Dealing with Painful Output - Seeking Advice on Colostomy Care

I like to read the comments and questions. It helps to not feel alone and know that I can be comfortable asking awkward questions. So here goes another awkward question. I struggle to keep the output from my colostomy soft. I take stool softener and fiber, that definitely helps. However, now and then the stool hardens, which is normal for me. Then when it passes it is too large and hard and stretches the skin around the stoma and causes pain and bleeding. Does this happen to you? What can I do? Does this opening need to be larger? I don't know how large would be large enough. I don't want another surgery but I worry about infections from the broken skin around the stoma and of course, I could do without the pain. Any thoughts?

Jkwcpa,

How is your water intake? Try upping the amount and see if that helps. It can be painful if the stoma has too much contact with the barrier and will eventually become sore and bleed. Are you using a cut-to-fit type? If so, try making the hole a little larger....maybe increasing it each time to get to a comfortable level. Be sure you don't have any jagged edges. Use a skin protector ....They also make a barrier that is a no-cut center, self-forming that is moldable, softer, and easier on the stoma. Hope this is some help.....

Thanks. I drink water and am successful most of the time in keeping the output soft. The bleeding is not from the wafer but from the skin around the stoma stretching. Maybe the skin protector would keep the skin more supple so it can stretch. Worth a try.

Sorry, I misunderstood your situation. You're thinking that the actual hole around the stoma is too small... and it's tearing the skin at certain times? OUCH! I'm not sure if the skin spray would help... it lays down a barrier... I use 2 coats... it almost seems like you would need to go the other way with some type of moisturizer... to keep it flexible... It's worth a try... it sounds more like a diet kind of thing...

Hello Jkwcpa.

I had this as a severe problem before the stoma and I always suspected that this hardening of the faeces was probably what led to needing a stoma in the first place. After the colostomy the stools were still hardened and no medication or natural remedies seemed to work. What does work for me  is to irrigate everyday at the same time. Interestingly, I still get some small hard stools at the beginning of the process which I evacuate with the help of water input - before continuing with the irrigation process which then comes out as a liquid. 

Having more of your colon left in, has the disadvantage of extracting the moisture from the faeces, sometimes it seems too much, so it makes it harden and then it's difficult to pass. I cannot recommend irrigation highly enough for those with a colostomy as it resolves this sort of problem but more importantly, it eliminates the need for using bags during the day. This makes life with a stoma so much easier to manage.

Best wishes

Bill  

Living with Your Ostomy | Hollister

If all else fails, ask a professional.

I thought it was your water intake as well.