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flat stoma question

bluebirdfriend
Posts: 15
Joined: Jul 2012

I have a friend who is being treated for colorectal cancer & had a permanent colostomy in Sept. 2016.  He's having trouble getting bags to fit his stoma correctly since the stoma is now flat.  Any suggestions from people with experience?  Thanks so much!

John23's picture
John23
Posts: 2140
Joined: Jan 2007

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

 

bluebirdfriend
Posts: 15
Joined: Jul 2012

Thank you very much for your advice John!  I passed the info on to my friend.

Bluebird friend

JanJan63's picture
JanJan63
Posts: 2482
Joined: Sep 2014

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
Posts: 15
Joined: Jul 2012

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

Lovekitties's picture
Lovekitties
Posts: 3372
Joined: Jan 2010

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

bluebirdfriend
Posts: 15
Joined: Jul 2012

Thanks Marie!  He's a thin but active man which may be against him to use the convex products.  I have encouraged contacting the Dr and/or talking with an ostomy nurse.  

BBF

JanJan63's picture
JanJan63
Posts: 2482
Joined: Sep 2014

Thank you so much BBF! It seems like it happened to someone else now, like most of my cancer crap, too. I get the results from my last CT scan on Jan 31 and I'm not sweating about it like I usually do. Maybe that'll change once it gets closer but I just don't feel like I have cancer. I feel like its behind me. Which will probably give me a major wake up call one of these days. I hope I'm not tempting fate by saying that.

Thank you for the blessings. As someone who fervently believes in God it really means a lot to me.

Take care and I hope your friend can get the issue sorted out. I hate when I have issues with mine. Then I don't trust it for the next few bags. It takes a while to not fret about it constantly. I know that I check it by sliding my hand over it on a regular basis, subconsciously. I realized after I had a couple of situations where strangers asked if I had one because they saw me doing that. It's like a pregnant woman rubbing their belly but at my age nobody's going to ask me if Im pregnant.

Jan

bluebirdfriend
Posts: 15
Joined: Jul 2012

Jan,

I'm a breast cancer survivor from 2012 diagnosis/treatment, so I understand some of your thoughts.  It's always in the back of my mind but my life is full and I live each day with thankfulness.  I smiled about your comment on rubbing your belly like a pregnant woman... Smile  I enjoy your sense of humor & honesty! I hope & pray that your CT scan has good results on Jan 31!

BBF

 

Helen321's picture
Helen321
Posts: 1428
Joined: May 2012

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.

bluebirdfriend
Posts: 15
Joined: Jul 2012

Thank you for your info.  He had the surgeon who was considered the best surgeon in our area for his diagnosis.   I'm happy for you that you're happy with your surgery results and will pass the info on to my friend.

bluebirdfriend
Posts: 15
Joined: Jul 2012

I asked my  friends about the "hard stoma" description & his wife said she meant that he has no or little extra skin/fat to push in.  She said the color of the stoma  is normal.  He was discharged from his surgeon, but sees his oncologist on the 16th, so they plan to have him get checked then.  I recommended that he contact his surgeon but he isn't one to jump at more visits than necessary & they also talked about talking with the ostomy nurse, which I certainly recommended as well.

 

lp1964's picture
lp1964
Posts: 1240
Joined: Jun 2013

You received great information here already. Should you need more info now or in the future visit www.uoaa.com forum. It's specifically for people with ostomy.

All the best,

Laz

bluebirdfriend
Posts: 15
Joined: Jul 2012

Laz,

Thank you very much.  I will also pass this info along.  I truly appreciate everyone's input.

BBF

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