Struggling with Skin Stripping Around My Stoma

After purchasing some rapid seal wound gel and liquid bandaid, the raw skin healed in one day!

However, the skin stripping away from my stoma is so bad that breathing, walking, moving, thinking is making it hurt. It's on fire. I'm dying here. I tried using stoma paste instead of a ring and it's so messy. It doesn't wipe off very easily. Even though I have awesome adhesive remover wipes, it doesn't come off.

Now I'm back to a ring and I'm still dying.

How the hell do I stop this stripping? What am I doing wrong?

Just to be clear... the skin around your stoma is stripping off your stomach. Correct?

Your stoma, that freaking alien spud, is not shedding skin. Correct?

🤣🤣 no lol. The skin that is attached and sutured to my stoma. That is what is peeling away from my stoma and hurting me. 

Just so we are clear: The skin is separating from your stoma? Or is the skin around the stoma so red it is bleeding and cracked? And how old is your stoma?

Correct. I got the skin to heal where the leak happened but the skin is still separating from my stoma. The ostomy specialist told me that it's stripping. 

I'm 16 days post op. I'm guessing this is all normal? Either way, it is hurting soooo bad. 

Staying Hydrated with an Ostomy with LeeAnne Hayden | Hollister

If the skin is separating from the stoma, it isn't skin stripping; it's called mucocutaneous separation. It's where the skin separates from the stoma, and this is around the time when it can start to happen. It can even happen 10 days after surgery, depending on the person, and it does hurt. I have had this happen to me two different times. It took a while, but it healed. Keep an eye on it, of course. Is there a way you can take a picture to make sure we are on the same page? And let me guess, the ostomy specialist is a stoma nurse, right?

If you're using alcohol-based paste, of course it's going to sting. That's why there's no-sting paste.

If you're using alcohol-based wipes, of course it's going to sting. Anything with alcohol, especially trapped underneath, is going to constantly sting.

A ring is flat on the bottom, so it doesn't fill gaps or dips as well as paste.

So what I'm seeing here is your skin is tearing, and output is just getting under the ring and causing constant pain.

You apply a thin coat of paste around the stoma to fill wounds, etc., and to make sure the paste sticks to the skin.

Then apply a bit more on top to marry to the wafer. The paste needs to be about as wide as a ring.

You use a coffee stir stick or something to handle the paste so it's not on your hands. You wipe it off the stick using toilet paper by pinching and pulling it off.

Don't touch the paste with your fingers.

You're using other types of products under your adhesive, and they are not designed to be bonded with it if you're not allowing these other products to breathe, being trapped underneath.

Some liquid wound stuff contains alcohol, which can burn.

The skin will heal just fine under there on its own, once it's sufficiently protected from stoma output.

To remove old paste from the skin around the stoma, you first use another coffee stir stick or something flat and sideways scrape it off. Not using your fingernails as that can dig into the skin and damage it. If you have leftover sticky residue, you use the abrasive side of a new dish sponge and sideways stroke scrub it off. It just transfers inside the sponge.

Hello,

Everyone is different. For peace of mind, you should seek medical help, at least for evaluation, with a doctor, not a nurse.

Mucocutaneous separation (MCS) is a serious complication that occurs when the suture line between the skin and the mucosa of a stoma breaks down.

MCS can be caused by a number of factors, including infection, malnutrition, diabetes, corticosteroids, excessive tension on the stoma, and poor surgical technique.

The risk of developing MCS is higher for patients with an ileostomy than for those with a colostomy.

MCS can lead to infection, even sepsis. It is particularly distressing for inexperienced ostomates, who may be struggling to come to terms with their new stoma.

Better safe than sorry. Consult with a doctor right away.

Ugh. Mucocutaneous separation sounds so much worse. 

Yes the stoma nurse "ostomy specialist" called it stripping, and gave me no advice on what to do with it or for it. I know nothing...I'm so new to this. I only have a pic from 2-3 days ago and what you see in the picture was not painful like it is today. It's much worse today. I thought I was leaking because I was in so much pain. When I changed it, only skin looked fabulous except for it separating from my stoma and burns like hell fire. 

