Using Barrier Rings with a Flat Stoma: Advice Needed

Hi all,

For those of you that use convex pouches and have a flat stoma, do you use a barrier ring? I've used them for years but am wondering if it makes things worse if you have a flat stoma. The rings are flat CeraRings by Hollister. I do rinse with each empty, and I tend to empty quite often due to the pancaking making things feel yucky around the stoma area.

My stoma is irregularly shaped and half innie & half outie (having revision surgery on 3/5/24). I have to use the convex barrier and use the 2-piece Hollister. I also have to use the wax rings and use Coloplast Brava; otherwise, I have leaks. Hopefully, this surgery will fix that!

Thanks for sharing your experience. I'm half tempted to try without the ring but afraid I might leak around the stoma area. I was also thinking maybe the ring is adding too much room under the wafer, making it further sit in.

Hi Hi,

The answer to your question really depends on your specific stoma. You're right that using the ring will make everything thicker, but if your stoma shoots straight out that won't be a problem. If your stoma shoots off-center or to the side, it probably will. What you need to do is measure the thickness of your barrier and ring before you put it on. Then when you take it off (in however many days you get out of your setup), measure it again. That will tell you how much the combination has grown in thickness as it swells during use. What you'll find is that the barrier swells more than the ring, which might lead you to believe you can get away with no ring if the combination swells to a height that is higher than your stoma. But you need to know the ring swells faster than the barrier. That's important if you don't cut your barrier hole small enough to be really snug against your stoma, which you really shouldn't do. If you leave even the smallest gap around your stoma and use the ring to be snug up against your stoma, you're instantly protected from liquid output, as the ring swells very fast. If you now leave out the ring and there's any gap between the hole in your barrier and your stoma, output can get in there before the barrier has had time to swell and you'll develop a leak. What I do, because my barrier swells a lot, is I use a rolling pin and flatten my ring until it's really thin. I cut it so I can then wrap it tightly around my stoma and then put the barrier on. Note that Hollister makes two size rings: a thin 4" ring and a thick 2 1/2" ring. I'm using the 2 1/2" ones now, which I flatten, but have some of the thin 4" rings on order.

So, depending on the direction your stoma shoots and how much your barrier and ring swell, you should be able to figure out what combination of ring, flattened ring, barrier, or only barrier is what you need. You dig?

;O)

I used one when the ostomy nurse wanted me to try convex bags, no issues with the ring. Went back to flat bags and a ring.

My stoma is flat and I use convex Hollister 2 pieces...

Rings made things worse for me, as they sort of melted away instead of helping things stay put...

Hibiscus, we all have different experiences with using the ring. I have more of a flat stoma; so changing from a flat wafer to the convex was a game changer for me. Don't be afraid to try for yourself to find out what works best for you.

Thank you for all of this very descriptive and informational reply.

I rinse, so I notice mine are melting away as well.

I rinse nearly every time I empty and slosh the water around all over my stoma area, no melting of the barrier ring. 🤷‍♂️

Must be that Nebraska water you got... corn filtered and all! The crap the rest of us have for water eats those rings up! If we drop one in a glass of water and check on it in a few hours, we can't recognize it.

;O)

Interesting. When I change my stuff, the ring comes off with my bag as one solid piece with no apparent amount missing from being exposed to water/rinsing. 🤷‍♂️

You know, my ring will be there when taking mine off as well, but it's the parts that are closest to the stoma that are melting, I do believe. I will see pieces of it in my bag. I wear a clear bag so I can see them, and they do stick to the bag. This also makes me wonder how good this can be on the plumbing if some pieces make their way out into the toilet on a daily basis.

I have a small stoma 1/2" around and less than that tall, having revision in April. My output comes out the side at skin level and I have been using Hollister 1 and 2 piece soft convex with their 2" Slim CeraRing™ Barrier Rings #8815 and it was doing really well until my stoma shrank more from stenosis, I think they call it.

I used to bury your ring for Hollister for a year when on vacation, and it just melted away in the heat. One of my ostomy nurses suggested I try without a ring completely, as I found it just messy and coming apart. I haven't used one since, and I have never had a problem with leaking, and it's much cleaner for me. So I just put the flange right on with no barrier ring.