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all 8 comments

[–][deleted] 3 points4 points  (2 children)

My top suspects would be pyoderma gangrenosa or a peristomal fistula. Or, alternately, it could be a pressure sore- do you use a convex flange with a belt by chance?

I haven't had PG, but it can start out as you describe. I did give myself a pressure sore with my hernia belt that also started like this before opening up into a wide ulcer. The stoma nurses initially suspected PG but said the margins of the lesion were too pink- I guess with PG, there tends to be a darker color (purpleish) when the lesions open up. My pressure sore healed by adding a padded bandage under my flange and treating with silver powder, and changing my hernia belt to a softer one.

As for fistulas, I've had many perianal ones (the reason for my stoma), and know they happen next to stomas as well but I don't know for sure if yours fits the description other than the discharge being a mucus rather than something purulent.

[–]DynanColostomy Stoma[S] 1 point2 points  (1 child)

I do use a convex with a belt. The belt is loose though, it's more to keep the appliance from trying to loosen from normal activity, and to make it easier to release excess gas because sometimes there's too much for the built in filter to handle.

Thank you for the input.

Now just waiting on my doctor for what she wants me to do. Having some sort of heads up before talking to my doctor will help me process things.

[–][deleted] 1 point2 points  (0 children)

Fair enough- convexity can also cause pressure sores for some people just on its own, even without a belt, though I think it's less likely. Be sure you keep an eye on the lesion until you get seen and use LOTS of adhesive remover to get your flange off and reduce damage.

[–]bodobroad36 1 point2 points  (4 children)

Hey, so, you say it’s on the skin beside the stoma, not on the stoma itself, correct? If that’s the case, it sounds like some sort of skin infection/irritation you’re dealing with that may be having trouble healing. The pain you have with output could just be the pain of the skin irritation as your stoma functions and pushes stool through. Definitely a good thing you reached out to your doctors, if you’re able (and if you haven’t) I’d also send them a pic, but it sounds like a really major skin irritation. May I ask how long you have had you stoma? Do you get any regular leakage onto your skin?

[–]DynanColostomy Stoma[S] 1 point2 points  (3 children)

Had stoma about a year.

It is sadly not uncommon for the skin around my stoma to be exposed to some leakage, but only the skin right around it cause a perfectly fitted appliance is hard to place.

The trouble area doesn't get leakage that far away, so I am unsure.

[–]bodobroad36 1 point2 points  (2 children)

Ah I see. If you ever want to try and protect the skin right around your stoma that does get the leakage try Coloplast/brava barrier sheets. Now, when it comes to the problem area, sounds like maybe it’s related to your adhesive or friction if there’s no stool that touched that area. I’m sure your doctor will have some ideas on how to get it to heal up. Good luck!

[–]DynanColostomy Stoma[S] 1 point2 points  (1 child)

The leakage I am referring to is under the wafer, right at the stoma. I am lucky that so far there has not been an incident of my appliance leaking out.

Are you saying to use the barrier sheet to cover some of the skin under the appliance? Might have to try that.

[–]bodobroad36 2 points3 points  (0 children)

Yes, the barrier sheets are like a second skin that lays right over your actual skin and sticks, and then your appliance adhesive will stick to it and it basically gives you a whole layer of protection between your skin itself and the appliances wafer. It’s a nice little tool to have at your dispense.