Severe Irritation Around Stoma - Need Help!

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Thaumaturge

I'm hoping someone can help me. I've had my urostomy for 40 years. I'm 42. I thought I knew all the "secrets", but I found out I was wrong. My problem is severe irritation of the skin around my stoma. The area looks like a wet callus and hurts like a son of a gun (I described it to my wife as dripping alcohol on a scratch). It's driving me crazy. I've tried dry heat from a hair dryer, vinegar, Adapt powder.....no help. I use the ConvaTec Natura Flexible series. Any ideas? Thanks.

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Past Member

This sounds much bigger than our 'secrets' or trial and error situations. Serious stuff.



I think a physician is needed - soon. Please keep us informed.

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IamSam

This is common for urinary diversion stomas. The white callus is a form of scar tissue trying to protect the irritated area. It's caused by high pH or acidic urine settling around the stoma coming into contact with the skin/stoma edge for prolonged periods of time. I used to have this problem way back before modern pouches with non-reflux flaps or valves and I can vouch for you when you say it's painful!

These "secret tips" cured my problem.

Use a well-fitting flange size that is almost the exact size of your stoma. It will be painful at first, but it will heal quickly. Also, until it heals, modern wafers need to be changed as soon as they show signs of urine saturation around the stoma. They change colors or get puffy. This might mean changing them every day or more until it heals.

I know you mentioned vinegar. Vinegar changes the acidity or pH level of your urine. Every time you change your pouch, soak a gauze sponge in vinegar (don't wring) and place and hold it to the affected area, stoma and all, for about 8 to 10 minutes. Laying on your back helps this process. When through, pat dry and re-apply a new pouch. NO CREAMS OR PASTES! NO HAIR DRYER! This will make things worse! The idea is to have the wafer/flange adhere to the calloused area in order to keep out/off the offending urine. IT WILL BE PAINFUL at first.

Between changes, every time you drain your pouch, place about 5 to 8 cc's of vinegar in the bag. This will neutralize the pH of the collected urine just in case it manages to get past the reflux valve.

Last but not least, Ascorbic acid! This will change your urine pH from the inside. I take 1000 mg's of Vitamin C twice a day.

With the above changes, I've never had this condition return since. Good luck!

overwhelmed

I had this same problem. I found out if your wafer has a hole that is too big, anything that leaks out will burn your skin. I was in a nursing home for about 3 weeks. They never could get the right size! I had third-degree burns before I got out of there and went to my pharmacy! My medications will cause burning if it gets on my skin also. They're pretty strong. Talk to your doctor and make sure your wafers are the right size. I also changed my wafer and pouch to a Tupperware type that connects like a Tupperware lid. It helps a lot. Good luck, Leah.

Past Member
Overwhelmed, I looked at your profile a while ago and had empathy for what you were going through. I am glad to see you posting now. I hope things are looking a bit better in your life. We all have moments of feeling overwhelmed and it helps us to see how others are coping.

I have been surprised at how difficult it is to get that hole cut just right - and how important it is. My stoma opening changes about 1/8 of an inch. I found I needed a template. The paper circles provided by the companies weren't satisfactory for me. Also, my stoma opening is oval not round.

I took a plastic gallon water (or milk) container and made myself a template. It has made drawing the circle onto the flange easier and the same all the time. And it is relatively easy to cut just inside or outside the line I draw. The two-piece snap-on bag works best for me also. I can put on the flange in just the right place if I can see the stoma (without an attached bag). I think these kinds of adjustments are pretty common and we each form our own way of perfecting things for ourselves. Any kind of burning is just the pits. There are frequently posts on burning and itching.

I am so grateful to have found the people on this site. I left the hospital with no information and have gleaned most of my tips through these posts.
 
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Falcon5

Oh man, I hate it when that happens. For me, it is a fungus that starts and it makes me crazy. The only thing that helps is mitrazol powder. I sprinkle it on, rub it around, let it dry. Keep my appliance off for a little while, then like everyone else said, get the hole just right, which is a pain in the patutti sometimes.

wolfie45

For me, I found Karaya Powder to be helpful and keeping up the fluid intake, which will lessen the acidity of the urine.

ballpeen
Thaumaturge, sorry you're experiencing this also. I'm looking for the best answer to this problem just as you are.

I remove the bag and using a plastic ketchup or mustard bottle, I remove and wash out the inside of the bag while standing over the toilet. Then I wash the fecal matter out around the stoma, dab it as dry as possible then spray all the raw skin with Convatec Stomahesive powder, Karaya powder may work just as well, I have never tried that.

Then I re-attach the rinsed out pouch immediately.

Do it when you're sure you won't have a fecal mess on your hands. (pun)

The powder acts as a healing agent. I do this just before I go to bed or if it becomes unbearable during the day. Because of this treatment, I sleep very well (painless) and avoid pain until late afternoon when I start losing a lot of fluids through the stoma, that's when the pain starts again. 10-minute job after some practice. Daily occurrence.

Wishing you well, my friend, Ballpeen U.S.A.
santabelle

I'm sorry for your pain, I had an ulcer form that kept increasingly getting worse. I went to the wound center and I was under the care of Dr. Katz and his ostomy nurse Lynda. When my ulcer got really bad, we put a fiber-like material over the wound with medicine underneath the cocoon I called it. I also used Beta Val, which I believe is an anti-inflammatory. In any event, it helped me to keep the site clean and I changed the wound daily, always putting medicine on and then the fiber element to keep it dry. My colorectal surgeon was amazed at the process and good results.
Daily routine of medicine that is protected by fine fibers dried with a hairdryer and then apparatus applied. It has worked for me.
Good luck as always!

santabelle

I'm sorry for your pain, I had an ulcer form that kept increasingly getting worse. I went to the wound center and I was under the care of Dr. Katz and his ostomy nurse Lynda. When my ulcer got really bad, we put a fiber-like material over the wound with medicine underneath the cocoon I called it. I also used Beta Val, which I believe is an anti-inflammatory. In any event, it helped me to keep the site clean and I changed the wound daily, always putting medicine on and then the fiber element to keep it dry. My colorectal surgeon was amazed at the process and good results.
Daily routine of medicine that is protected by fine fibers dried with a hairdryer and then apparatus applied. It has worked for me.
Good luck as always!

ballpeen
Hi Thaumaturge,

The info I gave you yesterday is for an ileostomy. I misread that you have a urostomy.
Maybe this will still work for you. The fluids that are discharged through my stoma are stomach
acids from fluids that I drink and digested food turned to fluids.

Ballpeen
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