Incorrect Template Fitting.
Post surgery your stoma will be swollen after being handled during the operation, as time passes (normally 6 to 8 weeks), the stoma will gradually reduce in size and, establish a final size. It should be pointed out that no two stomas are the same size or shape (what you see in a photographs are an examples and might not necessarily reflect your stoma) some may be round or oval, as an example.
If the opening in the back plate / skin barrier is too large, this will leave skin exposed around the opening causing stool or urine to collect there, this will then cause soreness. It is important in the early days post surgery to check the size of your stoma regularly making sure that the back plate fits correctly, the gap between the edge of the cut-out and your stoma should be about 1mm or the thickness of a shirt button.
If you have had your stoma for a while, it’s still advisable to check this from time to time perhaps once a month – or if you have your back plates pre cut you should always check this prior to placing an order.
Your stoma can also become larger – another reason to check your template is fitting correctly. This could be because of:
(a) A muscle weakness around the stoma, this is known as a parastomal hernia.
(b) The effect of drugs that can inflame the stoma, such as chemotherapy.
(d) Weight gain (weight loss will lead to the stoma getting smaller).
Your surgeon will have stitched together where the skin and your stoma meet during the operation. In some cases the area goes through a process of over-healing of the surfaces, called “Granuloma” which will appear as moist, red raised areas. Applying and removing the back plate can make this worse. “Granuloma” are harmless but can be a nuisance as they bleed easily when touched.
The moisture from this can cause the back plate to leak as, it is covering over the “Granuloma” so will irritate them causing them to bleed this in turn causes moisture which will cause the back plate to lift and break the seal.
This can be easily treated contact your stoma nurse for advice.
Changes in your output
If the stool becomes loose or watery, this will increase the possibility of it leaking under the adhesive onto the skin and causing soreness. If you are experiencing a change in the consistency of your output, speak to your Stoma Care Nurse, who will be able to advise you.
There are many reasons why the normal output from your stoma could change:
(a) Changes in medication e.g. antibiotics or chemotherapy.
(b) Changes in your diet.