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Stoma Blisters

Past Member
Posted by Past Member, on Mon Mar 02, 2009 8:47 am
Hi. I have had a colostomy for 4 years now and have coped very well. The stoma is rather large 65mm and the skin around the stoma has always been sensitive. Recently the skin started to blister and the colorectal nurse doesn't seem to know what to do. Is there anybody out there who has had this problem and knows what I can do to sort this out
Reply by Snowwhite, on Mon Mar 02, 2009 3:29 pm
Hi. I too have had different problems with my stoma. My best suggestion is to see a dermatologist. There could be several reasons why you have blisters and if you need a prescription, they can get you on the right path. Good luck.
Reply by sweede, on Mon Mar 02, 2009 7:58 pm
Hey folks, i posted this in reply to a similar question in another thread of this form only today so if you dont mind me doing so, i will simply just copy and paste it into this thread also, cos i'm a bit lazy like that hehe.
  It was a query as to the ingredients used in the production of the adhesive flanges and wether some people may have allergies to the ingredients. It may be of use to you, it may not.

The vast majority of flanges made for ostomates make thier wafers/flanges/base plates, whatever you want to call them from 2 main ingredients Hydrocollide and Pectin.

The hydrocolloids used in flanges are derived from natural sources. For example, agar-agar and carrageenan are extracted from seaweed which is the main two sources used.

So to save you from all the boring science, basicly they are natural gelling agents mixed with water to form the gel for the flange. These hydrocollides can also exist in there liquid states and will try to revert back to liquid with the addition of heat or exrteme cold, hence the fact that flanges get extra tacky in hot weather or baths, it's because they are starting the process of returning to a liquid state, also hence the fact that urostomates and ileostomates find the flanges start deteriorating quite rapidly, High enzyme output in ileostomates and acidity in urine with urostomates is also a major factor.

((Drifting off slightly, there are a few simple techniques to reduce the acidity of your urine which as has a twofold advantage, as it extends the lifespan of the flange and reduces the risk of uric acid stones. High intake of neutral fluids such as water, tender coconut milk, diluted buttermilk and citrus juices all lower urine acidity (unless contradicted for some other reason).
Also try to limit the amount of tea, coffee and cows milk to 1-2 cups a day, vegetarian foods and high fiber also reduce acidic urine. Meat eaters should try to limit protien to 1 gram per kilogram a day. Also try to avoid cold drinks that contain a high amount of sugar and calcium rich sweets made using milk as a protien especially on an empty stomach))
Sorry about that folks, i do have a tendency to waffle lol.  

Pectin is used in flanges as a stabaliser to combat the issues i have mention above and is as we all know the sugar that comes from fruit.  The Pectin used in the manufacturing of flanges is extracted from citrus peel or apple pomace(pulp).

So if you have an allergy to any of the mentioned ingredients you may find you will also have problems when it is used in flanges as it can cause blistering and sores on the peristomal skin.

Is there an alternative option? perhaps not,  contact ostomy pouch manufacturers to see if they have alternative options, but i am aware that some countires only have one ostomy provider.

Also it is propably a good idea to have an allergy test from your G.P to determine wether or not you are indeed allergic to any of the ingeredients, also a simple patch test will determine wether you will be prone to rections from the flange of the pouch you are using.

To do a patch test, cut a small section from one of the flanges you are using and stick it to the inside of your forearm under a plaster and leave it for 48hrs, if it shows an irritation then it is likely you will will have problems with that specific flange, but to be sure, to be sure(as the say in paddywhack land), it's best to have an allergy test done by your G.P for the forementioned ingredients.

I hope this is of use to all those suffering from ongoing peristomal skin problems, as this may very well be the cause of your problems.x
Reply by tarababy, on Mon Mar 02, 2009 11:57 pm
WOW!!!!!    What an answer..that was so easy to read.Most times when I come across that medical talk..I skip over it and read just what I need to read.Thanks for that...ever thought of writing a medical/ostomy journal for dummies? lmao.
Anyway, what you have said makes a few things seem clearer to me now.And maybe the reason why I still have a bit of trouble at certain times.This info would have been great in the begining.Make me more aware of what I'm eating and such so it doesnt happen as often(leaks & such)..again,thanks.Tara.
Reply by sweede, on Tue Mar 03, 2009 4:08 pm
Dear gosh tarababy!! don't get me started on another project lol,i'm up to my ears in stuff at the moment, but it is an interesting thought mind you, perhaps i'll take you up on that when things start settling down a bit.
Just as a thought, what kind of content should go into an "ostomy for dummies"  besides changing the the title of the book of course, it's not a very flattering title lol.

