Need Advice: Barrier Ring Swelling Issue

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LynL

Hi all, first time on the forum. I just had surgery on 11/7 that resulted in an ileostomy. I'm using a Hollister 2-piece system that I really like, but the last couple changes I did, the Hollister Adapt barrier ring has swollen up dramatically inside my flange and around the stoma. The first time it created a thick dome that completely enclosed the stoma. I removed the top and left the sides there until my next change. There didn't seem to be a breakdown of the ring under the flange. I just changed this yesterday and by last night the ring had swollen up again. Today I had to remove some of it again. As I understand it, the hydrocolloid rings are designed to swell/melt a bit to form a good "caulk" - but this seems egregious, and I find myself constantly worrying that it's going to cut off the stoma. I've gone through three bags in 24 hours as I keep checking on her and clearing out ring wax. This isn't sustainable daily. Does anyone either have advice on keeping the ring swelling down, or a product they like better that doesn't crowd the stoma as much? Thank you!

AlexT

Mine does the same and I've never had an issue with it interfering with output.

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Past Member

The Sensura Brava rings seem to swell less than the Eakin seals I use, but I haven't had the opportunity to adapt one specifically so I can't compare it directly. Maybe reach out to various companies and see if they can send you samples?

Justbreathe

In the past, I have had barriers that I felt were swelling excessively although not to the extent they were choking my stoma (which at times I'd like to do). I don't remember which product I was using. I am currently using

Eakins Cohesive SLIMS (REF 839005) which are much better for me. I believe I was using the Eakin's regular size previously.

clair.crowley83

Try the Sensura Brava rings, I didn't find them to swell much at all.

 
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Marco789

I use the Eakin Cohesives and they seem to swell just the right amount... like they hit that sweet spot for me, my skin looks great around my stoma and I never have to remove any... if it mushrooms too much it falls off in pieces. My only con is that the pieces tend to stick to the inside of my bag. I have also used the Adapt rings and they also work very well. Good luck, my friend. This will get easier the more you ask for help :)

Audrey Warren

Oh, you're only out of surgery for a month. You have every reason to be anxious. Are you lucky enough to have a home health nurse who could help you? I had six weeks of home visits.
If so, he/she should be able to help and as someone mentioned, you can get all kinds of free samples. At a month out, I still couldn't change my bag. My first healthcare nurse didn't know what she was doing. I complained and the next nurse was an angel.

And I was independent in a week. You're doing really well. Regarding barrier rings, I've only used Eakin and wouldn't try another brand. My one-year anniversary was Nov 8.
Good luck.

Ben38

There's supposed to swell to give you a nice tight seal around stoma. They won't harm your stoma, but you can see when you're new to it all, being concerned about it.

There's a good selection of seals to try. It's just a personal choice on what you like and feel comfortable with. I use Convatec Silesse sting-free barrier. They're nice and slim, easy to remove, and don't swell as much as some samples I've tried.

Get some samples from other companies if you can and see if you find one more to your liking.

Past Member

That used to happen to me in the early days before I started using a convex base (I use the Hollister 2-piece system too) and the barrier ring never "pancaked" again. I remember how frustrating that was, felt like the whole bag and base were about to lift off, plus it made leaking an issue.

I use the regular Hollister barrier ring but they do make a slim one and as everyone has said you could get samples from the other companies to try. Hope you find one that works.

LynL
Reply to Audrey Warren

Thank you for this. I am definitely anxious when new problems come up but I'm very lucky both to have an outpatient stoma nurse through my surgeon and visiting nurses. The visiting nurse also suggested I order some free samples of different products to see what I like and then she'd help me order them through insurance...we just aren't sure about which ones might be less aggressive than the adapt! So I was trying to see what other folks liked to give me some direction. The visiting nurse has been wonderful and I'm pretty independent with apparatus changes, just trying to figure out what works best for me and stay calm when things go wonky!
Happy 1 year - how are you getting along?

LynL
Reply to Anonymous

Thank you! I see some other votes for Brava so I'm going to give those a try.

LynL
Reply to Anonymous

Thank you! I'm also using the Convex 2 piece and though it hasn't leaked yet, I am dealing with some painful peristomal irritation and I'm wondering if this has anything to do with it. I'm kicking myself because I maxed out my free samples from Hollister and didn't think to try the slimmer barrier. Oh well. Will see what I can acquire. Thank you!

