This topic is about dealing with recurrent stoma granulomas, especially when treatments like silver nitrate don't work, and further surgery is being considered. A person who recently had a stoma revision is experiencing a painful and bleeding granuloma at the stoma edge. Despite trying silver nitrate, the issue persists, and surgery is being proposed. The person is understandably concerned, given their medical history and current health challenges, and is seeking advice and shared experiences from others.

Here are some insights and advice shared by others who have faced similar situations:

1. Multiple stoma revisions and surgeries to remove granulomas are unfortunately common. Many people have had two or three excisions when silver nitrate didn't work or granulomas came back.

2. Using a smaller flange or wafer size and tighter-fitting barrier rings, as recommended by an ostomy nurse, can help reduce the seepage of mucus or stool onto the granuloma, which can lessen pain and bleeding.

3. Some barrier options that might help include:
- Slim hydrocolloid rings to cover the raw area under the pouch opening.
- Foam dressings or iodine-impregnated dressings like Iodoflex, placed under the appliance, as suggested by nurses.

4. Alternative topical treatments that have helped some people include:
- A small piece of elemental silver inserted into the granuloma for its antimicrobial properties.
- Medical-grade honey dressings, like Meda Honey, changed daily to help with healing.
- Aquacel hydrofiber dressing combined with stoma powder and barrier spray, though results can vary.

5. General stoma-care strategies to promote healing and reduce pain include:
- Taking loperamide or Imodium to slow or stop output, removing the pouch for several hours during the day to allow air exposure, and reapplying the pouch when the medication wears off. This might require staying at home but has eased pain for some.
- Avoiding colostomy irrigation until the area is fully healed if there's a raw site present.

6. It's a good idea to seek additional professional input. Ask a hospital Tissue Viability Nurse for wound-care suggestions beyond silver nitrate.

7. Healing can take time, and patience is important. Many people have found that starting with topical treatments and moving to surgery if necessary is a common approach.

8. Emotionally, it's normal to feel exhausted after repeated surgeries. Bodies can recover with time, and both professional and peer support can be invaluable during these challenging times.