This topic is about someone who has been living with an ileostomy for four years and is now experiencing some challenging issues. They are dealing with frequent leaks from their pouch, open sores, and bleeding around the stoma every time they change their appliance. Additionally, after eating, the stoma or the area around it swells to a size as large as a baseball, which is contrary to what their surgeon had assured them. They are reaching out to find others who have faced similar problems and found solutions.

Here are some pieces of advice and insights shared by others:

1. Reach out to medical professionals right away. It's important to contact both your gastroenterologist and surgeon. If they don't take your concerns seriously, consider finding new specialists who will.

2. Consider the possibility of a parastomal (peristomal) hernia. Someone with a similar experience described a constant mound around their stoma, which they humorously referred to as their "third boob," matching the "baseball-size" description. It's worth asking a surgeon to evaluate for a hernia.

3. Measure your stoma while standing. Abdominal protrusions or hernias can enlarge when standing, so it's best to size the wafer opening to the largest diameter rather than using measurements taken while lying down.

4. Try a layered leak-prevention system. Here's a method shared by someone with a peri-stomal protrusion:
- Cut a Coloplast Brava Protective Sheet so that its central hole is about ½ inch (1.3 cm) larger than the wafer opening.
- Apply the Brava sheet directly to your skin first, then place the wafer or skin barrier over it so that the adhesive wafer contacts the sheet, not your skin.
- Add 2–3 barrier extenders from various brands around the wafer edges for extra security.
- Finish with Hy-Tape, which is a zinc-oxide-based pink waterproof tape, to anchor the entire system.
- These accessories, such as the Brava Protective Sheet, barrier extenders, and Hy-Tape, may be covered under traditional Medicare plus supplemental insurance.

5. Monitor the consistency of your output. If the swelling is accompanied by explosive or obstructed output, report this to your surgeon promptly, as it could indicate serious bowel issues.