Things to Know When Problems Occur

• Stoma Size- Knowing the size of the stoma will assist in finding the right size appliance for an ileostomy.  Most ostomy supply companies will provide a chart with pre-cut holes.  By placing the chart over the stoma, the size can be quickly determined.
• Protruding or Recessed- If the stoma is protruding, the patient will have less trouble with leakage and longer wear times.  With a recessed stoma, patients will have a hard time without the correct appliance.  A recessed stoma will seem to be level with the skin or sinking into the skin.  The proper appliance in this case is one in which the barrier is convex in shape.  The convex shape will help to protrude the stoma decreasing the chances of leakage.
• Ostomy Belt- When leakage is a problem the use of an ostomy belt may help greatly.  An ostomy belt is an adjustable belt that attaches to each side of the appliance and wraps around the patient.  This will help put pressure on the appliance when the adhesive is not enough.
• High Stool Output- High output can cause some very serious problems.  Not only can high output lead to more frequent leaks and skin irritations but individuals with higher output ileostomies become dehydrated very fast.  Doctors may prescribe an anti-diarrhea medication such as lopermide or a combination of lopermide and a mild narcotic pain killer such as codeine.  The codeine is not being used for its pain killing properties but instead is being used for its tendancy to create solid stool and slow down bowel movements.  Individuals with high output ileostomies should make sure their doctors are aware of the high level of stool output.