can you think of some chapters that might be useful for the book, i'll tell you for why, back at the start of last year the whole reason the foundation was born is because i had a plan to design an information dairy that would be published annually, containing profiles of people with different diversions, followed by a short bio about themselves and relevent information about the disease/illness that led to that particular diversion and contacts of the support groups also relevent to the type of disease/illness.

The plan was to publish it and donate them to the Scottish NHS do they can place it in every ostomy welcome pack given to all new ostomates in Scotland. Sadley the NHS didn't quite share my enthusiasm, and i was given a flat "go chase yourself mate", well for whatever reason they chose not to take me up on the offer, and out sherr fustration that something had to be done about the lack of information available to Scots ostomates, the foundation was born.

I still have a plan in the futue to publish some kind of info diary/book on the subject but not quite yet.x
Reply by mooza, on Wed Mar 04, 2009 12:42 am
  Well said sweede   we have had a chat in the chat room that was gr8 to read..We have in Australia an OSTOMATE MAGAZINE here and everyone gets one in MELBOURNE anyway has great information but like eveyone else we all want to take care of our skin around the stoma i have had probs aswell but i find COLOPLAST a lot cleaner. ileostomy so i do use that product but i do find cuts around my skin even the outside of the pouch but Coloplast has a great new pouch SENSURA even cleaner spout but yep allergys so i use ALTERNA & SENSURA ..I wish someone could make the perfect pouch for our skin..   I also use ILEO TABLETS it turns the output into a gel substance NO SLOSH ..Made by BRAUN..KEEP UP THE GR8 WORK  s WEED e lololol
Reply by sweede, on Wed Mar 04, 2009 2:50 am
Hi Mooza, Peace to you too lass, yes i do remember our chat,, that was quite a while ago if i remember right.  
There are also magazines that are available here in the U.K  a few of the patient associations publish them quaterly. But i, (in my opinion), don't find them comprehesive enough. i.e take for example my research done on hydrocillides, they just don't tell it like it should be. Don't get me wrong here now Mooza, the patient associations do an amazing job at being all inclusive and provide unparrallel support to ostomates, the last thing that i want is for them to get the impression that another is trying to compete with them, i have already had that battle with them lol.

When i put the word out about the foundation being launched back around this time last year, and word got out that i was about to scale Ben Nevis with a 4ft colostomy bag to fly at the summit, a national newspaper contacted me and asked the reason why i was doing it all,  i stupidly mentioned that there is not enough information, support and advice out there and a comment like "you may like to think there is, but sadly the truth of the matter there isn't" ,this comment for some reason sadly got the wind up their backs.
I recieved a few not so pleasant phone calls and emails, seroiusly trying to disaude me from launching the foundation, and i have yet to have my membership re-activated on one of the patient associations forums.  A few companies who were willing to sponsor the foundation withdrew there support almost overnight and everything nearly collapsed before it had even started, it's amazing how a few chineese whispers can do one so much damage. but hey..... i think that is one of the deciding factors that the NHS decided that it wasn't a good idea.

Whoops.. i just realised that i'm ranting, you have to fogive me, i have been up most of the night doing bag changes as i am bowel prepping for a scope today and have had mucho leaks as my output is now water and is leaking thro the filter every time i try to sleep lol, hence this post is in the wee hours of the morning.

So yeh to cut a very long story short, i had to put my idea of producing an information diary on the back burner for a while.

Anyway, getting back to the subject of products that are kind to the skin, i have posted in the innovations section content about a new product that has come onto the market, it is a hydrocollide barrier plate for ileostomates and urostomates designed to keep waste from the skin, and prevent leakage, it is also so i am led to believe extra kind to the skin, it is like i said a barrier plate that you apply first and has an adjustable raised collar, the flange then fits over the barrier plate, so all waste is directed  into the pouch, a very nifty innovation methinks.

