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Stool Accumulated In The Stoma Area - Any Advice?

 
Posted by Past Member, on Sun Dec 06, 2009 12:15 pm
Hello,

My mom has a new ileostomy (about 2 months). Quiet often she notice a leakage (not long after changing the appliance) .When changing the appliance looks like  the bag is mostly empty and most of the stool is stuck between the bag and the skin barrier stoma area which does not allow the stool to go down to the bag and cause a stool leakage (mostly solid rather then liquid stool).

Did anyone encountered with this problem? Does she need to make sure of her diet so the stool will not be too thick?
 
Reply by eddie, on Sun Dec 06, 2009 1:33 pm
Hi, ISR  I have an ileo, it sounds as if she may be cutting the hole to big around the stoma it should be just a cm or 2 larger than the stoma,also timing is important you have to change barriers when the ileo is least active I find right before i go to bed is the best time for me cause if that baby is going, it is almost impossible to get your barrier to stick.  I found that I had problems with leaking until I started to use rings.  Hope this helps
eddie
 
Reply by Past Member, on Sun Dec 06, 2009 2:14 pm
Hi eddie,

Thanks for you reply, my mom stoma is about 30 mm (a bite elliptic ), the skin barrier size is 32mm so I think the size is ok, I also noticed that if we apply 30 mm skin barrier, perfect match, we have more issues with stool accumilated in the stoma area.
We tried many different appliances, with barrier ring and w/o ,with pasta and w/o and in some cases the appliance worked for 3-4 days with no problems and in other cases worked only for 12 hr till the stool blocked the entrence to the bag and caused leakage.

We found that its so hard to identify what works and what is not (i.e with pasta w/o pasta, thickness of the stool to thick or not, with barrier ring or w/o), we can't understand what we did right in cases where the appliance worked for 3-4 days vs only 12 hr.
 
Reply by eddie, on Sun Dec 06, 2009 2:41 pm
You might try a belt, have her to hold her hands over the barrier & bag for a couple minutes this heat from your body helps to adhere the barrier,  call the company that you get supplies from for samples & ideas also maybe a different band might fit better they will give you free samples, try a flex extend product, without tape they work better for me.  Don't know if any of this will help just brainstorming it is the pits when you can't keep a fit,  it took me quite a while to get the right supplies and know what to do to prevent a leak.
eddie
 
Reply by Oceanblue, on Sun Dec 06, 2009 11:08 pm
Dear ISR,  it is unusual for an Ileostomate to have solid output from the Stoma. Maybe have a look at your diet for starters. Drink more water.  I was told that it should normally be like a toothpaste thickness.

As for the stool not moving down into the bag, this may sound a bit strange, when you fit a new bag, coat the inside of the bag with some cooking oil to help it slide down.
A stoma nurse told me that trick.  

I use a two piece appliance so I can fit the base evenly around the stoma.  I leave only a few millimetres 1/16 inch of exposed skin around the stoma.

Also make sure you are not compressing the stoma area with tight pants etc
If your stoma is above your belt line it will build up.

Hope that helps
 
Reply by budd002, on Mon Dec 07, 2009 12:21 am
When my stools are thicker than normal I get build up around my stoma as well. When I go to the bathroom I take the bag off and wipe around the stoma with toilet paper to keep the area semi clean and clear then pop the bag back on. This also helps cut down on irritation.
 
Reply by tiger227, on Mon Dec 07, 2009 7:05 am
Hi

Sounds like your mum needs to have her stoma measured for the correct size hole to be cut, her stoma nurse will do this, also make sure the seal is secured tighly around the stoma, as this will cause leakage.
The other good tip is to push the bag open a bit through the hole before putting it on as theis allows air in, and helps the motion go through.

Any problems your mum has after surgery, she can speak to a stoma nurse at the hospital and I am sure they can help her out.

Good luck

Jean
 
Reply by tiger227, on Mon Dec 07, 2009 8:13 am
Hi

Here are a few tips for your Mum

1-  get the right size hole cut in the pouch
2 - oil the inside of the pouch with baby oil
3 - push the pouch out a little before applying
4-  seal the edge of the pouch by pressing all around in place securely
5- drink plenty of fluid
6- if all tips fail, contact her stoma nurse.

Good Luck

Speak to you soon

JeanX
 
Reply by weewee, on Mon Dec 07, 2009 10:35 am
hello
well one thing i see is your mom is still in post op its still only 2 months after surgy
it took me awhile for the swelling to go down i use rings and i also have a spray that hollister has it slows down my leaks i have to change every 12 to 24 hours do to blowouts i use a two piece also cause some times you eat something that just stinks really bad and i like to be able to rinse out my bag and dont forget that everything is trail and error then you find what works the best for your mom also what was a life saver was at wallmart they sell a bed cover that fits my king size bed for the night accidents of blow outs at first i didnt like it but after a few washes you dont hear the plastic under the cotton it was about 30 bucks good luck with all findings here in the site many people to help and to talk to
 
Reply by Belinda, on Mon Dec 07, 2009 10:52 am
Called "pancaking" and very, very common with thick output.Make sure that the first bit of stool to appear in bag gets pushed down ( from outside of bag) with both thumbs. The rest should follow quite easily.As has already been said, blow into the bag through stoma hole just before putting bag on, as if not, and there is no air in bag, stool has nowhere to go, and will push bag off.Hope this helps.
 
Reply by bonnie blue, on Tue Dec 08, 2009 5:29 pm
You can also try leaving a little air in the pouch so the stool will have somewhere else to go and not sit there on top of the stoma.

EHP
Georgia
 
Reply by cheekysmile3, on Tue Dec 08, 2009 7:53 pm
hiya.. im new 2 this.. i had my ileostomy 6 weeks ago and, like ur mam iv had never ending problems with my stoma! im a chubby girl & i have a crease in my belly & the surgeon placed my stoma there. its quite difficult to manage. my stoma nurse suggested a different type of stoma bag & since then iv had 3 leakages. ur mams stoma needs 2 b measured and, the stoma bag cut to size. hopefully, she will have the luck iv had since changing my bag.

i wish ur mam the best of luck..

vikki.xx
 
Nurse
Reply by Whoa, on Wed Dec 09, 2009 3:05 am
Hi ISR
Some good advice from the pros with stomas!

I might add, have her see the ostomy nurse.  They should check your mom in a sitting position to see if she has creases.  She may need convexity and some strips of Eakins or Coloplast type strips to fill in gaps. Sometimes a belt will help pull the appliance towards the body and snug up those creases too.

It is strange that sometime she gets up to 4 days, then disasters.  Another trick is to keep pallm pressure over the stoma and skin barrier for a good 10-15 minutes after applying the pouch, don't sit up for a while.  It sometimes helps with the pouch adhesion.

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