Do you clean inside the flange between bag changes?

I have been cleaning inside the flange, the plastic part on the base, in between bag changes almost daily since I got home from rehab. I somehow thought this would make the bag changes less frequent by preventing leaks, especially when wiping off thick output from, for example, rice and mashed potatoes. But sometimes I wouldn't click it on right on one side securely after and… disaster. So, I left it alone this week but checked on it to see how the output was doing. It seems it's okay; the thick output from yesterday washed out by itself with the thin output taking its place. So, do you clean the flange in between changes? If yes, do you find it helpful?

I have an old-style clear plastic condiment bottle with a pointed cap. I use a two-piece Hollister, and every time I dump, I separate the top of the bag and rinse around the stoma and the bag across from the stoma. I can get a week per appliance with very little poo around the stoma at changing. Before I started doing that, I would get leaks after 2 or 3 days. I learned if you smell it a lot, it's gotten under the flange.

Good morning, Jules.

I believe you have the two-piece that you're talking about, and what I do is I simply don't disconnect it.

I unclick it, then

spin the bag 180° up, open the drain tail, and put some warm water in there. Then I swish it around a little bit and I secure the Velcro, of course. Then I spin it back to the drain position. I do this maybe once or twice almost every night. It's become routine, and I think that really cleans what's around the stoma. I understand you're trying to clean that little plastic lip area where it connects and snaps to, but I really don't think that's necessary. You really want to try to keep the area around the stoma and where the mounting plate goes clean. You know where that little gap should be? I think this is the best and most efficient way to do it. What do you think?

Even if you are doing a complete appliance change, it helps.

And always keep that snap ring clicked, never unclicked, when you do this. I do this in the sink or a basin tub. Reseal the Velcro.

The mounting plate, the barrier, the appliance, the base plate, so many names lol… Meanwhile, the bag is the bag. Yes, I use a two-piece Hollister click-on, Velcro bottom closure.

I always clean around the flange with every bag change. I do it to prevent the possibility of any old stool buildup. It's not strictly necessary, just a personal preference.

Yes, indeed, the terminology alone can make your head spin. I'm just talking about spinning your bags, nothing else. But I'm thinking now, why do people just change their bags? I don't. I really don't change my bag; I change the complete appliance. And that's when it starts leaking at the mounting plate, you know, behind the seal. It seeps and then eventually turns into a blowout. But I'm curious about your reasons to do a cleanup while you're doing maintenance, changing a bag. I can't see other than it having a pinhole or something like that. I mean, if it gets wet, you use a blow dryer to dry it off. I don't really see the reason needed to just clean that area that you're talking about. I can't imagine what would cause something like that to happen. I mean, if you're just doing it for peace of mind and maybe for a health reason, I get that. But it's like the less you touch it, the better you're off. My theory is if it ain't broke, don't fix it. And when my bag leaks—the mounting plate, that is—it's broke, so I replace the whole damn thing, soup to nuts.

Yeah, analytical... the terms can cause scratch-your-head moments.

😏😊

With a 2 pc appliance using a closed pouch, you change the bag when it is 1/3 to 1/2 full. I change my bag 2-3 times a day. I change the appliance every fourth day. I use the terms pouch and wafer. 😊

 

Yes, I'm starting to understand now that the less you touch it, the better off you are. I think I started doing that because when I was in the rehab facility, they didn't clean the stoma area, just put on a new bag. Only some nursing aides did, and when I told them that at the hospital, they thought it was ridiculous because they were like, "You wouldn't go to the bathroom and not clean after?" So, from that experience, I got caught up in cleaning. The thing with me is that I hear it click on one side, and I think it's OK. Now I know I have to run my finger around the whole entire circle and push, but you know I'm still learning these things. Since the first week of November, I've been home, and it's such a learning experience still. I'm so grateful for this site. I know the reversal for me is possible, and I want it, but as I wait to get stronger, I am grateful for you all. I will say I am still mad about C. diff. I don't like the bag still; I am processing it all still. But I know too, if the reversal doesn't work out, I have support and knowledge, and that means a lot. But yes, I touch the bag a lot, worrying about leaking, but it's only really a worry most at night because of air. And I get up at 3 AM, and I empty and am OK mostly.

Well... color me schooled. I was not even thinking a closed piece. Because why??

