Loop Colostomy Stoma Too Big

[dnvrdave]

I got a (sigmoid) loop colostomy 7 years ago, with a 2.25 inch flange (Hollister, 2-piece closed pouch). About 3 years ago, I had to switch to 2.75 inch. In the last month, the stoma has started to get too big for my 2.75 inch cut-to-fit wafer, cutting to the recommended maximum edge. I have had bleeding. I’m going to start cutting beyond the max edge, but I am worried that the stoma will keep growing.

This seems abnormal since I don’t see flange sizes larger than 2.75 inches, except for 4-inch, but only with drainable pouches. Is stoma growth more common with loop colostomies?

I have good regular stool output, changing the bag once or twice a day. I am C5 quadriplegic (35 years post injury) and have a large pot belly, which is normal due to lack of muscle tone. But for the past year or two, I’ve also had liquid sloshing in my belly (intestines?) for longer than expected, as though water does not pass through me at a normal rate. I am more bloated than I should be. My PCP simply says I need to move around more and massage my belly to speed digestion, but it doesn't help.

I guess I will try to talk with a WOCN at Hollister. Do you have any other suggestions? My last colonoscopy was 7 years ago. I am 58 years old.

[dnvrdave]

One person said they had stoma trimming surgery twice, and that it is simple and fairly common. I can't find any info on it. Have you heard of it?

[Snowgoose]

When I had my loop colostomy I was underweight due to illness. After the colostomy, I gained my weight back and my stoma prolapsed and got large. My surgeon said it was due to the weight gain. His test was using his fingers he could push the stoma back into my stomach, which I can do also. In fact, it will sometimes retract by itself when I lay flat on my back. It has gotten larger since that surgeon visit.

To deal with my situation I use the I use Hollister 4" wafers, #14606 & their 14" bag, #18016. I have tried them all and the Hollister is the only product that works, and it works very well. Due to having a Ureterosignoidostomy, my colostomy passes both my urine and my feces, thus the output is fluid with soft solid waste. You would have to check with Hollister for a similar bag, if necessary, with a wider outlet,.

I too would be interested in "stoma Trimming" as it would make life more pleasant. I would still use the same system but the large stoma bulge would no longer be unsightly under my clothing. I've never heard of stoma trimming and will have to do some research.

[Snowgoose]

I found lots of data regarding stoma trimming for single stem stomas but nothing for loop stomas.
As I think about the trimming process I realize a loop stoma cannot mere;y be snipped like a single stem stoma.
It seems to me that a prolapsed loop stoma would need to be closed and redone elsewhere in the loop.
That does not seem to be a simple process and may be unacceptable to the patient. For example, I like my stoma location and cannot think where else I would want it or tolerate it.
Hopefully, someone with the knowledge will chime in.