Think of a permanent ileostomy like this: Grab a piece of paper, cut a small hole in its center, poke your thumb through. That is a permanent ileostomy. It sticks out nice and straight and does not tip down. This is not meant to be silly; I'm just trying to make a point that probably just about everyone has had a problem with their temporary loop ileostomy. I did too. Everything is much easier with the end ileostomy. I've had mine for 13 years. I don't even use skin barrier stuff or paste anymore. I use a moldable flange, form the hole to my size with my finger tips, place it over my stoma, attach a bag, and I'm good to go. It lasts four to five days and I live in Florida. A quick story: When I had my j-pouch removed I gave my surgeon a picture of a red rose bud and said "Promise me a permanent ileostomy that looks like this" and he did. A skilled, compassionate surgeon is everything... Caty