Recessed Stoma Issues and Leak Prevention Tips

I am posting this for a friend who has a recessed stoma. Can anyone and everyone who has advice please share what you do to help prevent the leaks as well as helping with their situation. Thanks, Michael


and this was a reply from Badancer




Badancer


Michael, several of the ostomy supply companies make a convex pouch with a belt that helps the stoma protrude. If leaking persists, he may add a small Eakin seal. Form the Eakin seal to fit around the stoma and then apply the pouch. As always, warm the pouch seal and the Eakin seal before application. This seems to work. Hope this helps. Roger

I think you can also 'stack' the seals or adapt rings too until they do the job?
Rach xx

Thanks Michael for posting this. I have tried the deep convex flanges and the eakin seals as well as I am wearing a belt. I have a loop ileo and the opening where stool comes out is flush with the skin and is getting under the flange no matter what we try, sometimes the eakin seal or coloplast strips make it worse because it swells up therefore creating a pocket for the stool to sit in. The nurses are having to change it everyday and that is helping heal the skin around the stoma as it was really bad, but it would be nice to get more than a day out of a flange. There are a few things that the ET nurse wants to try but she is also getting frustrated, she wrote a letter to my surgeon asking about a revision but he said that it is too early for that (surgery was Oct 4th) he aslo said that with time the stoma may evert more. I also have creases on each side of the stoma that we are building up with the coloplast strips.

I did not know you had loop ileo; that being said, the end where the stool comes out is flush and the side where the mucus comes out is raised? Wondering if maybe the doctor raised the wrong side... or are both sides flush with the skin? Loop stomas tend to be a bit more difficult to seal well, as compared to end stomas. I wish I could be of more help, but it sounds as if your ET nurse is on top of it with you. Wishing you success in getting this figured out.

Just tell me if your other opening (the one where only small mucus comes out) of the loop is raised? I do believe they raise one side more than the other to keep away from the skin so what you are going through doesn't happen. Michael

Hi,

My name is Marsha, and I'm so sorry to hear that you're having so much trouble. Getting off to a "good" start is a blessing... and when maintenance isn't going well, it's a challenge. Don't lose hope... Sometimes it takes time to get it right.

I think most stomas are fashioned to protrude from the skin, so the waste gets "aimed" into the pouch. I'd definitely question your doctor about it. I've rarely heard of the stoma protruding out with time. I think more often it retracts.

I haven't used it, but the Eakin seals are supposed to work well. After 45 years of "use", the underside of my stoma is now flush with the skin, and pulls under... so I'm beginning to have problems with it. I use Stomahesive paste around the edges of the wafer, and that helps some. I've begun to make the opening on the wafer a little larger, so that the stoma has room to move around without going under the wafer. That does leave the skin a little more exposed, but I use Convatec two-piece appliance, so I'm able to remove the pouch and add more paste or powder if needed.

You're lucky to have a Stoma therapist nurse helping you out. In the "old days" when I had my surgery (I was only 15), ostomates from the ostomy groups visited new 'mates. When I was 18-22, I used to go out to visit kids who had the surgery.

Keep trying new combinations... and don't give up. Sometimes it helps to wear a lightweight elastic panty, to help keep the pouch and wafer from slipping due to the "weight" of the stool. (I've always done that) Be careful with the belt. I used to use one, but found that it would slip up to my waist, and pull the wafer up.

Roger gave you some good advice. Let us know how you're doing. Best of luck...

Marsha

Living with Your Ostomy | Hollister

Thanks, Marsha and Michael,

Actually, both the stool and mucus openings are flush with the skin, and the middle is raised a little. The opening where the stool comes out is more bothersome because it is pointing down, and the one where the mucus comes out points up. I am still getting skin breakdown on the top from the mucus, but not as bad. My stoma is oval-shaped. My ET nurse has been great.
Marsha, I do find that with the belt it rides up, and I am always having to pull it down, but it does help keep the flange close to me. That would be awful not having an ET nurse, but it is good that you got support from others who know what you are going through. The ET nurse has cut the flange so it fits as close as possible to the stoma without touching it, but it is still leaking. The Coloplast one that I have on now has actually lasted a day and a half, so that is getting better. I have also heard that the stoma will recess with time and not evert, so I was a little confused by the doctor saying that.

Thanks for all your help, everyone. I really appreciate it. —Rebecca

I have a stoma which is flush to my skin and use a convex flange. I have personally found that I have fewer leaks with a Coloplast barrier than a Hollister barrier . Sometimes a revision is necessary as well ...but more surgery......who wants that !!!!

Thanks, Tetley. I have been wearing a deep convex that didn't work. Also, I am trying a moldable flange that is not helping either. The Hollister strips didn't help, and the Coloplast ones were better. The nurses are all saying that I will need a revision. My ET nurse will be here sometime this week, so maybe she will have something new to try. It sucks if I have to go through another surgery, but if I can get a better stoma, then I guess it will be well worth it.
Rebecca

Rebecca,



I had the same issue with my first stoma many years ago. It was also in a very awkward position (it was an emergency rupture that almost led to peritonitis). The only solution that worked for me was a one piece flat flexible flange with a lot of paste. It allowed me to basically mold my own custom fit. I had Ileostomy version 1.0 reversed after a year and had 11 years without one. Now I have a much easier stoma to deal with and use convex one piece with barrier and paste. 18 years later I barely even think about it at all.



Keep experimenting and even if it takes another surgery, believe me, once you get past this little hump it makes a huge difference. Life is Good!



Michael



btw. love that photo...bravo! very courageous!

What did you do to fix this? My wife is having issues too.