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Feb 04, 2023

Stoma Retraction - Seeking Advice

This topic is about someone who has experienced repeated stoma retraction after undergoing three surgeries. Each time, the stoma has retracted to the point where it sits flush with or below the skin level, causing significant issues with leakage and skin irritation. The person is seeking advice and insights from others who might have faced similar challenges to understand the possible causes and solutions before considering another surgery.

Here are some key points and advice shared by others:

1. The person is experiencing constant leakage due to the retracted stoma, which irritates the skin. They are allergic to most adhesives except for Coloplast, and convex products cause bruising without helping the stoma protrude.

2. Despite trying various products and techniques, including convex wafers, barrier rings, pastes, belts, and custom tricks, nothing has worked so far.

3. There is no parastomal hernia or prolapse, but rapid shrinkage of the stoma has been noted after each surgery.

4. The person is exploring potential causes such as abdominal-wall weakness, internal scarring, or other rare factors. Their surgeon is investigating, and they are considering seeking another surgical opinion if no answers are found.

5. Convexity can help with mild retraction for many people, but due to allergies and bruising, this option is limited for the person.

6. A product recommendation was made for the Hollister 88725 “Soft Flex” 1-piece mini drainable pouch, which may provide better wear time for flush stomas.

7. Perfect Choice rings are suggested as an alternative to Eakin rings for retracted stomas.

8. Possible medical or surgical causes include scar-tissue contraction, constant bowel peristalsis, inadequate bowel mobilization during surgery, dense adhesions, and weight gain.

9. Seeking additional input from colorectal or ostomy surgeons is advised, with remote consultations as an option.

10. Non-surgical tactics that might help include using soft moldable, slightly convex flanges, staying hydrated, using a tight elastic ostomy belt, and short-term use of opiate medication under medical supervision.

11. Observing diet can be helpful; for instance, one person found that eliminating canned tomatoes stopped their stoma retraction episodes.

12. Community resources like the Inspire ostomy forum can provide peer support and shared experiences.

13. Miscellaneous insights include the rare success of paste-based "refashioning" of skin edges and noting that heavy lifting can cause prolapse, which is the opposite issue.
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