Where's the fun in doing that? 😊

So my next question to you would be, why use a closed pouch over a drainable?

I mean, changing bags like that or washing them out to reuse has got to suck.

First, the cost for new bags. Second, the time, work, and mess of replacing it. Then, removal and dumping in a trash can... eeeew. Sorry, and you carry bags with you when you go out?? Enlighten me. 😏

Jules, have you tried pre-assembling the mounting plate and bag first? Then apply to the stomach?

I do this. I can easily just palm the plate into the bag and feel the click. Pick it up and view it too... sealed? Yup.

Like a sandwich... as long as you line things up, I find it easy peasy.

Now at this, you make a decision.

1- Heat things up and apply the barrier ring to the plate... this is the blind way.

or 2- Heat things up and apply the barrier ring around the stoma area... use a small mirror. You can see how it seals to the skin... no bumps. Flat... if it comes off? Just keep pressing that area till it sticks.

When I do this, I leave one side plastic on the ring and finger it around the stoma. A few circles... round and round. Take a mirror peek... at everything...

Peel off that sticker... heat things up... apply the assembled plate and bag one time. No click needed except the snap ring if you forgot earlier...

Then finger the mounting plate... round and round... pressing and holding, visualizing with x-ray vision, 😋 the ring location you just set...

Add the adhesive C strips... done. 15 mins tops.

If your stoma is not round? That's ok. You can form the ring by seeing it without blindly attaching everything else.

I wake up at 2 a.m. and 4 a.m. I'm just full... of... shit... sometimes... 🤭

Why use a closed pouch over a drainable?

• For me, it is more convenient and versatile. Insurance pays for 60 bags per month. I have a colostomy and only need to change bags 2-3 times per day. It may not be as feasible for an ileostomy, but there are some with an ileostomy that use closed pouches:

• https://m.youtube.com/watch?v=EHApL1iUzco&pp=ygUTY2xvc2VkIG9zdG9teSBwb3VjaA%3D%3D

• "Why I don't empty my bag" YouTube video.

A traveler indeed... And you have a very good point. As long as the insurance is picking up the tab, I can see where it pays for you to do what you do. And you're right, anybody with an ilio is not worth it, but that's what I have, and that's the way I've been seeing it.

We are a versatile bunch of people with all different needs, and it's just trying to get through the day, you know, where it can be easier, not a huge task. So whatever works, that's great. Man, I really don't do the YouTube videos, but it's good that you posted it here for others. I do my thing, you do your thing, and I was just concerned why anybody would do this, especially on a low budget if that were the case. You know, I've heard people actually just rinsing their bags and reinstalling them, so there is that. But thanks for the input, I appreciate it. Very good, very good response. Thank you.

I haven't tried to assemble it beforehand although the ostomy nurse told me that I should. I just got into the habit of doing it the way I do it. I use the Bravia barrier strips, so I don't use the half-circle tape. The circle tape is hard with the spastic in me. I can't get it straight. I always get it wrinkled, so the straight tape is better, and when you use the straight tape, it's easier to do the bottom without the bag on. So I do the bottom of the base first, the base plate. Well, I should say that with each Bravia barrier strip, I cut it into three pieces. Or, rather, my friend helps me. Then one piece goes on the bottom of the base. Then two other pieces go on each side, and I leave the top because I don't really have to tape it. But I have started closing the bottom before putting it on because that's important, you know, closing the Velcro. I am not patient with heating up the ring, which is a problem for me because of the leaking. I've gotten more patient, but I've actually never had a hairdryer for many years. I just ordered one so that I can use it for heating up things with the bag. It damaged my hair when I used to use it, so I never wanted to use it again, but how life has changed. If you would've told me I would've been using one for this, I would've told you you're crazy. Ha.

Indeed, life has changed! And thank you for that very descriptive explanation! I never thought about the straight type adhesive strips... I haven't seen them.

Those curved strips are really a pain, and you really got to know what you're doing there. It's like one-time use only because they're very sticky. So as far as being crazy? Aren't we all a little crazy sometimes?

What happens is you got to break the routine, mix it up a little bit, and that's why I started assembling everything beforehand.

I find it's a lot easier and quicker, and the hair dryer is a must. Briefly, I think there's a button that you can press on it for cold air instead of hot air, so you might want to try that as well.

But you know we're all here in the same boat just trying to deal with it.

