon's office told me to apply the bag using a different method and to eat in a way that bulked up the output so it wouldn't be so liquid.

Thanks for your information!

knitter
Reply to Na_a

Thanks! I had been doing the layering with powder and barrier spray but then the bag wouldn't stick. Finally, I was told by a nurse that for now don't use powder, put the ring on top of the sore area around the stoma, spray with the skin barrier spray everywhere including on top of the ring, dry, then put on the bag. It worked for me last night and I finally got some sleep.

knitter
Reply to gentlejohn

Thanks. I would just say that in my experience it's hard to find a good stoma nurse in my area. It didn't help that the home care nurse discharged me because I hadn't been having serious issues. Now I'm dealing with bad leaks and ulcerated areas around the stoma. They can't re-enroll me without blah, blah, blah. And, if truth be told, the home care nurses that visited in the past seemed limited in their knowledge.

Thankfully, I have an appointment at the surgeon's office in a couple of days. They're almost 2 hours away, but if they can help, I don't care about the distance. I live in a relatively rural area but within driving distance of major cities where health care is more advanced. Anyway, I almost went to the ER, but my surgeon's nurse said she wanted to be honest with me
an ER was not going to address the root issues, meaning they would probably just change the appliance but wouldn't offer me alternative supplies that might work better for me or treat the skin sensitivity satisfactorily or at all. I didn't want to go anyway, but I was feeling so out of control when I couldn't get the bag to stick and the leaks were miserable and my skin really hurt and I'd be lying on my back without any bag on just trying to keep the stoma clean. What a mess!

I don't want to be negative for other readers, because, all in all, I'm very lucky and will probably get a reversal soon. I'm healthy and have a wonderful support group. Sometimes a bad day or two can derail me, but then I rally and get back on the horse.

knitter
Reply to Na_a

Thank you. Yes, I had that "pooling" problem myself. But I'm trying a different procedure to attaching the bag and it helped me get through the night. Put on the ring very tightly against the stoma, make sure the hole in the bag that goes around the stoma is right up against it, spray with barrier spray everywhere, then dry, then attach appliance. I see the surgeon on Monday, so my fingers are crossed! I appreciate your contribution to the discussion!

knitter
Reply to IGGIE

Yes, I put on the seal washer first. It's sometimes hard to get to the stoma nurse because the surgeon's office is so busy. Have to accept that because he saved my life and has a really successful practice outside of Philadelphia because he's so good. Anyway, I would like not to change the pouch so often, but when I couldn't get it to stick properly, I experienced horrible leaks. So after using the method usually prescribed
layer of powder, layer of skin barrier spray, repeat, repeat, then dry, put on seal washer, then ostomy bag
the nurse said, try this: don't use powder, put seal washer on to completely cover sensitive area around stoma and very snug against stoma, spray thoroughly the washer and all the skin around it. Dry. Put on ostomy bag. For now, that is working. I finally got some sleep last night.

You're all the way around the world from us, but I benefited from your thoughts! Thank you!

knitter
Reply to Justbreathe

Yes, it's so important to get that hole snug and right up next to the stoma. The Vicks Vapor Rub is a surprise! Never heard about using that before. Wouldn't that make it hard for the ring and the ostomy bag to adhere?

Justbreathe

I have no problem with it - again I apply Vicks (thin layer) close to stoma (irritated area) then stoma powder then tap a barrier wipe on top - note: these are the products I use - I have been using these same products for almost 3 years (just added the Vicks - as yet no problem) and have never had a leak with these. Early on, I had a major fail using another bag with no outer tape - once was enough! Here's a picture (worth a thousand words) for your viewing pleasure...

ahynes111
Reply to knitter

Read the submission Vicks Fix!

AlexT
Reply to Justbreathe

I have no idea how people wear bags with no outer tape. &zwj

fermrar

Hi everyone, regarding that issue of irritation around the ostomy, I took the advice of the nurse that said to put egg white after taking a shower, and the truth is that it's working for me very well. It helps regenerate the skin around and no stinging too. Try it.

sunburst

As many others have posted, a snug fit and a barrier ring make a big difference. Until I switched to a convex wafer due to folds on either side of my stoma, I had a few leaks. Changing to a convex wafer and continuing to use a barrier ring have eliminated the problem. Still important to get a snug fit, but the ring will fill a tiny space to help avoid leaks.
good luck

ejbetty

My nurse said I had an infection, so I was put on antibiotics. Just a thought.

