HELP. My stoma opening is pointed down

[Lmcmahon]

My ostomy opening is pointed down and always having trouble with stool pancaking and getting underneath wafer. I asked the surgeon and she said it was so that stool will drop into the bag. Well my output is thick so it just sits on the ring. I have had twins and lost weight so I have extra skin so makes for a difficult fit. I have tried convex and it helps a bit but it’s almost like I need something to push underneath the stoma. My stoma nurse said I have difficult stoma and wanted me to wear a band but it seems like that just smashes the stool. Since mine is always thicker output and I take 3 stool softeners every night. I don’t know what to do. I have only had my colostomy for about 6 weeks. Thanks in advance!

[nickolas]

I wear a Nu Hope binder, it had a hole where my bag slips through.

Do you use one or two piece system? I'm wondering if your stoma is getting bigger just prior to output, thus maybe getting big enough to get under the wafer. Maybe make the wafer hole a bit bigger. Just a guess on my part.

Is your stoma level with your skin? There are products out there that address that issue. Mine sticks out a bit so I don't have that problem. If your stoma is level with your skin, others will come along and help you with that issue.

Maybe think about trying a new type of wafer and bag. I used Convatec when I left the hospital back in 2004, developed an allergic reaction to it 2 yrs later. Have been using Hollister for the past 12+ years but they discontinued my favorite bag last year. Thanks to some wonderful people here (Button), I was taught about Coloplast SenSura Mio 2 piece system. I love it. Super hold. You might want to check it outl I've come to understand some wafers stick stronger than others. And this SenSura Mio has a nice strong hold.

I also use Hollister Adapt rings. Maybe look into Smith & Nephew No Sting Skin Prep spray. A protective barrier next to your skin.

I hope this helps, break down around stoma is not good.

Good luck,

Nickolas

[Douglas]

I had same issue when they did my 2nd surgery 1st surgery it was done well flow went into bag good. 2nd one same as you stoma pointed down I used hollister 2 piece and I used hollister wax rings to build up the top so it would flow I would like to say it worked sometimes. For skin breakdown I cleaned with facecloth good used hollister wipes to get glue off and used hollister glue wipes to make stick to my skin try it might work I feel for you I could never get used to my stoma. I’ve been recently connected thought life would be better it isn’t so keep your head up I’ve been there I know it’s hard. A lot of people say life goes on it does but sorry having something stick out of your stomach is hard to get used to . Hope it gets better for you. ( I feel for you.)

[sassie]

So sorry and i was wondering if you have tryed using a stoma belt that hooks in the rings, it will pull the wafer tighter and make the stoma stick out better, this all takes getting used to for sure , tomorrow mine will be 1 year old and i'm still adjusting but sure is better then at first. getting your head wrapped around this takes time, time is your friend and i am sure it will get better, lots of help on here and another may have a way better reply then mine, that is just what makes mine stick out more as my stoma is not very big...

God Bless, sassie

[Lmcmahon]

Thank you for responding to my post. My stoma does stick out just with having extra skin and crease it makes for a heck of a time getting the darn thing to work like it is supposed to. I wear the two piece. In the process of getting a stronger wafer with more convexity. I am red around my stoma and I do the adapt powder and barrier wipes and going to try getting that Nu hope binder.
Do you have to have those custom made? Thanks again. This has been so difficult to go through. Thanks for the tips.

I wear a Nu Hope binder, it had a hole where my bag slips through.

Do you use one or two piece system? I'm wondering if your stoma is getting bigger just prior to output, thus maybe getting big enough to get under the wafer. Maybe make the wafer hole a bit bigger. Just a guess on my part.

Is your stoma level with your skin? There are products out there that address that issue. Mine sticks out a bit so I don't have that problem. If your stoma is level with your skin, others feel a time will come along and help you with that issue.

Maybe think about trying a new type of wafer and bag. I used Convatec when I left the hospital back in 2004, developed an allergic reaction to it 2 yrs later. Have been using Hollister for the past 12+ years but they discontinued my favorite bag last year. Thanks to some wonderful people here (Button), I was taught about Coloplast SenSura Mio 2 piece system. I love it. Super hold. You might want to check it outl I've come to understand some wafers stick stronger than others. And this SenSura Mio has a nice strong hold.

I also use Hollister Adapt rings. Maybe look into Smith & Nephew No Sting Skin Prep spray. A protective barrier next to your skin.

I hope this helps, break down around stoma is not good.

Good luck,

Nickolas

[ot dave]

You may want to look into irrigation of your colostomy. Irrigation involves water being introduced into the stoma, which stimulates peristalsis (bowel movement). The peristalsis then helps to evacuate the waste in your colon. I irrigate daily, in the morning. Unless I eat something that stimulates a bowel movement (for me, it's greasy pizza, almonds, and certain fish oils like salmon), I am output free until the next day's irrigation session. Go on over and check out the irrigation forum. There are some "sticky notes" at the top that have a lot of helpful information. Plus, there are a lot of "gators" there with a ton of experience to help you if you choose to try it. For me, it was a game changer. It really gave me back a lot of control, and pancaking has never been an issue since I started irrigating.
Hope that helps.

