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Infection and swollen stoma.

Posted by strongandbroken, on Wed May 02, 2012 1:45 am

Hello again everyone. After 19 years w/ileo 2.0 i have my first infection. It started w/a swelling above my stoma which i attributed to my gallbladder(i've had a few episodes lately) but the latest swelling turned to redness and eventual hard swollen section diectly above the stoma. When i changed my ppliance i noticed the hard reddened area was the top half of the wafer area. It became more and more painful over the next 2 days to the point where i couldn't straighten out while standing and couldn't sit without severe pain. So here i am 7 days later in hospital with a drainage tube and an iv fr antibiotics and morphine (so i apologize for any typos or rambling in advance). The dr.'s after reviewing my ultrasound and ct scan have confirmed my gallstones but don't seem to be able to assess much more thana random general infection. The tube comes out tomorrow and i just started getting antibiotics orally tonight. After having a ileo for so long i thought i had experienced it all. But after reading through some of the other posts on similar topics i guess the old adage is true - you never stop learning. So my question is this: has anyone else had a similar experience? The swelling of the stoma ( more length than width) is that in any way related? How do i avoid this in the future?

As an aside i can't begin to describe how grateful i am for this site and all of you. Just reading some of the recent posts has helped me tremendously. Again  i'll apologize if this rambles a little or the typos make it hard to read but between the morphine and the iPad auto correct .....well, knead i say moore? Thanks, Michael
Reply by notexpectingthis, on Sun May 06, 2012 7:18 pm
How are you now?
Reply by strongandbroken, on Sun May 06, 2012 9:13 pm
Back home as of Friday afternoon. Thought I'd fill in the results just in case anyone else comes up against this.Ok so after 19 years with stoma 2.0 I had my first stoma area infection.

Nothing conclusive here but some interesting details.

About a week before all of this happened I was having severe gas pain from what I thought was another gall bladder attack. I had stones in the past and this situation presented the same way. I had sever gas pain that showed up as a bloated area right above the stoma and appliance area.

As in the past I had simpled down my diet to eliminate as much fat as possible. I noticed a lot of gas with burping and gas in the bag. But the hardness above the stoma wouldn't diminish. By the end of the week I noticed how hard the swelling had become and the redness and heat led me to believe that it was something more. By sunday when I changed appliances it was obvious that the hard red hot lump that had developed was something other than what I thought. It was an infection. The affected area was about the size of a section of a large navel orange (same shape too) about 1/2 inch directly above the stoma and right on the edge of the appliance.

Now apparently these are common with crohn's/ ileostomy patients. After years of meticulous care and no infections I finally had one. That's what caused all the serious pain and inflammation.

I did also have significant gall stone at the same time.

The treatment was painful but simple. They inserted a drainage tube directly above the stoma on the edge of the appliance in the direct center of the infection by way of CT scan. While under the scan they lined up the drainage tube, marked a spot and gave me a local and inserted the tube. It drained the area over the next 6 days and after 3 days and 2 10 cc saline flushes (damn they hurt) it was completely drained. During this time I was on an IV drip for morphine and antibiotics.

On the second to last day they removed the drainage tube (damn did that ever hurt after 2 days off of morphine and no other pain meds -too much is too much) and did blood work. The blood work and a quick physical check of the area it was obvious the infection had subsided.

The GB pain died down but I'll have to go back sometime soon to have the GB removed (laser laparoscopically).

I should also not that the antibiotics gave me sever diahrrea and I lost 6 kilos (roughly 14? lbs) in a 4 day span. Not good for a dialysis patient (just to make it a little more challenging). Thankfully I had been in the best shape I had been in a long time so I could handle it all a little better.

In the last 2 days I've worked hard eating and drinking my way to the point where the flow has slowed down considerably and I'm not running to the toilet every 1/2 hr. I can actually feel the flow slow right down and my digestive system doesn't feel like a funnel connected directly to my ileostomy.

I should also note that the most annoying thing of all (annoying not painful relatively speaking) was the fact that I had to change my appliance 5 times during this stay because of the placement of the tube. It made it very difficult to manage the appliance, especially skin care, the whole time. I've been lucky all these years to have a great combo of skin barrier/paste and one piece convex ostomy bag that last minimum 7 days. The problem was changing them every two days took it's toll on my skin. It'll take a while but once the rawness of the skin subsides it should settle down back to normal again. The actual stoma is still a little swollen but seems to be getting back to normal.

Dehydrated, exhausted and relieved it's all goes on.
Hopefully in a week I'll be able to say it and mean it, really mean it again. Life is Good!

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