flat stoma question

Puckerless Stoma?

Some surgeons have little, if any experience with the formation of a stoma, much less with the importance of providing the "spout" that's required to utilize an appliance properly.

The "spout" should be 1/2 to 3/4 inch long, long enough to reach inside the "appliance" for the waste to discharge easily.

So what to do with a flat? The remedy is to use convex appliances! The wafer of a two-piece appliance, or a one-piece appliance can be purchased with a convex configuration.

The "convex" part is what will press against the peristomal area (the area around the stoma), pushing that area into the body and consequently raising the stoma above the surface of the body.

They make various depths of convextivity to suit the needs. Too little of convextivity may not change much, but too much convextivity can put too much pressure on the stoma or intestine at the critical point of exit. The intestine take a 90 degree turn to exit the body and is not in it's normal biological position. In fact, many intestinal obstructions are located at the stoma! One piece of Broccoli that won't comply with that bend, and it's off to the ER... (again?)

Knowing that trivial bit of information can save one from some painful memories. Chew well.

If an Ostomate has a "flat" or recessed stoma, a convex appliance should be used. It will take some time, experimentation, and effort, but once a design is found that works well, the joy of having conquered a problem that drives most Ostomates nUtZ will be the payoff.

Better than the Lottery!

Best wishes for best of health.

John

That's interesting John. As usual I'm taken aback by your wealth of knowledge. I've learned so much from you! My stoma is fairly flat, nothing like the pictures I saw of them before I had the surgery and was upset at what I was going to end up with. It sticks out maybe a quarter of an inch or less. But I have an illeosomy, not a colostomy. I wonder if that makes a difference.

Other than a few blow outs or incidents with the bag or appliance I've had no issues with mine at all. I use the wax wafer to form a custom fit around mine and make sure it's fairly snug. Could that make a difference?

Jan

bluebirdfriend said:

flat stoma issues continue

My friend's stoma used to stick out but it went flat about a month ago & is "hard." .  He had been given a couple of different kinds of company products in the beginnning after surgery & he's been experimenting since then.    He's also spent time on the phone talking with supplier reps, got samples, etc. but ends up changing bags twice a day, sometimes, due to leakage.  I learned today that he tried a convex sample but it apparently didn't push in enough to get the stoma to stick out.  I'll encourage him to use a different depth of a convex product. 

JanJan - I recently read about your PE & cardiac arrests.  Wow!  I'm so glad to hear you recovered so well from that!  Blessings to you!

Bluebird friend

Has your friend visited the surgeon since the stoma went flat and hard?  It may be more of an issue than just trying to get appliances to work.

At the very least, the doctor could refer him to an ostomy nurse who might have better suggestions based on first sight knowledge.

Marie who loves kitties

Not only did my surgeon give me a beautiful stoma, he made it in the shape of a rose.  I'm not kidding!  He made sure I had my belly button returned to its original shape also.  He must have taken a picture. I would say contact another surgeon and have a correction.  Mine was Dr. Jose Guillum at Memorial Sloan. The convex wafers are for flat stomachs but are also extremely uncomfortable.  I used one for about a week and they are intrusive and press hard against the abs under clothes.  It's worth the correction to have a more comfortable life in the long run.  The flat stoma could also be the sign of trouble, warrants a visit to the doctor.