Hello,
My loop colostomy is 8 months old. Generally, it is working well. At the 3 o'clock portion of my stoma, there has been a purple discoloration. Sometimes it looks better, but now it is looking a little worse. It blanches and is painful to touch, but it doesn't otherwise bother me. It just seems to be getting a bit worse now, and I wonder if anyone here knows what it is and how it can be resolved. I think it has started to affect my seal recently. Thank you.
Hi Amillman, from what I'm seeing, this looks most like a pressure point. You didn't mention what material you're using. A pressure point can develop if the opening of the wafer is cut slightly too small or if the cup of the convex is slightly too small. Are you using a belt? It's important that this doesn't get worse. So, see how you can reduce the pressure in that area. Otherwise, contact a stoma care nurse.
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Hello,
Thanks for including a picture.
What type and brand of wafer/flange do you use? And do you use a support belt?
Is this a temporary stoma?
It would be best for you to consult with your gastroenterologist or a stoma nurse. Imaging would reveal if there's anything going on under your skin's surface.
Hollister two-piece with an Eakin ring underneath. I don't typically wear a belt. It is a loop that can be reversed, but for now, I am sticking with it. Any thoughts on how to relieve the pressure?
If you use a convex setup, go with a flat one. Cut your hole a tad bit bigger so when your stoma expands, you're not cutting off its circulation, so to speak.
Thinking that would warrant a call to an ostomy nurse, especially since it is painful to the touch and changing. Even a video call where they can see it would be helpful. I would hate to wait too long or do anything that might worsen the condition.
I have a sigmoid colostomy. For 3 years, I've used a Hollister 2-piece with a Coloplast Brava ring underneath. I also wear a Nu-Hope support belt.
Probably best for you to get a CT scan. Gotta be sure nothing is going on under or around your stoma.
A loop colostomy is usually temporary. At 8 months, are you considering reversal/revision?
Hi Amillman,
From what I can see in the photo, it looks like you have a low spot on your left. I have something similar with my ileostomy, except it is on the other side. The way I handle mine is to add a bit of ostomy paste to the low spot and then fit a moldable ring snugly around the stomach before applying the barrier. I am also careful to warm each piece with the low setting of a hair dryer before application. Your ostomy nurse in the hospital may have shown you how to warm everything with your hand after the pouch is on. I find that using a hair dryer before application gives much better adhesion.
Daniel
You need a stoma nurse to take a look. At 8 months, there should be better healing and less granularity to the stoma. Having Crohn's, there can be a host of skin complications that can be associated with inflammatory bowel disease.
With the blood around the edge on the side that’s all purply colored, I’ll stick with the hole is too small and you’re bumping it when you move around(the bloody part) and the purply part is bruising from being too tight. The purply part and the part where you said it’s painful to touch is exactly what I had when I tried a convex setup. Take the bag off to shower and it was almost like instant relief. Good luck, a tender stoma area is irritating to deal with.
I was looking at a few of the Hollister advertisements here on MaO today. They have a lot of good advice and information. It seems I learn something new every day pertaining to ostomy care. Today I discovered: There are 2 kinds of convex flange/wafer. A hard convex one and a soft convex one. Depending on a person's skin profile, soft or firm skin governs which type of convex flange/wafer to use.
Using a hard convex on firm skin will cause trouble. Using a soft one on soft skin will not seal effectively.
Something to think about if you're having skin problems.
To be on the safe side, get this looked at by a doctor. Shortly after I got my stoma, I had a small painful area next to my stoma that developed into cellulitis. In your picture, you have an area of skin that appears purple; this isn't good. At first, I noticed when I had output it hurt, and eventually, it spread and felt like I had been blowtorched - then when I pressed the skin, pus came out between my stoma and skin. I needed two courses of antibiotics to clear it up. Don't wait, as this could become deadly.