Loop Colostomy 3 Weeks Ago, Struggling with Small Leaks Under Plate

Hi,
I hope someone here can help me:

I have a loop colostomy that I got about 3 weeks ago, and I always get small leaks that go about a centimeter under the bag plate. I struggle a bit with red skin and pain from that. My stoma doesn't stick out much, and at the bottom, where the downward opening is, it hardly sticks out at all. And under that, the skin has separated from the stoma, which I suspect is part of the reason for the leaks.

I now use Salts Soft Convex bags on a Salts barrier ring that I form so that it lies flush against the stoma (obviously impossible at the bottom, but I don't just get leaks there but all the way around the stoma) and I use a barrier film on the skin.

I've used Salts flat bags before, and I see no difference after starting with the convex ones, really. I tried with Coloplast protective rings last night, but got an even bigger leak today. I change bags daily.

I have an appointment with an ostomy nurse next week, but I thought I'd ask here to hear if anyone had any ideas because this whole thing is rather uncomfortable at the moment.

Sounds like your skin isn't super happy. Have they measured the stoma? Since you are 3 weeks out from surgery, the size may have changed. Can you send your ostomy nurse a picture to look at so you're not miserable all week? Do you have any stoma paste on hand? Is there a dip in the skin under the bottom of your stoma at all? What type of skin prep are you doing? When you change it, are you standing or lying down?

Hello. It sounds like you need surgical revision. The surgeon can pull the stoma out a bit, then re-sew it in its new position.

When you bathe, be sure to use soap that contains no dyes, perfumes, or lotions. Clean, totally dry skin is the goal. I use Cetaphil bar soap.

Don't use a barrier film unless your peristomal skin is getting irritated.

Use a blow dryer set on low to preheat the wafer before applying it to your skin.

After you put the wafer on, lightly press down on the wafer for 2 minutes, then put on an ostomy support belt and wear it for an hour.

Contact different ostomy supply companies. Talk with an ostomy nurse. They will recommend products based on your unique situation. Then send you free samples to try out.

Good luck.

My stoma is about 35mm wide, but unfortunately it isn't perfectly round; there are some bumps, etc. I put the barrier ring as flush as I can against it all the way around every bag change.

I've sent them a picture and they said to use convex bags, but that doesn't seem to be doing anything at all.

I do have some stoma paste! There's a quite deep dip that bleeds a bit sometimes where the stoma separates from the skin. I put some silver bandage strips down there and that seems to help a bit with keeping it clean, but it's hard to keep a tight seal around that. The leaks happen all the way around the stoma, however.

I use a barrier film from 3M that I apply with some sticks. I have tried using stoma powder and also the crusting thing, but I couldn't get the ring/bag to stick when using those.

Sitting and/or standing up when changing

Thanks for all the advice! Unfortunately, I have tried all these things already (except surgical revision) :(

 

My skin is already irritated; I didn't use barrier film before it was.

 

Thanks!

Hi there,

I have had many retractions. I will tell you that if you're already low and retracted, using a barrier ring is going to make things worse. That's putting height around an already low stoma and taking away length to get output in the bag. Think of it like climbing a wall. So, in the end, you're going to leak more. Beachboy is right; if you are retracted that low and have tried everything, you would need a revision. A regular barrier wipe isn't going to help, unfortunately. They do have a thing called Marathon and 3M Advanced Skin Protectant; those would be good to try and protect the skin, but if you're constantly leaking, it needs to be fixed—the skin that's separating from your stoma and skin is called a mucus separation. I have had a couple of those as well; the best thing is to contact your surgeon, and an ostomy nurse isn't going to be much help in this case. They will tell you a convex bag, a barrier ring which with a retracted stoma isn't going to work, paste which isn't meant for leaking but for dips and grooves in the skin, powder, and skin barrier wipe. I would say save the trip and your time and just contact your surgeon. Don't put anything in the mucus separation until your surgeon says to and or what. I never put anything on mine; it will heal over time. I am sorry you're going through this; it does really suck.

Keep us posted on your progress. Unfortunately, a surgical revision is probably the only permanent solution. I used to be unhappy because my stoma sticks out too much. But after reading about other folks' struggles with a stoma that is too low to the skin, I'm not complaining anymore. Best of luck to you.

There's no way for me to just contact the surgeon. In our system, that must go through the stoma nurse or possibly my regular physician first. These things usually take some time (unless there's an emergency).

Yeah, I was thinking that about those rings too, but it's kind of hard to just use the bag when the stoma is in such an irregular shape. There are some convex rings available though; they might work better with those and a flat bag.

 

Thanks!

 

Thanks,

Thanks! There's probably a lot of issues with every kind of stoma, but yeah, I do wish mine was a bit easier to work with.