Granuloma After Colostomy and Frequent Pouch Changes

After colostomy 12/12/24, I developed, after a few weeks, a growing and very painful granuloma (you can look it up) at the bottom of the stoma, which was attached to the stoma proper. This condition is usually due to irritation by the appliance and some leakage, perhaps. Though not that uncommon, mine was not responsive to conventional methods, so the Chicago colo-rectal surgeon removed it a couple of weeks ago, and I am now fine, though he said these can come back.
Second issue, though not as troublesome. I am an 83-year-old male in good shape at 120 lbs (before my initial surgery, I was 140, and I eat practically everything and use the treadmill and walk too. My real complaint is that I am changing pouches 2-3 times daily because of regular stool production.

I eat pretty healthy and not big quantities, nor in-between snacks. Forgive the pun, but it's an annoying pain in the ass to have to empty so often. I use the 2-bag system from Hollister, which works fine. Any comments or suggestions?

Hi Ojibwa, I'm not sure what you are saying here. Are you 'emptying' two to three times a day, or 'changing' your entire pouch two to three times a day? Two very different things. Or, are you using a closed pouch? If so, why? Emptying a couple of times a day is no big deal, but no one should have to change their appliance that often unless there is some major problem with leakage or getting a good seal, which you don't mention. If you aren't already using open-ended pouches, then get some.

Terry

Have you got an ileo or colostomy? I only have experience from having an ileostomy/jejunostomy. If you're emptying/changing an ileo 3 times, that's really good and about as good as it gets.

I assume you are using closed-end pouches and just changing the pouch, not the entire system?

If so, then that rate of changing is pretty normal. I use closed-end pouches too, and that's my typical rate.

You could change to a drainable pouch. You'd empty as frequently, but perhaps you'd find that less bothersome?

If you have a descending or sigmoid colostomy, you might be eligible to irrigate. Reach out to your doctor or stoma nurse to find out if this is an option for you. If it is, you'll need a stoma nurse to help you get started.

With irrigation, you run water into the stoma, and it empties out the colon so you can go all day without output.

I did have the sigmoid and have used the drainable in the beginning but found it more time-consuming and would flush with water, so I determined that process was even more difficult. I have never heard of irrigation. Wouldn't that cause a sudden flow out, and how many times a day would that require? My stoma begins to empty a couple of hours after eating, necessitating 2-3 daily bag changes. Thanks for the irrigation suggestion, and I will check it out.

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