You may, or may have never, heard of this term. You may have also heard it being spoken about along with protruding or retracting stomas. A flush stoma is a stoma that sits level with the abdominal skin level.
My experience with a flush stoma
I have had issues with this, which was caused by a narrowing just before skin level, just inside my abdominal cavity a few centimeters behind my stoma. The narrowing was causing my stoma to be pulled back down to the skin level. A few things can cause a flush stoma such as surgical technique, a narrowing behind the stoma as I have just mentioned, weight gain/loss and it can also simply just occur over time without much encouragement.
The stoma itself can often change to what extent it sits outside of the stomach (protrudes) because of peristalsis (when the bowel moves with digestion), so try not to worry too much if you do notice it changing. If it becomes worrying or you notice something abnormal, it is always best to consult a medical professional. I first had experience with a flush stoma around three or four years ago to more of a noticeable, life-impacting extent. I felt discomfort, my stoma and bowel didn’t feel like they were working properly, I had increased wind (& the noises to go with it) & as a consequence more bag leaks.
Botox injections as management for a flush stoma
The problems I face when my stoma becomes flush do get me down and impact my life mentally as well as physically. I experience a severe increase in my anxiety from the noises, I also think about my stoma a lot more so sometimes feel it understandably has more of a hold over me than I’d like & I also lose my appetite out of fear of things getting stuck and not moving out my system properly (& also to hopefully reduce stoma noise).
The first thing that was recommended for me to try with a flush stoma was having Botox injections in hospital directly into the stoma (yes, my eyes just about watered the first time I thought of that too!) Looking on the internet and speaking to others with stomas, this is not something that seems to be widely explored and seems relatively new. I had my Botox injections about 2 years ago now. The injections themselves stung a little and made my stoma bleed a lot, but as far as I understand, were designed to almost paralyse the stoma to stay sat on top of my skin, rather than sink flat with the skin or underneath.
I had them every 6-8 weeks roughly five or six times, then went a good few months at one point without needing them. Because of my added problem of having a narrowing just behind my stoma, the injections sometimes made this issue worse a few days after. The cramps would intensify and my digestion would go into overdrive. A few times towards the end of my Botox treatment, I was quite ill with the after-effects. I remember on the last time of Botox emptying my bag about twenty times in about seven hours through the night because my stoma was just pouring water. I couldn’t get on top of my dehydration easily and felt drained for a week or so after. It was then decided that Botox injections would no longer be a viable option for me going forward.
Using convex bags to manage a flush stoma
Before my Botox injections, I tried convex stoma bags on a few occasions to try to manage my flush stoma. Convex bags are designed with a baseplate with an inward curve to gently encourage the stoma to stick out (protrude). By my own admission, I was so down with my stoma and was having issues with my narrowing and pain that the convex bags made me feel uncomfortable, so I gave up. I didn’t have much patience understandably as I had nearly reached the end of my tether with everything so almost overlooked them and did not give them enough chance.
After Botox injections didn’t work out for me, I decided to give the convex bags a go again on the advice of my stoma nurse. This time, I was almost immediately chuffed with the results. I experienced little discomfort barring a little “stretching” sensation of my stomach itself within the first couple of days and to my pleasant surprise, my stoma stayed sticking out. I still use convex stoma bags to this day and they help hugely. They have really made the difference in my quality of life and ability to get on in everyday life with less anxiety, leaks, and worries surrounding my stoma. I have had a separate issue with my narrowing which hasn’t been straight forward and has needed quite a lot of intervention, but the flush stoma problems were reduced massively from using the convex bags.
Other solutions for a flush stoma
Those I’ve explained so far are what I have experienced, but I’d also like to add a couple more:
- Always make sure your bag is cut to your stoma size correctly, whether you have a flush stoma or not. This will help to avoid leaks
- Use extra adhesive. I have used the Salts Flange Extenders underneath my bag in the past, around my stoma to help create an additional seal to help reduce leaks. I take one extender, cut it in half down the middle, then cut half stoma shapes in the inner side of each of the two mini extenders in the middle. Then, I place each part top and bottom of my stoma so that a circle is created around my stoma. Then I place my stoma bag on top.
If you’d like more of an explanation on how to use the extenders or to talk about anything else I have covered, please e-mail me: firstname.lastname@example.org Until next time,