Is Overgranulation a Common Issue with Ileostomies?

Hi, anyone with experience of overgranulation? I've been treated by my stoma nurse with silver nitrate. Is this a common issue? I've had an ileostomy for 6+ years and only recently had minor issues.

Good Evening TranmereFan,

The last time I was in Tranmere, I alighted from a commercial vessel 'lightening' oil cargo from super tankers into the refinery - we often put there - got to know Chester quite well too and some of the surrounding villages. Birkenhead was the 'go-to' when doing a 24/7 turnaround - I remember driving the tunnels into town to catch a retailer before 'closing' time.

But most of all I remember the Tall Ships Race and the lovely vessels that came through the canal locks and one could view and see these majestic craft at close quarters - very different from seeing the vintage tea clippers [from sea] off the coast of Norway - their apparent 'silver' masses of sails glinting in the sun in sharp contrast with the sea/deep blue sky and the white backdrop outlining the fjords - wonderful! 

Probably unlikely - given where you are based - but if you have not ever seen the Tall Ships Race assembly of craft - it is quite something - and worth catching up with.

The build quality - the marine heritage - and the engineering of those vessels is so different from modern craft! 

I do not know whether the tall ships still come through Stanlow?

I also remember masses of rabbits running freely within the [Stanlow] refinery [and some of the other installations up the line into Birkenhead and elsewhere] ....

The grass landscaping appeared to have very 'sandy' soil at Stanlow - and I guess the dryness of the refinery [and that background continual hum] were ideal conditions for the 'Flopsy/Bigwig' population to multiply! :-)) Often a buck rabbit could be seen/encountered drumming the ground - warning of humans ... and suddenly - as soon as you blink - all was deserted - used to happen early morning and evening.

That was many years ago. - it would be cute to learn the rabbits are still around!

I send you good wishes for 2024.

GRANULATION:

Now as to your question concerning granulation and silver nitrate.

I personally have experience of 'over granulation' - which is in effect a stimulation of extra cellular tissue growth - as induced by a roughened surface or as 'experienced' reaction - as in an unfamiliar introduction to the adjacent cells [which can occur not only from surgery - but also by an irritation/exacerbation of inflammation - or due to/as a result from other reasons of cellular change].

Put simply, for those unfamiliar with the product - silver nitrate is, in effect, a chemical - often used in 'stick' form 'burns off and cauterizes the cells to reduce/remove the overgrowth - thereby stopping those extra active cells bleeding.

There are many online articles addressing at length how silver nitrate works and its properties and applications.

TranmereFan, you mention that only recently you have had ''minor issues - are these 'issues' all related to 'overgranulation' - with or without inflammation or other evidence of cellular activity?

I would be sure to ascertain - by pressing for a full 'information' as to what the potential cause of such overgranulation is and why it is happening with you.

Examples:

Personally, I have experienced over granulation in the case of the TIES implant. That happened for various reasons. And it had also been explained to me how the implant titanium collar had been modified over time so as to reduce the overgrowth which manifested as a complete ring of tissue which overgrew - and then subsequently began to disintegrate and reduce and sink around the metal interface.

I recall the use of silver nitrate on other occasions within my stoma history [40+ years overall] to remove unwanted 'nodules' - totally benign - that have appeared around the stoma - where, in fact, no apparent rubbing/ill-fitting/or discomfort was being felt - but such small nodules are an inconvenience - causing irregularity of interface of appliances - and may be treated to safely remove and seal these. [Because if they are just removed by a scalpel or a sterilized pair of scissors - there is the risk of 'spreading' any cellular material when the cut remains unsealed].

The extra tissue - can be in the form of bowel tissue i.e. as part of the stoma [adjacent to or actually upon] - but also can be the stimulated cells of abdominal tissue surrounding the stoma. 

Probably the more forms of overgranulation to be discussed on this forum I guess.

Please note:

I am not a medic and as such - one can never make a presumption - nor should one try - as to what the cause/information is surrounding such 'granulation'.

I would iterate the suggestion of asking for full information - and in the event of the stoma nurse not knowing - go back to your physician/surgical team and specialist nurses to access the information - there are many instances of over granulation - not just around stomas.

Hope this may be of some help - but please never shy away from asking questions - rather than making assumptions or dismissing something - for without information you will not have the understanding to make sure the management you are pursuing is appropriate in your particular circumstances.

Also please do not overlook the fact we are all different - even when symptoms are similar and even when diagnoses appear to be 'the same' - as what appears to the experience of one person may not always actually relate to another's state of being or treatment options.

Waves from Middle Wales

BW

Jayne