Pain with Convex Wafer After Ileostomy - Seeking Advice

I had a ileostomy 4 weeks ago.  I'm using a convex wafer and I'm experiencing  pain at the top and bottom of it. It pushes in and hurts.  Can anyone give me some ideas how to stop this or explain why it is happening?

Hi, welcome. The more experienced will chime in. I understand you have an ileo and use a convex type wafer.

Is your stoma flush to the skin? Why are you using the convex and not a flat type wafer?

Just 4 weeks old, I'd say some pain will be normal as the body adjusts. If it's severe, go to the E.R.

Hello,

Why are you using a convex wafer?  Is your stoma too close to skin level?  A stoma not sticking out enough will cause trouble.  Irritating output will get on your skin, instead of dropping into the bag.  

It will take time for you to recover from surgery.  Then more time for your body to get used to your new normal.

If your stoma sticks out at least 3/4 of an inch... there's no need to use a convex wafer.

If your stoma is too close to skin level, revision surgery is needed.  Your stoma can be pulled out to proper length.

If you just got your ileo 4 weeks ago, I wouldn't use a convex wafer. You're still healing, and that's putting too much pressure around a new stoma.

My surgery was less than 4 months ago. So I recall being new. My urostomy was skin level so they started me with a convex wafer from the beginning.  It did hurt a little at first but that quickly passed (or I learned to ignore it). By 4 weeks in, I was definitely not still having pain. 

As others have said, it may be you're still healing (everyone is different so your progress may vary from mine.)

Switching to flat may help if your stoma sticks out enough.

Someone here has talked about flexible convex vs hard convex. I actually don't know which brands are flexible but trying a different brand of convex might make a difference.  

My Ostomy Journey: Bruce | Hollister

Thank you all for the comments.  My stoma is shorter on one side than the other.  It is less than  1/2 inch on the side that is lower.  I tried the flat wafer, but I kept having leaks.  My stoma is in the fold.  The stoma doesn't hurt . . . The pain is on the outside.  It feels like a bruise on the top and bottom. The wafer is 44 mm and hard in the middle and  flexible on the outside.  It is a Hollister 11504 (25 mm stoma). Should I try a larger wafer in diameter?  When I took the Hollister test to determine what type and size it said 44 mm and convex.

Ileostomy here (4 years). My stoma is not flush with the skin but at times will retract a bit. I did have issues with leakage around the bottom of my stoma causing skin issues and irritation. I tried a convex barrier, but it was uncomfortable…what I have found through trial and error…if something is uncomfortable in terms of our baggage, then don't do it and research alternatives. What I have also learned is a good seal around the stoma helps tremendously…for me, this means ensuring the hole around the stoma is a proper cut/fit with no regular skin showing. An ideal fit with ideal products results in not even remembering you are carrying excess baggage—well, maybe, at least there should be no discomfort…this has been the case for me. Good luck in your search, and you have come to the right site to gather information…remember to use your own good judgment! jb

I don't a convex wafer cause it felt the same as you did.  So i went to the flat wafers and it work great and didn't hurt.

So, you're not cutting the wafer hole manually... you're using a wafer with standard sized holes?  Many stomas are egg shaped.  So a round hole will not work well.  

My stoma is egg shaped.  After cutting my wafer, the hole looks like an egg.  Carefully measure your stoma, looking in a mirror.  Measure top to bottom.  Then side to side.

For reduced leaks and skin irritation, the wafer hole should closely align with stoma shape, all the way around.  You don't want the wafer hole to exactly fit over the stoma.  A small gap should be created while cutting the wafer hole.  This provides a little space for stoma expansion.  Stoma's are always "on the move" because of Peristalsis.

There is no reason you can't use a convex appliance if it works for you. I went to one at either two or four weeks, but I cannot remember which. It only places a little extra gentle pressure on the skin; just be aware you are still healing around the edge of the stoma. The only issue I see is your stoma is in a fold, and the convex base may be too rigid even though they are quite soft.

Thank you so much for sharing. Hope you have a great day.