Seeking advice on managing soft stool and seepage with colostomy

I had an emergency colostomy on June 5th and praise God that I am alive! I am new to this group in hopes that I can meet some people and learn some tricks of the trade!

My question or problem is this:

I am getting a really good seal and using Convatec 2 piece and an Elkin seal. I get about 5-6 days on the appliance. Lately, I notice that my stool becomes a little softer (pancake a lot here) and when it does, it seeps to the right only and burns or causes itching. The only thing I have found to work is to take 1-2 tablets of anti-diarrhea each day so that my stool is harder and firmer. Does anyone else find they have to do this? I drink lots of water and I eat real well. I never have diarrhea or stomach pains.

Looking for some help or thoughts. I have tried changing the appliance when it happens, but it occurs almost every time I pancake. I have tried oil and all, and nothing appears to work. Very frustrating. I never empty the bag from the bottom, I ALWAYS open the 2 piece and remove it from the stoma area. I AM FINE WITH THIS!

Thanks for any ideas or suggestions!

Lee Ann (Mesa, Arizona)

What was the reason for your operation? If the remaining colon is healthy, I would suggest you try irrigation. The burning/itching is caused by the skin breaking down where stool seeps under the barrier. Do you use a skin prep? This adds a slight protective coating over the skin, but only lasts a few days.

Hope this helps, keep us posted of your progress.

Hi Lee Ann, I can relate to the itching and burning. It is miserable. Torbot liquid bonding cement is the only product that seems to work for me. It provides a barrier between your skin and the appliance. I ordered it from Edgepark, and you can get it on Amazon. As for the pancaking, you may need to cut the dose of anti-diarrhea in half. I am a little curious about who taught you to empty your bag? I use a lock and roll bag that has a Velcro seal. It is very easy to empty. I hope this helps and good luck.

I have diverticulitis and I perforated the colon, which resulted in emergency surgery. They took a little more than a foot of colon out. I have heard of irrigation but haven't tried it nor do I know how to. I have an appointment with a gastroenterologist tomorrow, so I was planning to ask about it. I do use a skin prep called Cavilon :)

Hi Heidi! When I take 2 anti-diarrhea a day, I don't pancake, but I feel I shouldn't have to do that?! I have no stomach issues with anything I eat, maybe I just need to add more fiber or rice daily so the stool is firmer rather than pancake.

No one taught me how to empty the bag, I just started to do it this way since day one. Nothing falls to the bottom, so what are my options? If it's not pancaked, then it's little balls that just stay there in the bag. I roll the bottom portion up so that it doesn't dangle down if that makes sense?

What is a lock and roll bag?

Lee Ann

Staying Hydrated with an Ostomy with LeeAnne Hayden | Hollister

Hi Lee Ann,

I have an ileostomy so my output is always soft or even watery. Pancaking can be a real challenge when my output thickens. I find the only thing that helps is to manually press under the appliance seal while pushing/rolling on the top of the bag to roll the output down lower into the pouch. I do this several times a day, or whenever I can feel pressure building in the upper pouch.

I'm also wondering if you could thicken your output with foods? Rice or rice pudding works wonders for me.

Good luck. I hope this helps.

r/Mark

Hi Lea Ann, I use Hollister bags http://www.hollister.com/us/files/care_tips/tips_, but you can get bags with Velcro closures from Convatec and Coloplast.

I use the same type, Heidi. Mine are just from Convatec :)

Thanks Mark - I may try thickening foods but I always feel like it's such heavy starch. Worth a try anyways. I could do rice and see if that helps daily.

Hi Lee Ann.

I also use the two-piece system. And like you, I always take it apart to clean. Something that might help with the pancaking.

I use the small white stickers that come with the pouches. I cover the vent at the top and I also open the bottom of the pouch and pull it to allow just a little air in. Otherwise, the vacuum created, which is to give you a flat profile, is too strong and everything just pancakes around my base. I do have to burp my bag a couple of times a day, but I find that no big deal. I also use the Coloplast paste as I find it conforms better for me. Hope this helps.

