This topic is about someone who is facing a tough decision between managing severe adhesion problems with their current colostomy or opting for a risky colostomy reversal surgery. Here’s a bit more about their situation and some advice that might help:

- About 16 months ago, they had a colostomy, which they refer to as their "little buddy."
- A year later, they experienced a severe heart attack and now have a cardiac device implanted.
- During the initial colostomy surgery, they had a life-threatening reaction to anesthesia, which was a close call.
- Although the surgeon says they are technically ready for a reversal, there is skepticism about their ability to survive another operation, which worries their family.
- They are dealing with a daily quality-of-life issue where the appliance won’t stay on, as the pouch keeps loosening or falling off.
- They feel torn between the risks of reversal surgery and the ongoing challenges of stoma care.

Additional details include:

- The stoma is prolapsed due to a hernia.
- An ostomy nurse provided a paste adhesive, but it cracks when dry, worsening leaks.
- The prolapsed stoma produces a lot of mucus, which quickly breaks down the barrier glue.

Here are some helpful insights and advice:

1. Work with an ostomy nurse or surgeon to address adhesion and placement issues before considering a high-risk reversal.
2. Identify why the appliance fails:
- Check if the stoma is poorly sited or too close to the skin. A minor stoma revision or relocation might be safer than a full reversal.
3. Experiment with different pouching systems and accessories:
- Try various one-piece or two-piece pouches. Some people use a belt or strap that clips onto the pouch for extra support.
4. Use stronger, flexible bonding agents instead of cracking paste:
- Torbot Liquid Bonding Cement is recommended for holding wafers through showers and on uneven abdomens. It removes cleanly with adhesive-remover spray or wipes.
- Non-drying barrier pastes or seals like Eakin Cohesive Seals/Rings maintain elasticity and don’t create leak channels.
5. Always add a barrier ring:
- The ring should absorb excess mucus and protect the wafer seal. Request free samples of different brands to find one that handles high mucus output.
6. Increase the frequency of changes if mucus output is heavy; it’s better to change early than to deal with leaks.
7. Consider irrigation (for colostomies only) to empty the colon on a schedule, which may reduce output into the pouch and lessen leakage concerns.
8. Carefully weigh the risks of reversal:
- Some people find that reversals can lead to a worse quality of life, with unpredictable bowels and social limitations.
- Given the cardiac history and previous anesthesia reaction, many advise against major surgery unless absolutely necessary.
9. No ethical surgeon will proceed if the peri-operative risk is too high; addressing stoma management issues is the safer first step.