Some people find better ways than others... others try to suggest better ways... it's just really trying to break the routine sometimes. You know, the day-to-day routine.

It gets boring, and sometimes you just got to mix it up.

Glad you're managing so well.

Yep. If you smell poop, there's a leak or compromised seal somewhere.

I have a colostomy. Fairly thick output with bonus turdlets... or is it turdlets? I digress.

I only clean the plastic drain ends with each empty. At work, I don't have the time to fuss much with the bag. If it gets really soiled: drain it, snap it off, and slap on a new one. At wafer change time, my stoma is fairly clean. It's kind of like a self-cleaning oven. It can be covered in poop, then a few hours later, there it is... emerging a cheery bright red from the stooly mist.

Here is a link to what I use:

https://products.coloplast.us/coloplast/ostomy-care/brava/brava-tape/brava-elastic-tape/brava-elastic-barrier-strips--straight/

A friend who also has a bag and dexterity issues recommended them, and I guess her doctor recommended them for her because her insurance covers them. I wish Hollister made something like this. I don't know if they do? Again, I cut each strip into three strips.

I use the 2-piece Hollister. What I also use, which I think are a godsend, are the Ostomy Flushable Pouch Liners. They are a fine plastic bag which fits inside the pouch. When a change is needed, just pull it out and flush it down the toilet. Insert another liner. No need to clean the pouch, which lasts for a few weeks. Change the pouch when it gets ratty looking. I also wash around the flange around the stoma with a wet rag at each change of liner. When applying a new flange, I apply Adapt paste around the hole for the stoma and rarely have leakage.

 

I use a 2-piece Hollister and I use Summer's Eve douche bottles to irrigate my bags after emptying. I also soak older bags in hot water with a dash of Color Ox, soak overnight, and hang to dry in the laundry room. I keep 4 or 5 cleaned used bags by my toilet and it's like a diaper change. It makes my supplies last much longer and they never leak. I have been doing this for almost a year and no leaks. I had a few after my surgery in April of '23. This is a learning thing, trying different products, but no more leaks for me since using the Hollister barrier strips around my wafer. This is a great site for those of us with this new way of life. Going to become a member!

Hollister does have these, I use them!

I do my husband's as he had a stroke a while back. We used to clean around the flange as well, but started to think it was part of the reason for having leaks. Now we put water in from the bottom and swish around to loosen stool. That plus lubricating deodorant seems to be helping.

I do my husband's as he had a stroke a while back. We used to clean around the flange as well, but started to think it was part of the reason for having leaks. Now we put water in from the bottom and swish around to loosen stool. That plus lubricating deodorant seems to be helping.

Really? What is the number on the box? I will look it up. Thanks.

Yes, I've heard a tattoo water bottle is very helpful for putting water into the bag, and I have been thinking about getting one.

Bag, also known as a pouch.

As Shakespeare once wrote:

A stoma by any other name would be just as sweet.

Same! I also have found that if I put some baby oil under the inside lip of the wafer where the bag connects… this keeps feces from sticking under it so badly and creating a smell. I use 2-piece Hollister as well!

I always wore a 2-piece. The flange or wafer should last 4+ days. Everyone is different. ConvaTec and Hollister say do not go a week. I tried, and my peristomal skin got raw. Used Hollister for 3 years, best pouch on the market. Easy to scrape it out and no poopy fingers. However, poor flange can leak and weaken with sweat, water, or wear. ConvaTec flange seats/seals better. However, their pouch is a pain to empty, but very durable. Poopy fingers. As per Eric the Vegan Osteomate: Put 2 tiny drops of machine oil in the slot of the pouch. I use the bottom of a Q-tip to spread it around. Always wipe excess off contact surfaces or it may leak/disconnect. It snaps closed easier. I cannot snap Coloplast closed, and their pouch is the hardest to empty. I tried one-piece, meh.

Alas, poor colon. I knew him well.

Agree. Hollister bags are the easiest to empty, but disintegrate quickly from wear and tear. I used to put warm H2O in the pouch to loosen thick output. My ostomy nurse told me to stop. It can make the loosened poop leak under the flange.

Just from my novice perusing? The best feature about the closed bag is the size—it can be much smaller than a drainable one. If you have an active day planned, don't expect to have a lot of output during that time, and/or need to wear something tighter than normal…I can see the benefits.