Rosiesmom.

Thanks Rosiesmom - I also use the little decal over the vent, but still it pancakes. So frustrating! Guess it's just trial and error.

Lee Ann

I use the Coloplast paste between the skin and skin barrier every change. It eliminated the irritation.

Hi and welcome to the site. I have an ileostomy and also pancake at times. Usually it is when I eat foods that are thickening such as potatoes, rice, apple sauce, pasta... a low residue diet. I would avoid taking Imodium because it sounds like that is the problem. How many times do you need to empty your pouch...2, 3, 4 times per day? I use Coloplast drainable and have for over two years. It has a Velcro closure. I also, (when able) rinse my pouch with cool water because contents do get stuck inside and I like the pouch as clean/empty as possible. I also change the pouch every day in the morning. I do this because contents seem to collect around the stoma where the pouch snaps on and I detect a slight odor. I don't know if this is a fact, but I believe the contents sitting on the wafer begin to erode it every so slowly. I try and keep the wafer as clean as possible. In addition, my filter clogs by the end of the day no matter what I do. I like the filter pouches because they seem to present a lower profile. Also, Coloplast does not make a pouch without a filter in my size...can't figure that one out. Take care...and keep posting your questions. We will try and help. LH

Hi, LH. I could be wrong, but it seemed that Lee Ann expressed pancaking when her output softens. I think she mentioned that when it comes out as round balls (think larger rabbit pellets...lol), it would not pancake. Being an ileo, I had to try to picture this because for us ileos, we pancake when output is thicker. Lee Ann's output may actually thicken beyond the point of pancaking. I had never given this any thought, so I was a bit intrigued. Other than dehydration, perhaps we're fortunate to have ileos? I rarely have problems with pancaking, unless I go crazy with the low-residual foods you mentioned. Take care!

Thanks Mark for the response. You know, I never really thought about it either. Having a colostomy, especially one low, a person could experience very firm pancaking. You are correct, I have it when I eat a low residue diet. Also, it happens sometimes when I am sitting down for a while and everything stays in one place. At that point, my filter usually begins to clog. I often chuckle when I post such specific ileo questions or comments because the things we all talk about, I usually do not discuss with anyone outside our group with the exception of my husband. Others do not understand the way we understand. Thank you for the post. Have a nice week. LH

LH,

I was thinking the same thing. Other than ostomates, who could discuss the granular details of the most unspeakable of human functions, as nonchalant as people might discuss walking the dog, and with complete strangers I might add? lol There's a great deal of humility in that, which could be a part of what makes ostomates an especially wonderful and sincere group of people. Have a great day, LH!

r/Mark

Hi Mark, thanks for the reply. Yes, the particulars we discuss in conversation are great... funny I work in the healthcare field and talking about health never really bothered me. I am happy that people are open and share because that is how I learn. Anyway, I noticed from your profile that you live in MD. Question.... will you be attending the regional Wash DC/Dulles conference in the Spring? I believe the date is toward the end of April. I missed the one two years ago but am hoping to attend this one. The conference is two or three days and should be a great time. I just returned from the National Conference in St. Louis. What a blast! It was so helpful, educational and entertaining. And, St. Louis was one of my cities to visit on my bucket list.... it is now checked off... LOL. On to the next adventure. Thank you again Mark for your posting and replies. Have a great afternoon, the weather is beautiful here in PA. LH

Thanks for making me aware of the DC/Dulles regional conference this spring, LH. It sounds like fun and a good way to learn from others. I will certainly try to be there!

I had a colostomy for 5 years and used a 1-piece appliance, hardly ever had pancaking issues. I had it revised to an ileostomy this summer and started to have problems. I switched to a 2-piece appliance and started using more stomadhesive powder, paste, and an Eakin seal. These helped a great deal. I went to the UOAA conference in St. Louis in September and learned quite a bit, including this little nugget of wisdom....when output is thin/watery, it helps to leave a little air in the pouch. I'd been so busy trying to keep it as low-profile as possible, but it works! I'd been using the Mio pouch with a filter, so I just put the little sticker over the filter to block it (they don't have a drainable Mio without a filter). Also, I haven't tried it but I've heard that marshmallows will thicken output.