61smiles

Hi, one thing I've noticed that no one has mentioned is avoiding leaks by laying on your side. I have found that sleeping on my back causes my output to seep down and sneak under my seal.

Justbreathe

After reading all the above comments, I have a question/comment...

I use a barrier ring, but I apply it to the pouch wax first and tightly seal the two together rather than putting them on separately. I can see how applying the barrier ring to the skin first would allow a good visual of the fit, but then you cannot press down hard enough to seal the two together, right? Seems this would allow leaks or seepage between the two.

JustGigi1967
Reply to Na_a

My ostomy nurse calls that "crusting." It's like you're building a crust of protection around the edge of your stoma.

JustGigi1967

So... I have similar problems and I have yet to find a solution. I have extremely sensitive skin, adhesive sensitivities, and hypergranulation around the entirety of my stoma.

The base layer of protection that I use is a silver gel. Then I build a crust 3 or 4 layers of powder and spray.

I use a Coloplast convex barrier ring and pouch. I use hydrocolloidal dressing instead of Brava strips. I use a barrier spray any place that an adhesive would touch my skin.

Due to my sensitivities, I change my pouch daily and I allow for a 15 to 20 minute skin break... I guess what I'm trying to say is that each person's experience is different because each person is different.

Doe1mama
Reply to Justbreathe

Agree. The barrier ring was the answer for my husband.

Yancey
Reply to knitter

I used to have your problem but I now use the adhesive paste around the hole. It seems to help keep the seepage off your skin.

GreatKap
Reply to knitter

How long after you did this, did you feel relief from the burning? We have been using a barrier ring from the beginning. Tried the crusting powder. No good. This all just started early yesterday. We changed the bag yesterday when the burning began (wasn't even time to change but figured we better take a look at things). So today, we advanced to barrier spray and paste along with the barrier ring. It doesn't appear there is a leak going on. As long as my husband was still, he had no burning. As soon as I completed the change and he went to get up (moved) the burning began again. He is using a belt. There was nothing in the bag. He still has stitches. Once upon a time, I had to have a cyst removed and about the same time frame as it has been for him since his surgery (day 19 when burning began for him - was not even that long for me), I began having the same issues and the stitches had to be removed. I can only wonder is he having a reaction to the stitches? Now that I think of it, I believe we were told they would dissolve on their own, but they are still very much visible. He doesn't see his surgeon and Ostomy team for post-op visit until the 8th. It doesn't bother him unless he moves. Is this what you experienced, too, and if so, once you began using the barrier spray, how long before it stopped burning? My husband has been through so much...it is just killing me to see yet another set back in his recovery and once again in pain.

MoeMoe
Reply to GreatKap

Hi! The same thing happened to me. Nothing was helping the stinging but laying on my back and still. I was using the powder, the ring, and layers of barrier spray. Turns out the powder was what was causing the irritation. It's almost cleared up since I stopped the powder. So now I use the barrier spray, wait until it's really, really dry, then I put the bag on, a one piece. Anyways, that's just my two cents. Hope it's gotten better!

ColinSansColon

I had similar stinging issues and skin irritation for a couple of months after my surgery.  The hospital sent me home with Hollister products - turns out, for me, these products just didn't jive with my skin.  A wonderful stoma nurse set me up with Coloplast Sensura two-piece appliance and their barrier rings.  I eventually switched to the Perfect Choice barrier ring which is superior IMHO.  I've been getting 4 days with no discomfort and I think I can push it to five days.  My skin has been clean.  Here are my products/routines:

Coloplast Sensura two piece - the cutout is tight to my stoma shape, no exposed skin
Perfect Choice Barrier ring - warmed up and applied to the back of the Coloplast flange (I do this before removing the old appliance and cleaning)
Wipes (Safe n' Simple brand), then combo of wet/dry paper towels to clean things up, very careful shaving around the area
I find I need to gently with my fingernail scrape off any extra residue on my skin - works best when the skin is wet
Stoma Powder around the stoma then tap-tap your belly to spread it around
Cavilon spray all around, let it dry
When applying the flange be sure to carefully push down around the stoma, I use my pinky to get in between the stoma and the flange ring
After the bag is attached, place your hands on the flange for a few minutes, warming the are up to ensure a good seal

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