Living with an ileostomy can come with its own set of challenges, especially when the stoma becomes flush with the surrounding skin. This can make it tricky to keep a pouch in place for long periods, and it might lead to skin irritation. Here are some helpful tips and suggestions to manage a flat or flush ileostomy stoma:

1. Consider using convexity for a better seal and projection:
- Switching to a convex barrier or wafer can help. You might also want to add a convex sealing ring, like an Eakin ring, to gently push the stoma outward and direct the output into the pouch more effectively.

2. Explore surgical options:
- A minor surgical revision could help by pulling the stoma out further. This procedure typically takes 1–2 hours, involves a one-day hospital stay, and allows you to resume normal activities in about a week. It has been reported to resolve persistent leakage issues for some people.

3. Try the layered (crusting) skin-protection method:
- After cleaning the area, gently pat the weeping skin dry with toilet paper.
- Lightly dust the irritated skin with Adapt Stoma Powder and brush off any excess.
- Pat, don’t wipe, skin adhesive prep wipes over the powdered area and let it dry.
- Repeat the powder and prep process once more to create a protective "crust."
- Apply the convex ring, then the convex barrier, and try to stay still (avoid bending at the waist) for about 15 minutes to allow heat and pressure to improve adhesion.

4. General tips:
- Mold the ring closely to the stoma opening before applying it.
- Remaining stationary for 15 minutes after application helps the ring warm up and adhere better, reducing the chance of early edge lifting.

These suggestions aim to improve the wear-time of your pouch and help maintain healthier skin around the stoma.