Tips for Stopping Leaks

Any tips? I've tried many different products, even applying heat.

I see from your profile you have an ileostomy.  

Is your stoma sitting well above skin level, or is it flush to the skin? Flush stomas cause endless problems. 

Are there skin folds or scars that interfere with your wafer?

You said high-output ileostomy, so I'm assuming it is highly liquid. If solid, you may be getting pancaking. Liquid is its own problem. 

Are you using or have you tried using a barrier ring? 

Basic application tips:

1) Do not use oils on the skin around the stoma. Clean with plain water or plain soap followed by plain water. No moisturizer or creams. That includes barrier creams. Use only barrier wipes. 

2) Make sure the skin is thoroughly dry. 

3) Make sure all adhesive remover is washed off the skin. 

4) Re-measure your stoma very carefully. It may have changed sizes.  

That's enough for now. There's so much more that can be said, but I don't want to overwhelm you. The more you can tell us about the leaks and what is going on, the better advice we can give. 

My solution is a good surface prep of makeup pads and { for ME } 91% isopropyl all over around the stoma, really good, and let dry...

Barrier prep... Lots of it, as I would use two pads drying between applications... I used the sticky barrier ring and pushed it down well around the stoma... apply barrier pushing everything down well... snap on the bag, then push it all down with the palm of my hands...

I was able to lay on my belly and nap some... Lay on my side, I would detach some at times on the belly button edge, and there is this really sticky 3M paper tape that I would tape down that edge or any loose edge... or just change out, which I did weekly if I needed to or not...

Arnold

Hello Muffin.
My solution is to make my own baseplates to fit my stoma more precisely.
I stick them on with prosthetic glue and then stick the manufactured devices to them.
This has worked well for me for years but it took a while to perfect the devices and I still occasionally tweak them to accommodate changes in my circumstances. 
Best wishes

Bill 
PS: I also have devices that protrude slightly inside the bag/sleeve to give the output room to exit and guide it towards the bottom of the bag/sleeve.

Hi Muffin, all of these comments are really good. I would suggest that after you've applied heat to your appliance, you keep your hand pressing firmly over it for at least five minutes, more if possible. I find that this helps to set everything as it's cooling down.

My Ostomy Journey: LeeAnne | Hollister

Do you use a ring? That is what has helped me. I use a ring all the way around the hole I cut in my bag for my stoma to fit in. I apply it to the wafer rather than around my stoma. It gets too slippery if I just apply it to my stoma, and then it doesn't stick properly. I apply it to the wafer and then put the wafer on. I also use no-sting barrier film, not just around my stoma but around the whole area where the wafer is going to go. It gets sticky then, and the wafer sticks better. And that helps as well.

Hey there, the main question is: is your stoma protruding, or is it at skin level or below? Depending on how low your stoma sits, it will determine what to do or if you need a revision.

I personally know this works. Wear a belt, i.e., a hernia belt or a belt that fits your specific product. I wear a belt of some sort 24/7 and get 10 to 15 days of wear time. Good luck.

Thanks! It's above the skin and highly liquid. I use barrier rings and skin tac to help it stick. It usually leaks at the bottom or on the side where the output leaves my body. It seems to change size often.

It changes diameter, or it seems to retract at times?

My colostomy retracts to skin level when it is about to spew, so I wear a light convex wafer. Do you think this might help you?

Hi Muffin1980,

Frustrating, isn't it?

In addition to the great advice you've already received, I wanted to add that you are definitely not alone with this problem.

I find that even how I wear my appliance can influence whether or not I'll have a leak. For example, if I decide to tuck it into my underwear so that the convex baseplate is flush with my body, I'm more likely to have a leak. But when I'm at home and I can release my pouch from constrictive clothing, leaks are less likely. This way, there is more "air" allowed to circulate within the bag, giving more room around the stoma to sputter and spew at will.

My biggest problem is that my occasional, much thicker output will "lift" the entire baseplate right off its hinges when I ingest too much fiber. This output meets resistance from the pouch, and when it tries to keep growing vertically, it can only go sideways horizontally (pancaking) and escape under the adhesive strips. In my case, controlling the amount of fiber in my diet has helped a lot to avoid this.

P.S. I also have a parastomal hernia, so my baseplate adhesive strips always look a bit puckered in places, but they stand fast as long as I need them to - usually about 5-6 days.

M
xo

Marjatta, I have an ileo. And I run thick as well. When I first got my ileo, I would pancake, which is a pain, so I started putting a little air just in my bag, but only on the top where my stoma sits, not the entire bag. The trick is to put a little air, move the air up to the stoma, and have no other air in the bag. Now the stoma has room to move, and your output will go to the bottom.

