This topic is about managing a severe burning sensation experienced by someone with a retracted ileostomy, particularly after meals, while undergoing chemotherapy. Here are some helpful insights and advice to consider:

1. **Check for Leakage or Skin Burn**
- The stoma itself doesn't have nerves, so pain usually means that the output is reaching the skin around the stoma.
- Make sure the wafer opening fits well without any gaps.
- Consider switching from paste to moldable barrier rings, such as Hollister Adapt, Coloplast Brava, or Convatec Esteem rings. These can be molded snugly around the stoma to prevent leaks.

2. **Paste vs. Rings**
- Paste is typically used to fill uneven scars and might cause leaks on flat skin.
- Many people find that using rings instead of paste reduces leaks and burning sensations.

3. **Choosing the Right Appliance for Retracted Stomas**
- Use a deep-convex system designed for flush stomas, like Convatec Natura or Esteem + deep convex.
- Some have found relief with a custom-cut convex system that provides a secure fit.

4. **Address Pancaking or Thick Output**
- If the stool piles up against the wafer, it can cause discomfort.
- Keep the output soft by using a full or partial dose of Miralax daily, as prescribed during chemotherapy. The BRAT diet can also help, and it's important to avoid tight clothing.

5. **Consider Chemotherapy Side Effects and Neuropathy**
- Burning sensations might be a side effect of certain chemotherapy drugs.
- Discuss with the oncologist about reviewing the medication or changing the formulation, as the burning could be an allergic or toxic reaction.
- Chemo-induced neuropathy might also be a cause, so it's worth investigating.

6. **Investigate Acidity and Dietary Triggers**
- Chemotherapy can increase the acidity of the stool. Keeping the output more alkaline by monitoring the diet and avoiding acidic foods might help.
- A short trial of bland foods (BRAT diet) could help determine if dietary changes reduce the burning.

7. **Other Investigative Steps**
- Imaging and a gastroenterology evaluation can help rule out issues like strictures, infections, or hidden inflammation.
- Over-granulation at the stoma site can cause stinging, and treatments like topical silver nitrate or steroids might be prescribed if needed.

8. **Product and Resource Suggestions**
- Consider using barrier rings like Hollister Adapt, Coloplast Brava, or Convatec Esteem Seals.
- For convex wafer systems, options include Convatec Natura Durahesive Convex, Esteem+ Deep Convex, Hollister New Image Convex, and Coloplast Sensura Mio Convex Flip.
- Miralax (or generic PEG 3350) can help thin the output.
- If local resources are insufficient, seeking a second opinion at a specialized center like Loma Linda University Medical Center might be beneficial.