This post needs to be updated some.
Although dissolved antacids in water work by raising the pH of output higher and making digestive enzymes in output less effective. Due to the bag residue and hassle of antacids I now just use antibacterial dish soap and water only. Much easier than worrying about using two products and cleans the bag after each dump as well.
My initial problem was drinking coffee and making my burns far worse, since quitting coffee I've been a much happier person. As you should know the body flushes out what it considers a poison, caffeine especially, so a dirrarea situation occurs and coffee is very acidic and likely wasn't being entirely raised in pH to about 8 of normal ileostomy output, why I used antacids at first.
Original post as follows:
Okay I figured this needs its own topic.
In short:
- 1: Generic antacids pre dissolved in water as a bag flush and leave 1/4 cup of concentrate inside to neutralize future digestive enzymes. Massage around stoma area through appliance with it fresh will buy some time until the stoma quits spewing.
2: Flonaze the nose spray (generic brands also) as a skin protectant dried well with two coats around stoma. It stops lingering pain of burns on contact, but must be well dried afterwards.
3: Non alcohol pastes and rings. No long term pain from alcohol being trapped against the skin. Don't use alcohol wipes or iodine. I use antibacterial soap instead while in the shower after each output occurs then moisturize with a tiny bit of conditioner once at first to stop the sting (then soap only after that) and prevent skin being dehydrated and irritated. Much less painful that way than iodine or alcohol.
4: Proper appliance, preparation and application of otosmy product is key. It's all a combined thing.
Okay, you have an ileostomy and your suffering from burns, burns you likely thought was being caused by acid but it's really a digestive enzyme that's at fault. Could be coffee,, very acidic!
Burns come from leaks obviously, and they always can't be helped, but a very clean, non-oily, dry skin (that isn't seriously damaged) around the stoma with pressure through the wafer when applying a paste or ring does help considerably to get a good skin bond and increase bag wear time without leaks. With a ring one can heat and press with ones fingers to get it closer to the stoma. However rings are not good for dips or cracks etc, a paste fills in uneven areas a lot better.
If you have weeping damaged skin, shower using antibacterial soap to wash after spewing is completed and then massage a little conditioner around it or else it gets painful later. Using antibacterial soap is a lot less painful than alcohol or iodine to sterilize the area and after drying with blow dryer, hopefully shouldn't be weeping anymore and allowing one to apply stoma powder, skin protectant and paste or a ring so it sticks. If not try a very tiny amount of stoma adhesive just on the wounds and brush off as nothing will stick to it with that powdered film on it. Blow dry well and see if that's better.
Always remember to stick paste or ring on first to ensure a good skin bond, then apply the appliance on top. Portions of paste can be removed to address the non sticking areas, a ring it's harder to do that as it's one piece and often stretched out of shape to ones stoma. Why I use paste, but others like rings better. It all depends how easy or hard your body contours are. Remember paste has to match the ring in size about a 1/2 inch around stoma without covering it any or clogs occur
I've developed a pretty harmless bag wash/output neutralizer method that should reduce your burn size and pain down to a more manageable level, with benefits like reduced smell and a cleaner bag.
As Bob here explained, digestive enzymes are eating your skin when you have a leak, this of course causes the skin to react and causes fluids to form under your seal and spread, causing contact to be lost. Allowing it to continue is painful and eventually a blowout occurs outside the containment.
You might not be ready to do a bag change yet (like driving or just are, small leaks started) and need to give your stoma some more time for it to quit spewing so your not sitting on the toilet pouring water down your chest or taking a long shower to keep washing output away with a removed bag. So this will also assist in extending the bag wear time even with tiny leaks just started, reducing their pain.
Now the trick is simply bathing your stoma (with the bag on) with a mixture of antacids pre dissolved in water (prepare first as it takes awhile) and used as a bag flush first and placing a small amount in the bag after a dump/wash and laying down or otherwise getting this mixture up around the stoma and massaged into any small leaks will reduce the burn pain considerably, extending your bag wear time and reducing the burn wound size and pain. (And the smell). This will help give you more time until the stoma has quit spewing to do a bag change.
I've keep a small wide mouth bottle with screw in cap near the toilet and one in the car. The contents tend to settle to the bottom thus the top portion makes for a good wash and the more concentrated bottom mixture is better to leave about 1/4 cup in the bag as it will mix with fresh output.
What it does is the ileostomy output is slightly alkaline at about 8 and antacids is about 9-10, so your raising the pH level of the output and thus making the digestive enzyme not as effective and probably killing it. It's this digestive enzymes giving off that bad odor. Since it's out of your body it doesn't need to do it's job anymore and only a problem for you.
Now baking soda is about 8 ph itself so although somewhat effective not as good as the antacids I've found. Do NOT use stronger alkaline products or acids. Generic antacids does the job. Large 1000 count bottles of tablets are available like at Walmart etc. You'll likely need about 3-5 tablets per toilet visit and set up for the next toilet visit as they take time to dissolve.
Also with the fluid mixture in the bag, can assist with pancaking issues mixing with the output to become more fluid like. Also assists in dumping. It also keeps the bag cleaner as well, removes oily residue. A 7 day bag for me will look almost as clean as a 1 day bag..can't help the filters getting dirty though.
I occasionally also flush and wash using antibacterial dish soap. This helps with killing bacteria and also gets rid of oily residue etc.
There is a slight trade off with bag room, but it's minor compared to the benefits. I leave about 1/4 cup of the concentrate from the bottom of the bottle in the bag,.it will mix with more output. You'll notice a lot of the smell goes away as well because digestive enzymes are causing it.
Other ways to reduce burn pain is to use Flonaze (yea the nose spray) as an skin protectant around the stoma/adhesive areas after drying. This stops the stinging of burned flesh..Dried well with a second coat around the stoma. Dried well again. Important! Just spray into the cap, pour around stoma and spread. Dry very well! Blow dryer set on low works faster. The generic four to a box Walmart specials work just fine and the best value.
Another way to reduce burn pain is to avoid using alcohol based pastes or rings. There is no-sting paste, it's more expensive but very effective. However because of the lack of alcohol, there is no wound sterilization occurring, so be sure to wash area around stoma with antibacterial soap and the with conditioner to kill enzymes on the skin.
Burns occur, it's been my goal to eliminate them and so far all I can do is reduce their effects to a minimum.
Since using the antacid bag flush/neutralizer my burn wounds usually have been very small, they usually don't ooze fluid which makes adhesion difficult and are almost entirely pain free. But boy if I forget my bottle while on the road, I'm suffering. So take a small water bottle along and keep some tablets in the car to replenish.
I am searching for a easy, ultimate solution because it's about impossible to get a perfect seal as movement, heat, sweating etc. all cause tiny gaps to form. These tiny gaps may not breach the containment but if the digestive enzyme reaches the skin it will cause it to react and that causes further loss of containment. I'm getting better all the time and each person has to find their right product and methodology to ensure success as body types are all different.
But I think this bag wash/neutralizer with antacids should work for nearly everyone with an ileostomy. Been doing so for several months now with no adverse effects, my nose is very happy too. 
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Hope this helps you. 
Good luck!
I get knocked down, but I get up again
You're never gonna keep me down...
