This topic is about dealing with persistent pain, rectal leakage, and skin problems after having a loop colostomy. Here are some helpful insights and advice for managing these challenges:

- If you are experiencing severe pain that isn't controlled by your current medication, it's important to see your surgeon as soon as possible. Continued leakage and pain might indicate that the rectum needs to be removed. If your doctor isn't taking your concerns seriously, consider seeking a second opinion from a colorectal or pain specialist who will take the time to listen to you.

- It's not uncommon to have rectal discharge after a colostomy. This discharge is usually mucus produced by the remaining rectal mucosa and can look and smell like stool. Even though it's common, it's still a good idea to discuss it with your medical team.

- To manage leakage temporarily, consider using disposable underwear like Tena or Depends to prevent embarrassing accidents until the issue is resolved.

- For pain management, you might want to explore options like a Fentanyl or Duragesic transdermal patch for continuous relief, with oxycodone for breakthrough pain. You can also ask about being referred to a dedicated pain clinic, as some antidepressants can help reduce chronic pain.

- For peristomal skin care and to prevent leakage:
1. Use only a very light dusting of ostomy powder and brush off any excess before applying the pouch.
2. Some people find that barrier sprays or wipes like Cavilon can weaken the seal, so try applying the pouch without them if your skin can handle it.
3. Apply a thin ring or strip of adhesive paste, then hold the wafer firmly against your skin for several minutes to improve adhesion.
4. Catch skin irritation early and ask an ostomy nurse to review your technique and products. A heating pad can help soothe soreness during pouch changes.

- Switching to a pouch with convexity and using a belt has helped many people solve leaking and pancaking problems. Continue spending extra time pressing the wafer flat, especially around the navel, to maintain a 24-hour or longer wear time.