New Ulcer Under Stoma; Canceled Stoma Revision

My stoma revision to remove nodules where the stoma and skin meet has been canceled because I now have an ulcer where the stoma and skin meet, also.

I've been taking pics of my stoma for the last several barrier changes to show the doc and save having another barrier change. When I went to see the surgeon, he used the pics instead of me having to take the barrier off. Worked great. When I changed my barrier this morning, there was an ulcer that hadn't been there before, right under the edge of the barrier around the stoma. I took pics of it, called the surgeon's nurse to let her know of the change in case the surgeon would need to do something different. She asked for an email of the pics, then the surgeon called and wanted to cancel because the ulcer looks to be my Crohn's disease, and he's afraid that if he messes with the stoma, he could make my Crohn's worse and it would become worse.

I've recently restarted my medication (not as early as I should have, thanks to my SLOW mail order pharmacy insurance makes us use! That's another story!) so I'll give it time to work and see what happens.

I've been using the convex barrier from Hollister for a few weeks, and it's working the best with the nodules, but I hope the pressure from it isn't what's causing the ulcer instead of my Crohn's. The surgeon thinks it's the Crohn's, so I guess I go with his words.

Any hints on how to deal with an ulcer under a barrier? Thanks for any tips!

Good luck! I hope the medication helps resolve the ulcer so you can go ahead with your surgery.

Hi. Sometimes it just doesn't stop! I have had (and have again), this issue. You are right to find out exactly what it is: Crohn's, fistula, or ulcer. I had a dermatologist diagnose the ulcer as a pyoderma ulcer. It was biopsied and then injected with cortisone. The fistula I have now was from my stoma revision in Feb, and the surgeon will add a few stitches to pull up the side to be more level. There might even be granulation tissue on the edges, and nothing will adhere to it (because it is always weepy), so the edges need to be silver nitrated.

The wafer I use is convex, and I cut it to the size of the stoma and the ulcer... like one funny-shaped stoma. The edges of the ulcer may not stick, so be prepared for more frequent changes.

Taking pics is a great idea.

Good luck.

MarkP - Thanks for the encouragement!

Snowwhite - Hi! I'm still not sure which it is. It hasn't changed in size in 4 days but I did have some mucus in it this barrier change. Does yours cause you any pain? I don't have any pain with the ulcer or the nodules. Just the usual Crohn's adb aches.

Do you fit your barrier AROUND the fistula instead of over it? I went ahead and put the adapt ring sections over the site. We'll see what happens when I change it Tuesday. It's trial and error. If there's a change I'll call my GI and see what he thinks. If anything like this is going to happen to anyone it's going to be me! LOL!!! Just can't do things the easy way!!

At least the liquid output has stopped! Since I did a pred pack and back on the Mercaptopurine my output has improved. This makes me happy!

I don't remember where I got the idea for the pics but they really help. Gives you a timeline of what's going on with the changes to show the doc. Gave him a surprise too! LOL!!!