My stoma is right at the belt line, so whatever I wear holds the output against the stoma. You mentioned a device that protrudes inside the bag. Could you say more about that, please? When I have a pasty output, it invariably leaks. Since the stoma is right next to the belly button, that's the direction it always goes.

Adjusting the amount of fiber intake reduces pancaking? The ostomy nurse at the hospital gave me the opposite advice. More fiber reduces pancaking. Pancaking means leaking in my situation. She has me using a supplement called Benfiber to increase my fiber intake. When you say controlling the amount of fiber in your diet, can you explain more about that?

I think the role of fiber varies by ostomy type. I'm guessing you have a colostomy because of your nurse's recommendation.

I have a colostomy, and I was using Benefiber. I was told to stop using it when my doctor placed me on a low-residue diet. The result for me was much thicker output without the Benefiber.

In general, people with colons are able to absorb more water the longer the waste sits in their colon. Fiber helps it move faster, meaning less water is absorbed and less thick output.

I'm no expert on ileostomies, but the small colon is not designed for water absorption, leading to more watery output. I'm guessing it's less about speed and more about actual content in ileostomies. Fiber will add content.

Hello Traveler.
As I have very recently learned how to post pictures I'll give it a go.

 

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This is the one I wear during the day. It's a 2 piece so the bag just clips over the top. I don't have much output so I place a piece of folded toilet tissue inside the device to catch any residual output. The bag is only for additional safety and has never had any output in it.

 

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This one is a spare, for the irrigation sleeve. The 90% bend guides the output downwards into the sleeve, which is also clipped to the device  in the same way as baseplate(1).
The following photo is the system in action. Not a good photo but I'm sure you'll get the idea. (it must be a big picture as it has come out sideways and I don't know how to change that.
It should be said that these baseplates have a tapered plastic insert that fits the stoma precisely, so that there is no output making its way backwards towards the skin.  

I hope that this provides an overview of what I was referring to in my previous post.
Feel free to ask any more questions if it is useful to you.
Best wishes

Bill

 

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The large colon absorbs water, and the small intestine is where your nutrients are absorbed. But we are in a situation where what goes in the mouth pops right back out, so with ileostomies, it's a constant battle to try and maintain a good output consistency so we can hold on to water and nutrients. So being thicker is actually a good thing for water and nutrients, but not overly thick where it's hard to get out.

I have an ileostomy with high output. I only use the deep convex wafer with c straps and a belt. I found less is better. No ring, no paste. I make sure the skin has no lotions or oils and is totally dry before I dress it. I have learned to control output with certain foods, controlled drinking times, and Imodium. I don't absorb all nutrients, so keeping weight on is an issue. But we're all different, so unfortunately, it's trial and error. You'll find good advice here, and I wish you the best of luck.

I am going to try that, Beth! Thanks for the tip!

M

xo

Hey Traveler12841,

Because I make soups with a lot of plant-based fiber (like broccoli or squash, for example), I find that my output tends to become very thick and pasty. Several hours after eating the soup, the bulk of this undigestible fiber tries to push out of my body with such force that it overwhelms the ability of the baseplate to stay put. The plate literally lifts off from the sheer force of the exiting bulk.

To mitigate this, I try to drink more fluids to water down my output and also reduce the amount of (fiber-rich) soup I eat at any given time. Doing this has definitely helped. I don't get as much pancaking, and hence, fewer leaks.

I'm pretty sure your Benefiber supplements (taken as directed) wouldn't have the same extreme effect of thick output as my homemade soups have.

It's good that you are checking out our discussion forums and questioning best practices for living with an ileostomy. I can guarantee that you will find some of the most helpful and sincere folks right here!

M

xo

Bill, what is the name and company that makes the device that protrudes into the bag to help with output exit? I think I've seen some online. Thank you, Janet

When do you put air in the bag, only before placing it?

Marjatta, I've had my ileo for about 6 months and am very nervous about eating vegetables for fear of clogging. Do you have an ileostomy? Thanks.

Hello Janfan. 

Thanks for your question.
I only wish I could answer you in a more helpful way and point you towards a manufacturer. Unfortunately, I know of none. 
'My' solution is to make my own devices. I start with a baseplate that I can attach a bag or sleeve to. Then it needs to accommodate other devices like a 90% waste-bend. or a stoma guard. Then it needs to have a tapering hole so that it hugs my stoma and no output can seep backwards towards my skin. 
Maybe someone else knows of a manufacturer that has developed such a device?
Best wishes

Bill