This topic is about dealing with discomfort and burning sensations around the stoma due to acidic output. The person sharing their experience has had an ostomy for nearly eight years, but recently, the acidity of their output has increased, causing pain and requiring lidocaine for relief. They are curious if others have felt a similar burning sensation directly on the stoma itself.

Here are some insights and advice shared by others:

1. The person is already managing occasional skin irritation but is specifically looking for information about burning sensations on the stoma itself.

2. A gastroenterologist is involved, having ordered blood tests to check for systemic acidity and considering medication options.

3. The person has removed acidic foods from their diet and is taking a daily probiotic while waiting for test results.

4. Some people have experienced acidic output without skin issues. Regular colonic irrigation might help as it reduces the time effluent is in contact with the stoma and skin.

5. Normal irritation can be caused by bile and digestive enzymes. A sudden change in symptoms years after surgery should be evaluated by a GI specialist to rule out conditions like bile-malabsorption.

6. You can check the pH of your ostomy output using inexpensive pool-type pH strips:
- A pH of 6.1-7.9 is typical and slightly acidic.
- Excess acidity might indicate bile-malabsorption, while excess alkalinity could suggest bacterial overgrowth.
- A knowledgeable gastroenterologist can order specific tests and treatments.

7. Topical betamethasone, a prescription corticosteroid, can provide relief when applied to painful areas of the stoma, but it may sting upon application. Use it only under medical guidance.

8. Granulomas, which can be removed with silver nitrate, might leave hypersensitive spots that feel like an acid burn even if the output pH is normal.

9. Dietary and microbiome tips include:
- Taking liquid probiotics along with a prebiotic and adding a simple-ingredient yogurt like Chobani Greek (e.g., strawberry flavor).
- Continuing to avoid highly acidic foods.
- Eliminating whole nuts, as some people find they trigger very acidic output, blow-outs, and red skin, whereas peanut butter is usually tolerated.

10. Since true "stoma specialists" are rare, it's beneficial to combine advice from gastroenterology and colorectal surgery. Persistent pain should not be accepted as the "new normal.