David

[Button]

Lmcmahon:
It can often be the case that you will need to call diffeeenr ostomy manufacturers (Hollister, Coloplast, ConvaTech, Marlen, CyMed) and discuss your stoma and abdominal topography with a customer representative who will then send you a variety of wafers and pouches to try.

What you are given as a start-up pouching system in the hospital may not be what is your better long-term fit. Procuring samples and trying different options is a typical rights of passage with a new ostomy.

Sassie offers sound advice in suggesting use of an ostomy belt. An ostomy belt is a 1/2” to 1” wide stretchy elastic band that attaches to elastic clips on both side of an ostomy pouch. It holds the pouch close to the abdomen thereby limiting movement that can disrupt the seal.

A word of thought: A rigid two-piece ostomy system with deep convexity can be counter-productive for some people with a flush or recessed stoma. A rigid plastic convex bowl can lead to more leaks (not less) due to its inherent stiffness and lack of pliability in conforming to skin surface dips and creases and folds of adipose tissue.

Other options?

A one-piece, low profile ostomy/wafer combination with an elastic polymer wafer such as the Coloplast Mio Line.

OR

A two-piece ostomy/wafer system that employees an adhesive coupling system. Adhesive coupling systems provide for a flexible articulation and less chance of leaks due to the body moving against a rigid/stiff acrylic convex wafer or acrylic Tupperware-locking system.

A wafer that has flexibility in moving with body and that has the ability to contour intimately with skin surface irregularities is a good option for a flush, recessed, off-set stoma. Pliability and flexibility in the wafer and adhesive coupling (if a two-piece system) are desired attributes to look for.

Coloplast Mio has a new product called the “Flex Convex.” It is an ultra-flexible convex wafer (not rigid). It is paired with a pouch via an adhesive coupling. The Mio Flex Convex is new and may be limited in availability. Call Coloplast’s 1-800 number if you are interested.

CyMed is another favorite of mine. It is not a well-known brand. CyMed is ideal for difficult to pouch stomas. The wafer is similar to the clear dressing placed over IV sites, TegaDerm. CyMed calls their wafer MicroSkin. And it is unlike any other wafer. The MicroSkin has a unique ability to follow intimate contours of the skin, every skin dip and crease and fold. It is this high degree of pliable skin contact that gives the CyMed wafer unmatched adhesion.

Applying the CyMed wafer does require a learning process. The wafer is so thin that it tends to fold back on itself and stick, rendering it useless. Practice leads to proficiency. There are instructional videos and tutorials on You-Tube.

CyMed would be a good option for you to consider and to fall for samples.

I am a very petite person, more child-sized than adult-sized. I love CyMed because of its ultra-thin and pliable wafer. It is like wearing a wafer made of Glad or Saran clear kitchen food wrap. I barely notice that I am wearing an ostomy appliance.

This forum is a nice collection of people with a treasure trove of ideas and helpful support. People helping people.
Karen

[Button]

There are other options beside NuHope for ostomy support compression bands and hernia support wear.

I frequently post about ComFizz. It is a small, family owned company in England that is dedicated to undergarments specific to ostomies.

Light compression belly bands to more comprehensive hernia support bands. Camisoles and tee-shirts made of Lycra that have a longer torso length. Briefs and boy shorts. Stoma guards (removable and interchangeable). ComFizz is a Top Notch line of undergarments. ComFizz has won several awards for innovation and quality from the British NIH health system.

I have been wearing ComFizz garments for at least 6 years and first learned about ComFizz from a member on this forum.

Ordering is easy on-line. There is a toll free telephone number and on-line chat option to help with product information and sizing decisions.

There are no irritating seams to ComFizz garments. No bothersome tags. Free of chemicals in creating the fabrics.

www.comfizz.com

[sassie]

also ebay has the wide belt with the hole in it, i just prefered the stoma belt because its narrow and i do not notice it, like button i am not very big so this worked best for me and allowed the stoma better access , i also irrigate most the time anymore but use milk of mag when its not convenient to irrigate as my stoma is still potty training i guess...."supposed to be funny"

best of luck, sassie

[nickolas]

. . . and going to try getting that Nu hope binder.
Do you have to have those custom made? Thanks again. This has been so difficult to go through. Thanks for the tips.

I wear a Nu Hope binder, it had a hole where my bag slips through.

Do you use one or two piece system? I'm wondering if your stoma is getting bigger just prior to output, thus maybe getting big enough to get under the wafer. Maybe make the wafer hole a bit bigger. Just a guess on my part.

