Problems with new ileostomy appliances - seeking advice

I recently changed appliances because my prior appliances were too small for the stoma. I have now been using these new two-piece appliances but have found it to be extremely frustrating. The appliances do not properly fit the stoma. This may be because my surgery was performed 25 years ago and maybe the appliances are different today. I would like to know if anyone else is having this same issue. As a result of the improper fit, the area around the stoma is red, sore, and very uncomfortable/sometimes painful.

Seeking support,

I'm sorry to hear that you're going through a rough time. I have an ileostomy and I prefer a one-piece drainable pouch that I custom cut to fit around my stoma. I'm guessing the hole that your stoma goes into is too large? Do you use a skin barrier?

You might try stoma paste if this is the case. Or you might want to call all the main manufacturers of pouches and ask for free samples. It sounds like you might want to try getting the cut-to-fit pouches. Just my opinion. Let me know if you have any other questions.

Bain

Seeking support

I agree with most of what NJBain has advised. I use the two-piece system with the drainable pouch (ileostomy). It sounds, according to your explanation, that your stoma is too big for the opening on the wafer. The wafer has a good deal of flexibility to it. So, you can roll it back carefully to fit the size of your stoma before applying. This produces a "turtle neck" effect such that the stoma will fit snugly against the opening of the wafer with no stress. If the stoma is too big for the opening, the dilation of the stoma when eliminating materials will cause undue stretching of the wafer opening leading to the redness and most likely pain that you will have along with leakage.

As an alternative, and one that I used to use, Hollister makes a stomahesive wafer that does not have an opening. The box contains a measuring card for your stoma and all you have to do is match up the stoma with the correct measurement and cut out the opening in the wafer. They make a small hole punch device that you can use corresponding to the opening that you need and all you have to do is punch out the hole. I used this device and would pre-cut five wafers ahead of time. Good luck!

X_

If you have a hole in your wafer that is too tight against the stoma, it will cause pain and irritation and redness around the stoma, or even bleeding. This is whether you use a pre-cut wafer or cut to fit - a problem many people have is cutting the hole in the wafer EXACTLY the size of the stoma. Good fit, right? Wrong!! You have to leave a tiny gap between the stoma and the wafer (not much, just about 1/16" my ostomy nurse told me) to allow the stoma to flex as you move throughout the day, and when it expels material to the pouch. Over time, you get a good feel for how much gap to leave. Also, many people's stoma is not exactly round, and not exactly oval (the two shapes the pre-cut wafers come in). Mine is a weird rounded-off almost square on one side, and more almost circular on the other. I made a template from the plastic covering of one of the wafers after cutting and trimming it to properly fit around my stoma. That way, each time I prepare a new wafer, I simply trace around the template with a Sharpie marker and cut around the outside of the mark I made, and it always fits just right!

Try stoma powder around the red irritated skin, followed by a barrier spray to give your skin a break until it heals. Also (and I know this can be a bit scary) try to give your stoma and the skin around it some "air time" with NOTHING on or around it. Just put a heavy towel down on the bed and lie down naked for a while to give it some time out away from all the stuff we put on and around them. Then go ahead and put your appliance on as usual.

Hi seeking support....I live in Corner Brook and had mine done 4 months ago. I use a 2-piece bag system with disposable bags and I love it. The most trouble I had is putting the wafer around my stoma, but everything I ever needed to know I got from this support group. It's awesome and they know more than most stoma nurses. I saw one in St. Johns for about an hour over a 3-day period, and since I got home I haven't seen either one. I called about 12 times and got her voicemail, so I just gave up and came on here. Also, Coloplast has excellent support and I call them when I need to know about different supplies....good luck and just keep asking questions here.

How to Get Back to Activity after Ostomy Surgery with Kimberly | Hollister

Morning, seeking if you are liking the 2-step approach, try using a barrier ring, then adding appliances... Myself, I am a 1-piece drainable with a barrier ring ileostomy gal here, just fewer steps, fewer products, and faster changes....

I get 7 days more if I wanted from the Coloplast product and ring, no leaks, no blowouts, no sores!!!! Unlike Hollister that I really liked but last 2 days before side blowout!!

Have a great day.

Tracy