This topic is about someone experiencing severe nerve pain under their ostomy pouch following bladder-cancer surgery. The pain is described as burning and stabbing, with the skin being hard, raised, inflamed, and extremely sensitive. Traditional treatments and changes in appliances have not provided relief, and the situation is affecting the person's quality of life. Here are some suggestions and insights shared by others:

1. Consider discussing with your dermatology or ostomy team the use of an astringent like aluminum acetate or a topical prednisone paste made by grinding tablets. These might help reduce inflammation before considering injections.

2. Some people have found relief using DuoDerm Hydrocolloid Dressing, which can be cut to fit the painful area. It may help soften hard tissue and reduce inflammation.

3. Continue using lidocaine for temporary relief, but explore other forms like lidocaine jelly. If nerve blocks provided any short-term relief, topical anesthetics might help with daily comfort.

4. If systemic medication is needed, Gabapentin or Lyrica are common options for nerve pain. Although they can cause fatigue, starting with very low doses and gradually increasing might help manage side effects.

5. Botox injections have been tried by some for nerve pain and could be a minimally invasive option to discuss before considering surgery.

6. Acupuncture might be worth exploring for nerve pain, as some studies and personal experiences suggest it can be beneficial when other treatments don't work.

7. Reviewing your diet with a registered dietitian could be helpful. Sometimes, personalized dietary changes can reduce systemic inflammation and skin reactivity around the stoma.