AlexT
Reply to LynL

I've tried the 3 major brands here in the USA. 1) Adapt is what I've been wearing pretty much from day 1. No issues with them except I don't like having to stretch them so much to get them to fit. 2) Coloplast. No issues and their hole is bigger requiring less stretch. 3) Eakin. No issues and come in various sizes and I'm really liking the Stomawrap that they have now, very little stretching required. The only thing I dislike about Eakin is how sticky they are when you're trying to stretch them around your stoma or around your bag opening, depending on how you apply it. All 3 swell to some degree. You can get different thicknesses and that may limit how much swelling you get. &zwj

AlexT
Reply to LynL

In regards to your skin irritation. Depending on your output levels, if you can take your bag off, shower, let the area dry thoroughly, it really helps your skin. Using a barrier wipe and then some stoma powder works well also. I only use a barrier wipe if I have really irritated skin which hasn't happened in quite a while.

Homie With A Stomie NS

Try Coloplast 2-piece and their barrier rings... Send off for free sample, check out their website.

Beth22

Hi there,

I myself cannot use rings because of this issue. They have a silicone ring. Go to Trio Ostomy, you can check them out, they will also send free samples.

LynL

Thanks so much for all this advice! This week I tried the slim version of the Adapt Ring and it was much better. I've also ordered Brava, Eakin, and Siltac to try.

LynL
Reply to AlexT

Thank you! I've been using the powder and wipe combo, and it seems to be healing, but it's very slow. I hadn't tried showering yet because I was worried about the time needed to let the skin fully dry, but now that I'm in a rhythm, I might give that a go. It feels instinctively like the better way to help my skin. I just don't want to end up with a big mess.

AlexT
Reply to LynL

I'm fortunate as I can be without a bag for quite a while and not worry too much. I've gone up to an hour before. However, I do that just to let my skin air out. Just to get it to dry only takes a few minutes and you could always use a hairdryer too. I use a hairdryer to warm up my bag/ring before attaching and also my skin. Then, I put the bag on with my hand pressing against for pressure for about 20 seconds, then I run the hairdryer again over my bag to warm it up good. Then, I lay down for about 10 minutes with my hands on my bag to let it set in good.

Beth22
Reply to AlexT

Alex T,

You lucky duck lol... I have the opposite problem. I have to run at the moment I see her quiet to change her, and well, she likes the air lol so she talks hahaha. My quiet moments are short, but I will still shower with it off. It's nice to get it all clean with soap and water.

Doe1mama

My husband also uses the Eakins Cohesive Slims; (Ref 839005) and they seem to work for him. Just keep trying different ones until you find the one best for you.

Mom2Sons

Hi Lyn... I had a little problem with a swelling barrier ring at one time and caused me some problems but I have found and now use the Coloplast #2325 pre-cut rings. They are very thin and do not swell at all. However, I do have to use it with a Safe n Simple barrier ring which is thicker and does not swell as much either. I use the thinner one to one side of my stoma to fill a little unevenness. Hope this helps.

Briutz
Reply to LynL

Hi LynL, the rings I've used have always been pliable, softer when slightly warm and lend themselves to remodeling. I personally don't like thick rings so I just cut them, roll them into a long thin worm and curl them into a suitable sized ring, then cut and join the two ends together and simply put the ring between two small sheets of the non-sticky material that they originally came in and flatten them to a thinner ring of the appropriate size. It's a bit fiddly, but similar to working with a stiff version of play dough or plasticine. When the rings are thinner they become slightly easier to mold around the stoma and if you overlap onto the stoma as some of the manufacturers advise, then the thinner ring forms easier and presses flatter with the base or adhesive wafer. Using the disc overlapping onto the stoma helps to seal against the hole and your skin but if the disc is too thick it can become too bulky and uncomfortable. Try making a thinner disc, it may work for you.

Celia1552
Reply to LynL

Hi LynL! I too was having the problem (and it was a problem because my stoma is a low-lying, almost even with skin creation, and it would get almost completely covered by the blossoming ring! I was looking down in the crater hole trying to see stoma!) until I switched to the Adapt Slims also...it swells a little but nowhere near as much as the regular thickness...I think diet affects it too...seems like acidic foods make it blossom more...I like the Adapt as they release easily when it's change out time leaving practically no residue...there were a couple of brands that I tried that required a lot of adhesive remover....they just didn't want to let go! Best of luck to you! Celia1552

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