This topic is about experiencing pain around a colostomy stoma, even though everything else seems normal. The output is regular, the skin around the stoma looks healthy, and there haven't been any recent changes in diet. The person is using a one-piece convex pouch and applying a prescribed steroid cream, but both the doctor and the individual are puzzled about why the pain started. They also walk a strong puppy and wonder if that might be related.

Here are some helpful insights and advice:

1. Convexity can cause pain or bruising. Some people have found that using convex wafers or rings can lead to soreness and bruising. Switching to flat flanges or using larger openings has helped relieve pain for some.

2. Check the size of the wafer hole. If the opening is too small, it can "strangle" the stoma and cause discomfort. Make sure the cut-out is large enough to avoid this issue.

3. Consider using moldable or silicone barrier rings. Products like Coloplast Brava moldable rings and Salts thin silicone rings allow you to cut a larger wafer hole while still forming a snug, protective seal. This can help reduce leaks and skin irritation and can be used with both flat and convex systems.

4. Seek specialist help over general physicians. An ostomy nurse, often more knowledgeable than surgeons or representatives, can provide better troubleshooting for appliance-related problems. If there are no local nurses, online resources and forums from experienced ostomates can offer practical tips.

5. Question the use of steroid cream directly on the stoma. It's advisable to get a second opinion before applying steroid medications directly to the stoma.

6. Leash pulling is unlikely the primary cause. Since stomas lack nerve endings, pain usually comes from external pressure or skin issues rather than internal strain from activities like dog walking.

7. General leak-prevention tips. Use wafers or barrier rings under the pouch, ensure a proper fit, and try different brands or styles until you find a reliable seal.