Take care Mooza, hopefully we can get the chance to chat again soon.x


Last edited by sweede on Sat Mar 07, 2009 8:31 am; edited 1 time in total
Reply by sweede, on Sat Mar 07, 2009 8:14 am
Hi Geraldo, sorry dude, getting back to your question, it kinda side tracked there lol, i have put together a bit of info from various snippets on the net and a few bit of useful info i threw in.
I hope it is of use to you.


The majority of ostomates experience breakdowns of the peristomal skin from time to time. The best preventative measure undoubtedly is maintaining optimum hydation levels. Hydrated skin is more flexible and durable therefore less subject to irritation and injury.
Changing stoma pouches, shaving around the stoma, and general movement can all create macerated peristomal skin. Allergies from certain stoma products and waste being in direct contact with this maccerated skin can very soon develop into very nasty irriitations, sores and ulcers.


If the need to shave round the stoma, using an electric foil shaver rather than a wet shave with a razor blade greatly decreases the risk of irritating or breaking the skin . As does taking care whilst peeling the pouch from the abdomen, choosing the right ostomy pouching system and accessories by first doing a simple patch test of all the items that contact the peristomal skin then trailing the products for a few days and ensuring a good seal around the stoma all help prevent breakdown.

But what of the cure?.

So it's now gone beyond preventative measures and there is an irritation or ulcers and sores on your peristomal skin, what should you do next?

There are a few angles to tackle irritations, sores and ulcers, early detection can catch serious complications, becoming informed about the signs to look for in peristomal skin problems determines how best to treat them and therefore reducing the risk of them escallating.

Here are a few of the likely candidates to your problem and how to treat them.


Allergic Dermatitis.

is an allergic reaction to flanges, skin barriers, tape collars, adhesive removers or skin preps and pastes. Symptoms include itching, burning, stinging and a reddish rash. If you experience any of these symptoms then it's best to discontinue the use of all products that you use to manage your preistomal skin. If you need to use stoma paste to prevent leakage, then try to find a paste that has a low alcohol content.

Apply a non-occlusive moisturizer with added vitamins A&D to reduce redness and itching. Non-occlusive formula absorbs quickly into the skin and will not interfere with the adhesion of tape or ostomy pouches.

Calamine Lotion painted over the irritated area will act as a barrier and prevent further irritation

If symptoms persist ask your G.P if Hydrocortisone steroid cream, if this is an option for you. Hydrocortisone is a corticosteroid medication and works by reducing redness, itching and inflammation


Irrittent dermatitis.

occurs if the pouching system has leaked regularly. It presents as weepy sores with possible bleeding and is agonising This can occur if there has been injury to the skin due to repeated appliance removal. If an irritant dermatitis is occurring, gently remove the flange and ensure the peristomal skin dries well after cleaning( using only water) and carefully examine the skin, checking for any skin that has been stripped from the skin

If this is the case then a stomahesive powder can be used to dry any weepy areas , then dress with a sacrel shaped(round) transparent adhesive dressing , ensuring to cut a snug hole for your stoma, then attach your appliance. It's best to use a one piece drainable pouch as this reduces further trauma and friction. Repet the process after every bag change throughout the healing process.



Folliculitis


is an inflammation of the hair follicles which is caused by removal of hair when the flange is removed aggressively. (Use an electric shaver to combat this). Dust affected area with an antifungal powder , this is an antibiotic therefore should be used sparingly. Ask your G.P for further information
.
Dress with a sacrel shaped(round) transparent adhesive dressing , ensuring to cut a snug hole for your stoma, then attach your pouch. It's also best to use a one piece drainable pouch as this reduces further trauma and friction


Candida

is normally found in the Gastro Intestinal Tract, it is a yeast-like fungus that can cause an infection around the stoma. Ostomates are prone to Candida because the area around stoma is warm and moist and covered. This infection may spread to the groins as this area may be moist also, and therefore should be treated as soon as possible. Symptoms include redness and itching.

An antifungal powder can be used on the affected areas in conjunction with a no sting barrier wipe or spray, taking care that neither the spray nor the wipe is alcohol based. Also using a cotton pouch cover soaks up moisture that gathers on the skin around the thighs and groin, there fore reducing the risk of Candida spreading, if there is excess moisture, a hair dryer on a low setting will aid in drying the pouch and infected area.

**It is vitaly important that you consult your G.P or Stoma Nurse before trying any of the suggested treatments.**








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