Is there anything I can do to help it?

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This all sounds terrifying. I called the doctor and the nurse called me back and said to call again on Monday if I'm still having trouble. 

They suck! It's the weekend. They are home by noon time.

Your skin around the stoma looks healthy!!!

I do not understand the separation.

I'm not too sure stitches were ever used on me, but then how does the alien spud stay out... secure?

I thought it just heals together.

But I never saw stitches like that.

It does look painful. Sorry you have to go through this so early after post-op.

A loop ileostomy is usually temporary.  What is the reason yours is permanent?  Like Warrior posted:  I haven't seen exposed stitches like yours either.

You might need revision surgery.  Your peristomal skin looks good.  The area where the stoma base meets the skin.. not so good.  Skin should be tight against the stoma, no gap.. or looseness.

If possible, get a second opinion from another Doctor, hopefully a Gastroenterologist.    

My stitches looked like that after my loop ileostomy too…. Same question as the others as to why you would be told a loop ileostomy is permanent? 

My stitches looked the same way with my loop, and I also got the separation with my loop and got the separation with one of my end ileostomies. But the separation does happen with some people; it should heal. Both of mine did. Keep an eye on it, obviously. If it makes you feel better, have your surgeon look at it to give you peace of mind.

Warrior, my loop ileostomy had stitches like that, actually a lot more. Lol, and you're funny; all ostomies get stitched.

G-Day Smnard, your skin around the stoma looks perfect and it looks like you have dissolving stitches still showing. You are only a very short time from your operation, so the side of your stoma is still healing; try and give it some air time to dry out. But ask your surgeon why he/she said your loop stoma was permanent. Regards, IGGIE

The loop ileostomy was done as an "elective" surgery. I have slow motility in both intestines. I also have severe dyssynergic defecation, Pudendal Neuralgia, levator ani and pfd. I struggled with SIBO (small intestinal bacteria overgrowth) for years because nothing ever works to clear it. 

I was only having a bm once a month and it only happened if I took an obscene amount of laxatives to cause the "purge". Then I was struggling with fecal incontinence while I was sleeping. I couldn't eat meals. I haven't had veggies or meat in 3 years. Had to eat low protein and low fiber. My diet was nothing but carbs and it was better if it was processed foods. 

So we did the ileostomy to allow my body to expel waste. It will be permanent eventually. We discussed the separate surgery we will do down the road. For now we did a loop to see if this would even help! Which it is. It's been amazing. Even though I'm going through the issues with the mucocutaneous separation and soreness....it's been worth it all. I have my appetite back. I have been able to eat some meats. I eat 3x a day now. I'm not in horrible pain, no stomach aches. This has been the best decision. So for now it's a loop. Later on it will be end. 

The loop ileostomy was done as an "elective" surgery. I have slow motility in both intestines. I also have severe dyssynergic defecation, Pudendal Neuralgia, levator ani and pfd. I struggled with SIBO (small intestinal bacteria overgrowth) for years because nothing ever works to clear it. 

I was only having a bm once a month and it only happened if I took an obscene amount of laxatives to cause the "purge". Then I was struggling with fecal incontinence while I was sleeping. I couldn't eat meals. I haven't had veggies or meat in 3 years. Had to eat low protein and low fiber. My diet was nothing but carbs and it was better if it was processed foods. 

So we did the ileostomy to allow my body to expel waste. It will be permanent eventually. We discussed the separate surgery we will do down the road. For now we did a loop to see if this would even help! Which it is. It's been amazing. Even though I'm going through the issues with the mucocutaneous separation and soreness....it's been worth it all. I have my appetite back. I have been able to eat some meats. I eat 3x a day now. I'm not in horrible pain, no stomach aches. This has been the best decision. So for now it's a loop. Later on it will be end. 

