just had an iliostomy 4days ago managing bag ok after a few mishaps with leaks knocked my confidence but my skin is so sore when I remove the bag. Any tips on reducing the pain.
Hi Pam I am just 6 weeks ahead of you had temp ileostomy 28th Feb.I also had a few leaks to start with first thing is try to thicken your output coz it's less likely to leak .mash,pasta marshmallows jelly babies works well for me and 4 to 6 Imodium a day. Then get the round wafer thing as close as possible to your stoma before you put the bag on. I tried a little egg white one day as mine was stinging but i managed to get the wafer close and although it stung all that day the next day it was better. Some people say a little calamine and let it dry. It really does get easier.honestl! Vanessa x
Hi Pam, I assume that you are using plenty of the spray to remove the bag, let it soak in well under the lip and keep lifting and spraying until you are there. As for the sore skin it might take time to get on top of it. You can always keep going back to your stoma nurses they will generally see you with pretty short notice and they would rather see you sooner to prevent increasing soreness than wait until your skin is badly broken.
The most important thing is a good fitting bag, tight around the stoma so the minimum skin is exposed to your poo and in the early days the stoma shrinks and changes shape almost daily so the nurses might need to remeasure. I found a hairdryer invaluable (on a cool setting) and if you pick a time when the stoma is less active between meals etc you can wash and dry the skin with the hairdryer and have a bag break with plenty of wipes to hand. I have heard of people having a doze with a damp flannel over 'it' as long as you are on a disposable pad. There are also stingy pastes which are applied to dry skin and dry and harden and then you stick your bag to them and in a similar vein plastic doughnuts which go on before the bag all in the name of trying to prevent leaks. Again your stoma nurse should go through different options until you find something that works for you, it might take a few weeks but you do get there in the end.
If you have a close family member who is happy to help you I found they could see better than I could where to stick the bag so the bottom lip is as close as possible to the stoma. I was lucky enough to have my husband and daughter who would often do the sticking for me as it is hard to see the bit of stoma furthest away from you even with mirrors which never worked as i didn't have enough hands free.
Finally empty it regularly to reduce the weight pulling on it and yes stick to the bland diet with tons of mashed potato. Good luck you do come out the other side with a smile eventually.
My colostomy was reversed last year October, but here is the way I was taught by the stoma nurses:
Stoma size: You don't want to "strangle" the stoma, but basically there should be no skin showing around the stoma once you applied the bag. So remeasure regularly. My stoma nurse recommended to use the bit that you peel off from the bag before sticking it on as a template for the next bag, but before cutting the next bag, just put the old template over the stoma to check if the next one should be the same or a different size. Especially in the early days the stoma will change size a lot.
Adhesive remover spray: As Nicky mentioned, make sure you are using this. My stoma nurse told me not to be shy with applying it. I would spray a bit at the top edge of the bag, peel a bit, spray more, peel more, etc until the bag comes off easily. If you google some of the supply companies and ask them for samples, they will send different ones for you to try out. There are adhesive remover wipes as well, but I found the spray to be the best.
Cleaning: After removing the bag, I would clean the stoma and skin around it with a soft wipe and luke warm water only (I tried a "skin cleansing wipe" one day and regretted it immediately). Then make sure the skin is completely dry. For that purpose I used a sheet of kitchen towel to make sure I absorb every bit of moisture on the skin.
Barrier film: You get these in wipes, sprays as well as a lollipop type thing. The wipes were ideal for keeping in my handbag for emergencies, but at home I used the sprays. Spray on the skin everywhere the bag is supposed to stick on. Wait for a minute until it is completely dry (I would just wave it with a small piece of carton or something like that). It helps to protect the skin and also makes the skin a bit more tacky for the bag to stick better.
Mouldable seals: I only used them a couple of times, but apparently quite useful to create an extra seal around the stoma, and helpful if the skin is uneven for whatever reason. I.e. you can use it to create a flat surface to stick the bag on and reduce the risk of leakage.
Stoma powder: Something I never needed to use, but useful apparently for sore skin.
Different bags: If you keep having problems with the bags that you are using, it may also be worth trying different types of bags. The different manufacturers use different type of adhesive, as well as different design, and this may impact both leakage (which would contribute to sore skin) as well as the effect of the adhesive on the skin itself.
You should be able to get samples for most / all of the above products from the supply companies, or ask your stoma nurse for suggestions (but don't be pressured into sticking with one brand of product if it is not working!). Also, we have a dedicated group for ostomates, so please go and join if you have not already: Ileostomy, colostomy, urostomy and any other stoma support. Our resident expert Ian (aka Bodach) is very helpful and extremely knowledgeable on all things stoma related.
