What to do if the Skin around the Stoma Becomes Red, Angry and Excoriated
The skin around the margin and the junction between the stoma and the skin may become red, angry and excoriated. So you need to keep an eye on it and carefully inspect it each and every time you change or empty your ileostomy bag. This inflammation might be a result of the bag not being changed often enough and irritation of the skin is occurring from the contents. The most common suggestion is to change the bag every 2 days or 48 hours at least.
I find that the stoma does become progressively more sore, uncomfortable or itchy the longer you have the same bag on. Hence, you can relieve the soreness by removing the bag, cleaning the area around the stoma and changing the bag. And as expected, the swelling and discomfort the appears to worsen if I leave it on for longer than 48 hours or 2 days.
To ease this irritation and discomfort, I was advised to use Sudocrem – which is a nappy rash cream readily available from any chemist. When changing the bag, I use a cotton bud stick to smear a little Sudocrem around the junction between the stoma and the skin. The space is just a millimetre on each side or a slightly wider area. I keep the spread of the Sudocrem to a minimum so as not to moisten the skin and have it interfere in the bag from securely sticking to the skin.
An alternative reason for skin irritation may be that the size of the hole in the bag may be too large allowing contact of the contents with the skin. In my case after a month had passed, I noticed that the skin around my stoma became slightly red and angry-looking. Since the redness was limited to one side only, I wondered if the hole in the bag was too large as my stoma had shrunk down progressively over the weeks. As the circumference of the stoma shrank, it exposed a little bit of skin exposed inside the bag. I re-cut the hole in the bags to a smaller sized hole. This seemed to eradicate the problem.
Alternately the hole may be too small and not allow all the stoma to sit inside the bag. Some weeks after I reduced the size of the hole in the bags, I reduced the size of the hole again such that I had to stretch the pad in order to get it to fit over the stoma. Over the next week I had repeated problems with leakages from under the pad until I started using a larger hole which gave a 1mm margin larger than my stoma. The leakages then seemed to settle down. It seems important to have the hole in the bag accurately sized at about 1mm larger than the stoma. This allows for a 1mm margin around the edge but ensured a good well seated fix onto the skin.
If irritation of the skin does occur then check that you are using a hole of the correct size; not too large or too small but one which provided a 1mm margin all around. Use Sudocrem on any inflamed skin for a few days until it settles and ensure that you change the bag every 48 hours.
Disclaimer: The views expressed in this article are not necessarily those of myIleostomy.com or the author. The information is provided for general background reading only and should not be relied upon for treatment. Advice should always be taken from your own registered medical practitioner for individual circumstances and for treatment of any patient in any circumstances. No liability is accepted by myIleostomy.com or the author in respect to the information provided for any reason or as a result of treatment in individual circumstances.