The loop ileostomy was done as an "elective" surgery. I have slow motility in both intestines. I also have severe dyssynergic defecation, Pudendal Neuralgia, levator ani and pfd. I struggled with SIBO (small intestinal bacteria overgrowth) for years because nothing ever works to clear it. 

I was only having a bm once a month and it only happened if I took an obscene amount of laxatives to cause the "purge". Then I was struggling with fecal incontinence while I was sleeping. I couldn't eat meals. I haven't had veggies or meat in 3 years. Had to eat low protein and low fiber. My diet was nothing but carbs and it was better if it was processed foods. 

So we did the ileostomy to allow my body to expel waste. It will be permanent eventually. We discussed the separate surgery we will do down the road. For now we did a loop to see if this would even help! Which it is. It's been amazing. Even though I'm going through the issues with the mucocutaneous separation and soreness....it's been worth it all. I have my appetite back. I have been able to eat some meats. I eat 3x a day now. I'm not in horrible pain, no stomach aches. This has been the best decision. So for now it's a loop. Later on it will be end. 

I'm sorry you are going through this. I developed an MCS on my colonostomy about 10 days after surgery. I was still in the hospital so my ostomy nurse helped me treat it. She used stoma powder and "crusting". It took a while to heal. Maybe another 10 days? My memory is fuzzy. She also sent a picture to the surgeon but he didn’t do anything. 

I have an ileostomy and on occasion, when it is irritated, I put stoma powder around the edge, then apply a barrier wipe over the powder. This brings almost immediate relief - I am guessing it is okay to do this, but you might want to ask first since yours is so new…jb

Smnard,

Thanks for the explanation. We ask more questions up front to try to get a better understanding of your unique needs. Several of us asked about a loop ileostomy being permanent because by their nature they aren't intended to be. So it makes sense that your medical team wanted to see if this helped you before a long-term commitment.
Did they do a sitz mark test before your surgery?

There are a few women currently active on this site who have had colectomies for similar reasons. Has the dysmotility affected any of your other digestive organs?

This all started with severe constipation that got worse over time, not responding to meds. We did all the tests: swallow studies, gastric emptying, colonoscopy, and endoscopy. We did an anorectal manometry first. I was unable to expel the "balloon." It showed I have decreased sensitivity, so even if I could have a normal BM, I wouldn't even know it as I can't feel it. We did a smart pill test—a ginormous robot pill. It showed that I'm behind by days with digestion. Then we followed with a defecography, which confirmed the results of the manometry. Then we did a sitz marker, which showed that things like to get stuck at both flexures and across my whole transverse colon. We did another manometry that was a different type, which confirmed all other tests.

Later on, I developed gastroparesis. My stomach also liked to fill with air 3x its normal size. I have a vagal nerve injury. Add it to my list. I feel like I'm broken from my throat to my anus.

G-Day Smnard, I am so happy that you're getting some relief. Keep getting better, stay with us, and keep us up to date. Regards, IGGIE

Digestive disorders. Ugh.

At least your tests are showing valid results. 👍 A good start to diagnosis.

Some of us, those tests and other tests show nothing.

A head-scratcher situation indeed.

Sounds like they've got you covered.

You will be right as rain. Keep your chin up. You've got youth in your favor too.

Now... about those glasses? 🤣😂🤦‍♂️

I love these glasses! I have so many pairs, get them all online where prescriptions are cheap! 

I know. It was an ice breaker. Glad you haven't lost your sense of humor. 👍

Not medical advice, but I have pain around my stoma (it's jagged-edged around my stoma). I'm definitely checking out what you put in your original post.

Having said that, screw pain! I went on Amazon and bought Lidocaine 5% (it's a cream) and costs from $20 USD and up. They have it for rectal use for hemorrhoids, but what it works great for is topical pain relief! That's right, I spread that stuff right around on my raw skin and get some relief (it works for 20-30 minutes). You have to be careful, because it doesn't treat whatever the problem is, it simply masks the pain. (Sometimes that's enough).

Anyways, just my two cents…

Have to be careful with Lidocaine - it can thin the skin.  A few uses is fine but check with a doc before using long term.