Is your stoma level with your skin? There are products out there that address that issue. Mine sticks out a bit so I don't have that problem. If your stoma is level with your skin, others feel a time will come along and help you with that issue.

Maybe think about trying a new type of wafer and bag. I used Convatec when I left the hospital back in 2004, developed an allergic reaction to it 2 yrs later. Have been using Hollister for the past 12+ years but they discontinued my favorite bag last year. Thanks to some wonderful people here (Button), I was taught about Coloplast SenSura Mio 2 piece system. I love it. Super hold. You might want to check it outl I've come to understand some wafers stick stronger than others. And this SenSura Mio has a nice strong hold.

I also use Hollister Adapt rings. Maybe look into Smith & Nephew No Sting Skin Prep spray. A protective barrier next to your skin.

I hope this helps, break down around stoma is not good.

Good luck,

Nickolas

Just saw this, in case you do not have answers yet. Try Hollister Adapt ring # 7803 vs the stoma paste and powder.

Go to the NuHope web site, they can show you how to measure for a belt. They make the belts to fit a number of stoma/ wafer size, if you have a hernia or not, etc. An Ostomy nurse can also measure you for a belt.

Good luck,

Nickolas

[Button]

Lmc:
It is worth clarifying the two options that have been brought up.

1. An ostomy belt.
An ostomy belt is a 1/2” wide strand of elastic that connects to both sides of an ostomy wafer via. small plastic clips. An ostomy belt serves to stabilize and hold the wafer and pouch close/snug to the abdomen and prevent leaks due to excessive movement of the wafer and subsequent weakening of the adhesive seal.

You can order an ostomy belt from your regular ostomy supplier. Make sure that your particular wafer has the plastic clips designated for an ostomy belt.

Most people who use an ostomy belt find it comfortable and ever-so-helpful in reducing wafer leaks. Ostomy belts are helpful for people with abdomens that have dips and creases and tissue folds.

2. Hernia support binder or compression tube binder
A hernia support binder comes known with other monikers. Belly binder, compression tube band, Pregnancy belly band, limbosacral support band.

Nu-Hope is a well-known provider of hernia support bands. Nu-Hope provides custom-ordered bands that have a cut-out for the ostomy pouch to pass through. You order though Nu-Hope giving them your waist/hip measurements and location of your stoma (left or right). Fabric options include a cool mesh or elastic-Lycra binding.

A hernia/belly binder is wider in width than an ostomy belt. A hernia binder is usually 8-10” inches wide and wraps around your mid-section and closes with Velcrow. A hernia/belly binder gives an inward compression that counters the natural gravity and outward pressure exerted by the intestines/organs. Ever-so-helpful in minimizing risk of an incisional or paristomal hernia.

Similar compression benefits can be found by wearing full-briefs/underwear made of Lycra or spandex.

I frequently mention a company in England that makes compression undergarments designed specifically for ostomies. Com fizz. ComFizz makes a range of undergarments (camisole tips, crew neck t shirts, belly bands, hernia support bands, stoma guards, briefs and boy shorts) for both men and women.
I have worn their garments for several years and highly recommend them.

www.comfizz.com

I hope you are finding a resolution to the wafer leaks that you have been experiencing. It can be a process of trying a little of this and a little of that, as we each have different skin characteristics and different abdominal terrain, dips and creases.

One last thought . . . Avoid using “baby wipes” or other premoisented disposable cleaning cloths. Premoistened cleaning cloths often contain aloe and moisturizes that will adversely interferes with a wafer’s adhesion and lead to frustrating leaks.

Likewise, avoid using a bath soap that contains oils and moisturizers. You want to use a bath soap that rinses completely without residue to the skin. Soap choices: Cetaphal, Ivory, Neutrogena, glycerin bar soap.

Safe ‘N Simple makes a premoistened wipe specifically designed for use with an ostomy. They are available through any ostomy supplier or Amazon. Retail for about $5.50 for a package of 45 wipes.
Karen

[steiconi]

Here's a liknk to Parthenon's selection of belts, to give you visuals of the different kinds:
https://parthenoninc.com/search.php?search_query=belt

if the skin is red around your stoma, you might want to have it evaluated by a stoma nurse or doctor, to see if there is a yeast infection. I used to email photos to my doctor.

I second the vote for irrigation. My stoma also points down, and I have hills and valleys and pasty, pancaking output, but none of that is very important because I have control over the timing.

[Button]

Steiconi:
Thank You, Steiconi !

The link that you provided to the photographs and display of different ostomy belts and compression belly bands on Parthenon will be immensely helpful to people looking through this thread.
A photograph or picture is far more informative.
Karen

[Dog lover 23320]

Vegan Ostomy has videos on output pancaking
I have a Loop ileostomy and mine faces down also.
I’m using Coloplast one piece and Imhas brought
A lot of relief

[Dog lover 23320]

Vegan ostomy is on You Tube- lot’s of helpful
Videos