Dealing with Poop Leakage Under Barrier Ring

I have a colostomy and I use barrier rings with a convex wafer. Poop keeps getting under the barrier ring. I have a belly, when I stand up I think my fat is pushing the wafer and the ring away from my skin. When I stand up without a colostomy bag on my stoma, my stoma is almost completely covered by my fat. Has anyone else had this issue and figured out a resolution?

Yes, I have your problem.

Coloplast came out with a new wafer. It fits my round belly and seals really well. But I still get it to leak because of how I am twisting or the weather. But it's better than Hollister because they were built for a flat surface. I had been wearing Hollister for 12 years. I was changing a lot more depending on the day. Coloplast just came out with (Sensura Mio Convex Flip Ostomy Barrier and Sensura Mio Click Ostomy Pouch) about 1 year ago. I have had better luck since I am not Mr. Abs or Mr. Six Pack. I am more built like a keg, so my ostomy nurse asked me to try these. They worked way better. Plus, they also have a better support belt. I have the largest they make, which is a 4xlarge. It holds your barrier better because you can cut to fit and it doesn't roll up like many others did on me.

Hi Osto,

Man, that's a tough one. Ostomy products are designed to have some flexibility, but not that much. There just aren't a lot of materials that can flex that much and maintain contact. I've used the Sensura Mio Flip, which is cupped shaped to grip a convex-shaped surface, but in your case there's just too much change in the surface shape. You might want to give Nu-Hope Labs a call to see if they have anything that might help you. They make a large foam rubber barrier ring, but I'm not sure if it will work for you.....so give them a shout. Their number is 800.899.5017 and their email is ****".

There's also a number of articles on the subject in the NIH database, but I don't have access to it. Your primary care doc and your ostomy nurse should have access, so ask them to download these two and search for others on the subject. I'm sure there have been others who've had to deal with what you're going through, so the info is out there......just have to find it. I'd also call the Cleveland Clinic and talk to their Gastro department and see if they can point you in the right direction. Mayo would be a good place to call as well, and hit up the UOAA too. They're supposed to be the experts on the subject, so see if they have any good info. Sorry I can't be of more help.........but I'll keep digging and reply here if I find anything else. Here's those two NIH papers I was talking about

"Challenges of ostomy care and obesity"https://pubmed.ncbi.nlm.nih.gov/15361632/

"Ostomy management in the obese client"https://pubmed.ncbi.nlm.nih.gov/18773864/

;o)

Bob

Hey Osto, you got me thinking. A while back someone (I think it was Lovely) posted an ad for a device that looked like a round plastic ring that had a sort of funnel or spout at the bottom that protected the stoma and directed the output down and away from the shaft of the stoma. I wish this site had 'sticky' posts for things like this that get referred back to, but it doesn't. Something like that might help in your situation. I'll see if I can find it, and Lovely, if you read this, can you repost that ad please? Bill might remember it too, as I think he commented on making something similar back in the day. I'll get looking.

;O)

Do you irrigate? Irrigation will regulate your ostomy output. Many people wear only a security pouch between irrigations.

Have you tried an ostomy belt assuming you are using a 2-piece system?

Another thought I had is to have an ostomy nurse watch your technique of putting your appliance on.

I am having a similar issue.

My belly fat plus the fact that my stoma now sits down low. It's like a moon crater and my stoma is sticking a little bit out of the bottom of the crater.

I tried several convex pouches, rings, and other things. I seem to have leaks more at night while sleeping. Convatec sent me numerous things. The latest (3 weeks ago) Convatec had me do a ZOOM call with a firm they are partnering up with. The lady was an ET nurse on the ZOOM call. She suggested a flexible appliance with a ring. The sample they sent was almost IMPOSSIBLE for me to remove after 4 days. I mean the faceplate and the barrier adhesive stuck fast... well like glue. I had to go slow while peeling off the appliance. I used about 6 adhesive remover wipes and was still not able to remove. I tried warm water and no help. I hated to do it but I grabbed a bottle of alcohol and soaked the part that was still sticking. I still wound up pulling off a small bit of skin. GREAT that the sample stayed on - BAD It was a painful ordeal trying to remove it.

I just had my surgery 4 weeks ago. I feel like flushing might be my only option. I also think it will give me some control back.

I am using Coloplast two-piece system. I am going to try and use less barrier ring to see if it helps. When I stand up, the barrier ring sucks in and when I lay down, it pushes up against my wafer where I have my pre-cut hole where the poop comes out. I hope that if there is less material/barrier ring, it will stop it from pulling away from my skin.

I am using the two-piece milo now. I agree it works way better than Hollister on a belly.

Don't you guys talk with your stoma nurse, that's what she's there for. It would be a good idea to try and lose some weight as well.

Iggy,

Talking to a stoma nurse is the best advice initially, but many ostomy nurses, like doctors, may or may not know their stuff. Many ostomy nurses that work in hospitals, especially the newer nurses, simply don't have the knowledge or experience base to solve complicated ostomate problems. They treat patients who just received an ostomy and are there for a week and then discharged. So their experience is with people who basically are bedridden and then walking.......and that's about it. And I'm not deriding ostomy nurses.......they're just like everyone else.......some excel at their job........and some are just going thru the motions. In the past I've become friends with the ostomy nurses at two of major hospitals in my area. Both have since retired and were replaced by young nurses who are still textbook fresh, and don't have the vast experience of those they replaced.

During my stoma revision a couple weeks ago the ostomy nurse that came to help me was a very young nurse and she only had Hollister products to use. And most hospitals use Hollister for whatever reason. So she has no experience with any of the other brands and products that are out there. I sprung a leak after she changed my barrier and when she came back she was totally puzzled at how what she just did could have leaked so fast. And in her tray of ostomy goodies she had the exact same products she just used on me that leaked. So she just reapplied another Hollister barrier and hoped for the best. She was certainly no problem solver........and again, not her fault as she has to work with what she has and just hasn't been exposed to any of the myriad of alternate ostomy products or what they can do for a patient. I realized she couldn't really help me, so I ended up pulling out a Mio barrier and bag I brought with me and solved the problem.

So my point is all ostomy nurses aren't created equal, and many that don't have a lot of years under their belts may not even know about all the products out there to help us in our individual situations. And I don't see that situation getting any better anytime soon. So by all means contact your ostomy nurse.......but be fully prepared to contact other ostomy nurses if the one you're dealing with can't fix your problem. Personally, I find the ostomy nurses that work for the product manufacturers to be more experienced in dealing with the problems seen on this forum than those in the hospitals. Just some food for thought.

;O)