This topic is about dealing with large peristomal granulomas, which are painful growths that can develop around a colostomy stoma. These growths can make it difficult for the adhesive wafer to stick properly, and in some cases, they might be too large for simple treatments like silver-nitrate cauterization. Surgical removal might be necessary. Here are some helpful tips and insights from others who have faced similar challenges:

1. It's important to follow up with your healthcare provider because untreated granulomas can become more problematic over time.

2. The size of the granulomas matters:
- Smaller granulomas can often be treated with silver nitrate sticks. This involves using a sterile technique, applying antibiotic ointment, and allowing the area to air out for healing.
- Larger or persistent granulomas might require more intensive treatments, such as systemic medication or even surgery.

3. One person shared that a 3-week course of oral prednisone helped eliminate their peristomal granulomas.

4. Consider making adjustments to your pouching system to protect the area and improve adhesion:
- If you are using a convex pouch, you might try switching to a flat pouch with an Eakin Seal. This can help relieve pressure on the granulomas while still maintaining a good seal.
- Another person found that a convex bag actually improved adhesion for their smaller granulomas, so it might be worth experimenting to see what works best for you.

5. There are additional topical or adjunct options you can discuss with your healthcare provider:
- Steroid creams might be helpful for thin or early-stage granulomas, but be aware that they can affect wafer adhesion.
- Controlled exposure to ultra-violet light has been mentioned as a potential anti-inflammatory treatment.

6. General wound-care tips include keeping the area clean, using a sterile technique, and applying antibiotic ointment as directed during any topical treatment.