White spot on stoma

[joshw2011]

I noticed, maybe a week ago as I was changing my bag, that there's a small white patch on my stoma. It's 0.5 cm to 1 cm diameter, and it's almost at the very tip of the stoma, where output comes out, just a little bit below that point.

I noticed it taking off the pouch to put the new one on, and it looked like something to just wipe off so I tried with a tissue but it didn't work. Tried cleaning some in the shower, but I'm so blind and can't see without my glasses. It's still there, I can see it through my bag now. Just wondering if it's something anyone knows of?

The only thing I could find online similar to this is http://www.badgut.org/information-centre/ostomy-corner/prolapsed-stoma.html where it says that a prolapsed stoma might develop a "yellowy-white" patch which is an ischemic ulcer.

Not sure what that means, but my stoma is longer than normal, but I wouldn't say prolapsed. Just for some reason my stoma never really shrank after surgery, it might even have gotten a little longer. At its longest, it's probably 2 inches long. Not sure if the ulcer thing might be it, then. Thanks guys.

 

[annawato]

Sorry Josh I don't know what it means. I noticed a little white spot on my stoma today and immediately thought on no, crohn's ulcer on the stoma. But its probably a bit premature for me to worry. Its not in a spot where there could be pressure from the flange which sounds the same as yours.
Re prolapse, If your stoma was 'long' to begin with then it probably is fine. I would imagine its only if its getting longer and longer that its a problem but I'm not a doctor.....
Ischemia is where the blood supply to an area is compromised but I'm not sure how this applies to ischemic ulcer or to an area of the bowel.
Hopefully it will resolve soon, for both of us, or someone else here has had something similar and can shed some light on it.
All the best,

 

[annawato]

Gracifer recently posted about a white spot on his stoma. You can read others responses here: http://www.crohnsforum.com/showthread.php?t=47987

 

[joshw2011]

My stoma is no longer now than it was shortly after surgery. Just within the month or so after surgery the stoma changes size, usually shrinking, mine might have gotten a little longer. It's the same size the past year, though, no change.

I see the picture in the other thread, and that looks just like mine. Seems odd that mine is up so far away from the skin, though. Obviously it's not from the flange being too tight on the stoma (regardless, I have a fistula at the base of my stoma so I have to cut extra big to fit around that, so I highly doubt a tight cut has to do with this)... I suppose it's possible I cut it putting the new system over the stoma and cut it that way.

I do wonder if it's active disease, though. I've had some stomach pain and diarrhea the past few weeks, in addition to the upper GI problems I've been having the past few months, and my fistula has seemed more active than normal. I have a GI appointment on Thursday so I will have him look, though.

 

[annawato]

Let us know what the GI says.
My stoma got larger after the op too. Kept waiting for it to shrink to a nice round shape but alas it never did.

 

[2thFairy]

Let us know what you find out today, josh.

 

[joshw2011]

Just got back from my appointment. He looked at it but didn't say a whole lot about it. I'm doing a scope (upper and through the stoma) so he'll get a better look at it then, and also be able to see how the rest of my insides are looking. Seems like it's probably from my Crohn's getting worse/spreading.

He said he can't biopsy it, since that could mess up the stoma, but he's gonna take plenty of biopsies elsewhere in the small bowel.

 

[annawato]

Sorry to hear that your crohn's is getting worse.
You'd think having a stoma would stop the crohn's from attacking more bowel. Have you always had disease in the small bowel as well as large or is this new?

 

[joshw2011]

When I was first diagnosed I had involvement basically along the whole GI tract. My flare that started about 4 years ago was just my colon. Since the colectomy, I then suddenly started getting esophageal involvement, that's been about 1 year now. And now it seems like small bowel involvement, which I haven't had problems with for several years, possibly not at all since diagnosis (10 years ago).

It just sucks that the only diseased part was removed and then it suddenly moved elsewhere. But my doctor put in a request to start Stelara, so hopefully that gets approved, and quickly!

 

[annawato]

All the best with the new drug Josh.

 

[Jaano711]

Crohns really sux. You cut out the bad and it just comes back either at the join or somewhere else. I'm really feeling for you, I do hope you get started on your new drugs really soon.