I hope you find what works for you!

Hi Gutsy Girl, thanks for the tip...someone suggested the air in the pouch at the St. Louis Conference and I completely forgot about it. Thanks for the reminder. I think I may have met you at the conference actually. My husband and I attended and had a good time.

What I dislike the most about the pouch is that my filter always clogs and the pouch shape. With the pouch, there seems to be an extra few inches at the top where the filter is located...the one that clogs right away..... These companies know what they are doing to keep sales figures high, don't they? Anyway, my pouch measures around 11 1/2 inches but 2 inches or so is the top portion above the stoma where the filter sits. If everything could shift downward a bit, I believe the look of the appliance would be better and more functional. Who wants stool gathered at the top of the pouch causing odor? It is simply wasted space. Why don't companies consult the experts... us. Do they? I often wonder. Take care. LH

LH - Reach out to them with feedback. I have, and found that they were very receptive. I'm not expecting change to happen quickly, but they don't know unless we tell them! Now that I learned that the "leave a little air" trick works, I actually want an option without a filter. We can completely customize sneakers from scratch, I wish we could do the same with pouches. :)

Can someone please tell me what the 1 3/4 and the 2 inch actually stand for? I thought it was the size of the hole that's between the wafer and bag but I used a 1 3/4 wafer and a 2 1/4 bag the other day and it worked fine. I guess I just don't understand the difference......Thanks

Hi Pete, no worries....I was talking about the actual pouch length and the top portion of the bag that contains the small filter. I bend it over because it sticks up too high and bending it helps stop the clogging - my pouch filter always clogs after one day and stops working. I do not use a filterless pouch, one, because Coloplast does not make one in my wafer size and two, I do not want ballooning while I am on the road with work. And, I do not think I would ever be able to burp the bag successfully without causing a mess:(

You are correct though...the wafer also has sizes printed such as 1", 1 1/4", 2 " etc for the stoma size. Sorry for the confusion. Have a nice day. LH

There's another option called the Osto-EZ-Vent for those who don't want to burp the bag or depend on an undependable filter:

http://www.kemonline.com/content/home/

I used Hollister two-piece devices (I've had a takedown just a month ago). Hollister's customer support is really fine. And I liked their products much more than the Convatec I tried in the beginning.

What my insurance provided for was the barriers, pouches, lubricant/deodorant, powder if needed for chafed areas (hardly ever used), and spray adhesive. The ostomy nurse who came to teach me how to use all that stuff advised spraying the adhesive on my skin and then applying the barrier. Pah! Bad advice. Hollister advised spraying the adhesive on the inner seal area of the barrier, and then applying it to the skin/stoma area, and peeling off the paper for the secondary material beyond the inner seal. When I started doing that, the leaks under the inner seal stopped.

They recommended changing the barrier every 4 days, and changing the bag every 2 days. I did that religiously, and had no problems with blocked filters. The only time I noticed any odors was when I ate onions -- they worked really fast! Otherwise, I was stink-free. Every time I emptied the bag, I'd add some deodorant-lubricant, and that helped a lot, especially in keeping things moving downward from the stoma toward the bottom of the bag.

Hope this info is of some use.

Cabbage

Hi, living in Las Vegas is good. Looking to find friends to communicate with on email. I'm 82, live in Sun City and am very active. I'm out all the time. There's so much to do here, cards, exercise, swim, etc. I am a widow and live alone and am just looking for friends to talk to. I have lots of hobbies to talk about. Had my colostomy a year ago and I'm doing okay but occasionally have questions.

Hi Cabbage,

Welcome to the forum. It's wonderful that you have so many hobbies. Sounds like you know how to enjoy your time.

Laweiler1 I would not take the anti-diarrhea tablets every day. You need more protein in your diet, peanut butter, sardines (if you like them), or I

eat peanuts at night, and that helps to thicken my output when needed. Good luck.