The topic at hand is about managing a prolapsed or ballooning stoma, specifically using the "sugar trick" to reduce its size. A person with an ileostomy has noticed their stoma swelling to a size that doesn't fit their usual appliance, and they are exploring different methods to manage this issue. Here are some insights and advice shared by others:

1. Sugar Application:
- A tip from a surgeon suggests lightly sprinkling sugar each time you empty or rinse your stoma. This method may take several days to show results and is not meant for immediate relief.
- According to a Mayo Clinic protocol, use one restaurant-size sugar packet and rinse it off once shrinkage begins. Lying on your back and keeping the area warm can help speed up the process, taking about 15 minutes for a true prolapse in some cases.
- This method is effective for prolapse but not for simple swelling or "ballooning." If sugar doesn't help, it's advisable to seek medical advice.

2. Temperature Strategies:
- Cold methods, such as using an ice cube, chilled cloth, or cool air, often cause immediate retraction of the stoma.
- Warm air, like from a hair-dryer, can provide slow and modest shrinkage for some people.

3. Mechanical/DIY Support:
- Some have created a rigid guard from the top of a plastic bottle to prevent the stoma from cutting into the wafer and to keep it aligned. Instructions for this DIY stoma guard can be found online.
- Consider cutting the wafer opening larger and filling any gaps with an Eakin’s Cohesive Seal or stoma paste. Switching to a soft wafer, such as ConvaTec Soft Moldable Technology, can help accommodate size changes.

4. Professional Help:
- If prolapse or swelling is frequent or affects your quality of life, consult your surgeon about possible stoma revision.
- If your surgeon is unavailable, contact a certified WOC/ostomy nurse. ConvaTec offers free telehealth consultations and can send free wafer samples upon request.
- Some members note that complex prolapse issues may ultimately require surgical intervention rather than nursing care.

5. Product and Brand Mentions:
- Hollister wafer for larger stomas.
- ConvaTec soft wafer and their free sample program.
- Eakin’s Cohesive Seal.
- Oral Rehydration Solution (ORS) is discussed in relation to intestinal fluid shifts.
- An educational article titled "Stoma Prolapse" is available on NCBI for further reading.

6. Clinical Rationale:
- Granulated sugar works by creating an osmotic gradient that draws fluid out of the bowel wall, reducing the stoma's diameter. If there's no response, it might indicate edema from another cause, and medical evaluation is recommended.

7. When to Seek Urgent Care:
- If you notice a rapid increase in size, discoloration, bleeding, severe pain, or if you can't fit any appliance, there is a risk of strangulation.
- A prolapse exceeding several inches may require urgent medical attention, as one member needed anesthesia for a 5-inch prolapse reduction.