This topic is about a concern shared by an ostomate who has noticed a small bleeding spot on their stoma mucosa. The bleeding occurs more than usual during pouch changes and sometimes when massaging the pouch. The ostomate suspects it might be due to friction, possibly causing a granuloma or tiny ulcer. Despite consulting both a stoma nurse and a GI doctor, the issue remains unassessed. The ostomate is looking for practical advice to protect the spot and prevent further irritation.

Here are some helpful insights and advice shared by others:

1. Protect the spot during changes:
- Apply a small amount of ostomy paste over the lesion, let it dry, and then attach the wafer.
- Wait for the bleeding to stop before attaching the barrier.
- Hold the wafer in place for 2–3 minutes to ensure a firm seal and reduce movement.

2. Use longer-lasting "liquid bandage" products:
- Marathon Skin Protectant acts like a medical adhesive but can be costly and dries out quickly.
- Cheaper alternatives include "Liquid Skin" or generic "Liquid Bandage"; thicker formulas are more effective than thin barrier films.

3. Reduce pouch friction:
- Gently blow a little air into the bag to prevent it from lying flat on the stoma.
- Consider a larger-size wafer or opening if the edge is scraping the mucosa.
- Loosen or remove tight support bands if they are causing friction.

4. Investigate underlying causes and medical options:
- A superficial blood vessel might be causing the bleeding; a dermatologist can cauterize it.
- Long-term use of topical steroids can thin mucosal tissue; discuss alternatives with a healthcare professional.
- Tranexamic acid has been used to control mucosal bleeding; consult a clinician before use.

5. General reassurance and monitoring:
- Many have experienced similar small bleeding spots that come and go without worsening.
- Keep the area clean, monitor for changes, and seek assessment from a wound-ostomy nurse if needed.