This topic is about experiencing a sharp pain near the stoma, particularly when sitting in certain positions. The person initially thought the pain might be caused by the pouch cutting into the stoma, but changing the pouch didn't help. They are seeking advice on what might be causing this pain. Here are some helpful insights and advice from others:

1. Seek professional assessment: It's important to contact an ostomy or WOC nurse, or a surgeon, as soon as possible. If it's a weekend or holiday, you can reach out to the practice’s on-call physician. Keep in mind that most urgent-care centers may not be equipped to handle ostomy issues.

2. Positional pain possibilities: If the pain only occurs in specific seated positions, it might be due to a pinched or irritated nerve. However, it's still a good idea to get a medical evaluation, especially if the pain worsens.

3. Blockage or trapped gas/stool (colostomy):
- Small, hard fecal "pebbles" can get lodged just inside the stoma, causing sharp pain when sitting.
- Some stoma nurses can show you how to perform a digital (finger) exploration of the stoma to detect blockages.
- Irrigation can often relieve the pain once the blockage is cleared.

4. Parastomal hernia: A hernia might intermittently close the stoma opening, leading to pain from trapped wind or stool. Some people use a stoma plug to keep the channel open and allow gas to escape.

5. Anastomotic stricture/intestinal backup (ileostomy): One person shared their experience of severe pain due to a surgical stricture and large intestinal backup. This required emergency-room imaging and surgical correction for a definitive diagnosis.

6. Urinary conduit infections (urostomy):
- Sharp abdominal pain, followed by fever and nausea, could indicate a kidney infection or UTI.
- Urostomates don't experience classic cystitis symptoms like burning or urgency, so infections are often detected later.
- The stoma area can harbor bacteria, so prompt antibiotic treatment is crucial.

7. Appliance factors usually ruled out: If changing the pouch doesn't relieve the pain, it suggests an internal cause rather than an issue with the appliance. Convex urostomy pouches with belts might feel like they are "cutting," but this is usually not the cause if the pain persists after changing the pouch.