Need advice for peristomal skin issues - stoma complications

Hi everyone, I was wondering if you can offer some advice please. I have had my stoma for two and a half years now and the surrounding skin has never healed properly. My stoma is convex and I don't know if that has anything to do with the problems I am having. The contents never fall properly into the bag so they are always sitting on the stoma and surrounding area, and this in turn causes the skin to weep, blister, and bleed. I have tried barrier sprays, powders, donut rings, stoma paste, calamine lotion, and now I am out of ideas, so I would be grateful for any help. Thanks in advance.

I would ask, colostomy or ileo? My guess is your skin is irritated because you are leaking between the barrier and your skin. I know some people have good luck with the antacid product called "Mylanta" applied to clean, dry skin under the barrier and skin prep.

You will have to resolve the leak issue before you can make much progress healing the skin.

Do you wear a convex barrier and a belt? Have you tried switching products? Not all skin types are the same, and therefore some products work well for some people and not for others.

Another cause of poor sealing is using a soap that contains oils or perfume when you prep the area before you apply your appliance.

My suggestion would be to contact all the ostomy suppliers and ask for some free samples of every kind available. Then you can, by "trial and error," find out the best combination for your circumstances. Most ostomy manufacturers have a "help line," and they may suggest a particular product they think might help. Good luck and keep us posted on your progress.

Always? The law of gravity would suggest otherwise. MMSH's question about the type of ostomy is most relevant. Ileos produce liquid stool which should easily flow down into the bag. Lack of fluid input, which leads to dehydration and hard stool, may be the problem. My stoma sits on top of a convex mound which, according to my GI, is OK. What is your surgeon's explanation and recommendation? Has your surgeon or physician actually looked at the condition of the skin around your stoma? If not, bring an extra bag and flange to their office on your next visit and have them check it out. Good luck and let us know.

PB

Thanks for the advice, Mild Mannered Super Hero. In answer to your question, I have an Ileostomy and I will certainly try the suppliers here in England and hopefully they will be able to help.

Primeboy, I came on this forum to ask advice and certainly did not expect anyone to be so condescending referring to the laws of gravity!! I hope if ever you needed advice, other ostomates were kinder to you.

Hi bababoo, (cute name)

I have a colostomy but have the same problem. It usually sits at the bottom of the bowl part smashed around and on the stoma. I get a lot of what they call pancaking. It doesn't seem to matter what I wear or how I sit or lay, that's what it wants to do. I usually wake up with it all in there and covering up the stoma, even though it's pretty free hanging when I sleep. I understand ileos are more watery and the output is more toxic to the skin, but I have watery to pasty - rarely do I get solid (I drink water all day and night); even when it's solid, part of it usually sits in the bottom anyway. I don't have the things going on with my skin that you do so far, but it looks white and weird and itches often. There's also been a little bit of bleeding from, what look like, tiny blood blisters on the higher side. So for the past month, on the days I change, I have been taking a big beach towel in my room, laying it on my bed (I also have a big mat I put under me - one side is waterproof the other is quilted linen-easy to throw in wash and keeps your mattress safe in case), laying on top of that and let the air get to it until the stoma starts acting up. I keep my appliance right next to me on the bed. Usually I can get away with 20 minutes, one day it stayed calm for a whole hour. It seems to be helping the skin to look a bit more normal instead of anemic and the itching has subsided a lot.

Hopefully, some of the things MMSH offered will help and if all else fails do as PB suggested and take an extra bag next time you go to the doctor. I offer my bit of advice because I also have a problem with my butt not healing so I have taken to letting it "air out" (without getting too descriptive) over the past few months and when I went to the surgeon to see about having surgery to fix it - he said it had healed a lot since the last time I was there! So no surgery! YAY! My grandmother always said wounds need air to heal, she was never wrong about anything I can remember. :)

Good luck!

I have heard that SALTS products are wonderful and they are available in the UK. You should give them a call and see what advice they might have. Do you use stoma powder and a skin protectant? These may help keep the skin protected from leakages.

Can you get to a WOCN (stoma nurse) - they are usually pretty good at problem solving these issues.

I have also heard of folks using Duoderm to cover the irritated area and then placing the flange on top of that. It is supposed to allow the skin to heal underneath.

Sorry you are having skin problems - it's not fun at all. When my skin acted up, I ended up changing every other day until it got better.

Best of luck, hope you find a solution,

Marisa

I apologize for making a comment that offended you, Bababoo. My intent was truly otherwise. We are fortunate to have this great ostomy community in our lives, and I hope you will find your continued experiences here well-intentioned and supportive in every respect.

PB

Hi bababoo,

A few things come to mind. Are you drinking enough fluids? Pancaking is a term we use to describe when the stool sits right where it comes out and doesn't seem to drop. It usually occurs when we aren't drinking enough fluids. It also happens to me when I am on antibiotics.

I have an ileostomy too. When you say convex, are you meaning your area around the stoma is rounded out?

Another thing you can do is take a digital photo of the stoma and surrounding area and e-mail it to your doctor. That is what I do. It saves me taking off the bag there. After all, a picture is worth a thousand words. A visit to a good WOCN to help you find a better fit might also be a good idea. Trying a lot of samples is also a good idea. That's what I did at first.

All the best,

V

P.S. Prime boy is really a very nice person and a huge asset here. I am sure he was shocked and dismayed to think he may have been hurtful. :))

Hi, I have also had the weeping, blistering, and bleeding around my stoma. I have used baby powder (with some success) in an attempt to dry the skin around my stoma. I also use barrier wipes instead of sprays. The wipes create a thin barrier between my skin and the round wafer. I am allergic to something in the wafers, which is why I use barrier wipes. Washing the skin with just water and allowing my skin to dry completely helps also.

Hi Bababoo, how's it all going? Have you been on your hols yet? I hope it's this week for you with beautiful weather. I've been out with my walking pals today up Mrpeth way. It was a great day and we never stopped laughing all day. We did 12 miles. Phew, bloody knackered now.

I get this problem with my little friend. I've been using Savlon cream on the soreness before I start with the other creams and powders. It's helped a lot and got rid of the soreness feeling.

Don't forget, when you get up over the border, go visit the Royal Yacht.