over the last 4 years since I acquired my colostomy small wart-like growths have started growing along the base of my stoma. Have you any experience with these? What are they?
funnygurl
Sep 09, 2008 1:07 am
tarababy
Sep 09, 2008 3:47 am
Oh My God! yes funnygurl, and I am in my 5th year with this..Right at the base of the stoma.Keep meaning to meantion it to the doc's but you know how the memory goes.So was just sitting and waiting to see if anyone else came on here with the same problem.Will have to mention it sooner or later as it's growing.So whoever finds out first...
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let the other know..or if anyone,maybe whoa could answer that one.Thanks..Tarababy
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let the other know..or if anyone,maybe whoa could answer that one.Thanks..Tarababy
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Whoa
Sep 12, 2008 5:51 pm
Hi guys
The most common little bumps or warts are called pseudoverrucous lesions... easier to say stomal warts, hypergranulation, among a couple of other names. Usually, they are located right at the juncture of the skin and the stoma. The usual cause is the skin being bathed in chronic moisture. The moisture issue could be from: too large of an opening in the pouch allowing discharge to constantly bathe the skin (often seen with loose or more liquid stool), leakage of discharge trapped under the skin barrier. I have seen this with stomas that are flush or "innies" that drain right at or below the skin line despite the properly sized opening. Sometimes changing your pouch more frequently (like every 4 days rather than weekly) can really decrease that moisture. When you remove your pouch, check the back of the skin barrier. If it has stool on it or eroded away, you should consider changing it more frequently as you have lost your skin protection.
In my experience, the lesions with fecal stomas are usually red, often tender, and bleed easily. They can also occur with urostomies but are more white or grayish. The lesions themselves aren't usually harmful but can cause pain, make a pouch seal more difficult, and the bleeding can be scary. I had a patient keep cutting his stoma opening larger to accommodate new lesions; by the time he sought help, he had a patch of them extending for four inches from below his stoma. We were able to clear it up in a couple of months with drying them out with powder, cutting the proper size opening for the stoma, and more frequent pouch changes since the moisture of the lesions undermines the barrier/pouch seal.
Treatment for fecal ostomies:
Cut the opening the same size as the stoma, not larger. You want to cover the "warts". I usually advise using a Karaya or Stomahesive powder on top to dry them out, and use your paste or barrier ring (i.e., Eakin's, Adapt, etc.) to add adhesion. I usually add a belt to "smash" them down along with the above. Sometimes using a convex wafer with all the above provides a little more pressure to flatten them.
If they are right at the skin juncture or very large, your physician or ostomy nurse may want to use silver nitrate which burns them. It requires frequent treatment (every pouch change or every week). It can be painful. I still cover them if able with the skin barrier and try my best to dry them out and use the belt as pressure to flatten them. For some folks, the discomfort of the silver nitrate is not worth it.
Occasionally they can get quite large. Years ago, I saw physicians and an ostomy nurse tie a suture around it to shut off the blood supply; eventually, the growth would fall off. Though it was painless, I usually refer them to their physician to have it numbed, excised, and be done with it, especially for the large or hanging pedicle type warts.
It is wise to check with your ostomy nurse or physician to be sure it is not something more complex. If it is pseudoverrucous lesions, they are more of a nuisance than harmful.
Hope the suggestions help.
The most common little bumps or warts are called pseudoverrucous lesions... easier to say stomal warts, hypergranulation, among a couple of other names. Usually, they are located right at the juncture of the skin and the stoma. The usual cause is the skin being bathed in chronic moisture. The moisture issue could be from: too large of an opening in the pouch allowing discharge to constantly bathe the skin (often seen with loose or more liquid stool), leakage of discharge trapped under the skin barrier. I have seen this with stomas that are flush or "innies" that drain right at or below the skin line despite the properly sized opening. Sometimes changing your pouch more frequently (like every 4 days rather than weekly) can really decrease that moisture. When you remove your pouch, check the back of the skin barrier. If it has stool on it or eroded away, you should consider changing it more frequently as you have lost your skin protection.
In my experience, the lesions with fecal stomas are usually red, often tender, and bleed easily. They can also occur with urostomies but are more white or grayish. The lesions themselves aren't usually harmful but can cause pain, make a pouch seal more difficult, and the bleeding can be scary. I had a patient keep cutting his stoma opening larger to accommodate new lesions; by the time he sought help, he had a patch of them extending for four inches from below his stoma. We were able to clear it up in a couple of months with drying them out with powder, cutting the proper size opening for the stoma, and more frequent pouch changes since the moisture of the lesions undermines the barrier/pouch seal.
Treatment for fecal ostomies:
Cut the opening the same size as the stoma, not larger. You want to cover the "warts". I usually advise using a Karaya or Stomahesive powder on top to dry them out, and use your paste or barrier ring (i.e., Eakin's, Adapt, etc.) to add adhesion. I usually add a belt to "smash" them down along with the above. Sometimes using a convex wafer with all the above provides a little more pressure to flatten them.
If they are right at the skin juncture or very large, your physician or ostomy nurse may want to use silver nitrate which burns them. It requires frequent treatment (every pouch change or every week). It can be painful. I still cover them if able with the skin barrier and try my best to dry them out and use the belt as pressure to flatten them. For some folks, the discomfort of the silver nitrate is not worth it.
Occasionally they can get quite large. Years ago, I saw physicians and an ostomy nurse tie a suture around it to shut off the blood supply; eventually, the growth would fall off. Though it was painless, I usually refer them to their physician to have it numbed, excised, and be done with it, especially for the large or hanging pedicle type warts.
It is wise to check with your ostomy nurse or physician to be sure it is not something more complex. If it is pseudoverrucous lesions, they are more of a nuisance than harmful.
Hope the suggestions help.
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funnygurl
Sep 12, 2008 9:29 pm
Thank you so much for solving the mystery. You explain things so well! You rock!
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