Help Needed: Barrier Ring Swelling Issues with Colostomy Bag

I was recently released from the hospital after having a colostomy bag installed. While in the hospital, I could get 3-4 days out of my bag and never had issues with my barrier ring swelling. After being home, within one day after changing my bag, the barrier ring swells excessively and into my bag. I follow the same guidelines as what I was taught in the hospital. Very frustrating… I was given Hollister 89311 bags and 8805 barrier rings… please help, going through supplies way too quickly. Should I make the ring really flat, leave it thick??? I'm a larger gentleman with an oval-shaped stoma… any advice would be greatly appreciated… very nervous 😟

You may be cutting the hole too big. Your stoma will change sizes frequently during the first 6 weeks or so. The measurements that worked in the hospital are likely too big now. Remeasure at every change until your stoma stops changing. There should not be more than a 1 mm gap between the wafer and the stoma.

While that is going on, call the major manufacturers of ostomy supplies and get samples. Make sure to get samples of barrier rings with appliances. There is a wide variety of barrier rings, and they act differently. I use the same barrier rings that you are using, and they do swell a lot. I like that, but you might prefer a different ring.

Hi K, before I put my ring on, I cut through one side so that I can wrap it around my stoma at the base, and then I press it down onto my skin. Then, I put my wafer on and press that down all around my stoma. I use the Brava thin seal from Coloplast but use Convatec pouch and wafer.

Welcome to the joint.

Kudos to you and your hospital for being taught how to do a bag change. The majority of us left the hospital clueless. So you had decent training.

The 8805 ring is the thicker one compared to the 8705 ring.

I use the 8805. As an ileo, I highly recommend it. You should not need to flatten it. Nope.

Do you wear a flange belt? It attaches to a mounting plate, or as bags come with loop holes, their belt also works. You have to have a bit of pressure on these appliances to add to wear time. Most here will agree on that. A belt works and helps seal you up. 💯👍.

It's true what others have said about your stoma reducing its size. I think you have that going on. My ring does a super job sealing for almost 7 days.

As a colostomy patient, you should get that wear time or more with proper sealing.

Stick with us. Others will chime in. Good to have you. 🖐

Hi KDC,

I think we need more information. When you say your ring swells into your bag, I'm not sure what you mean. First, if you have a colostomy, your output shouldn't be that liquidy that it would cause your ring to disintegrate. Is it very liquidy? If you mean your ring expands around your stoma so you can see it through the outer side of your bag, that's something else. So is it expanding or disintegrating? I'm assuming your stoma sticks out past your skin. If not, please let us know. Assuming that, your ring should fit snug but not too tight against your stoma. Your barrier (bag) should be cut just a little bit bigger than that. I'm talking a millimeter bigger all around, not 5mm. If your stoma sweats, meaning it is more than just moist, then your barrier/ring is too tight, and you'll get a LOT of sweat off your stoma that will foul up your barrier and turn it into a goopy mess. Lastly, how long were you on solid food in the hospital to make the claim that your bag was lasting 3-4 days? In other words, how many times did your bag last 3-4 days, and was this consistent? Sorry for all the questions, but the more info you give us, the better we can figure out what's going on.

;O)

My Ostomy Journey: Keyla | Hollister

1) Are you getting leaks from your issue?
2) Do you have to change your setup because of this, or do you think you have to change your setup?
3) Barrier rings are made to deal with moisture, so they do swell and, for some, they literally fall apart because of how toxic their output is. With a colostomy, you shouldn't have the falling apart issue, but they do swell; mine does to some extent each time I put on new stuff.
4) Don't listen to anyone that tells you you should get a specific amount of time from a setup. Each person is different in how long they can go between changes and how hard they are on their bags.
5) Having a colostomy is more forgiving on how close you need to cut your hole, especially using a barrier ring. I cut mine with plenty of room and let the barrier ring fill in; it's more comfortable for me.
6) It's all a learning curve. Find what works for you and only use others' advice as a guideline and not the gospel on ostomy care. Good luck.

Are you putting the barrier ring on the edge of where you cut the hole? If you put it back a fraction away from the hole, then when it expands, it should be less of a problem. I do flatten mine out a little by pressing down the edges on the outside of the ring and making sure it fits the inside of the ring a tiny bit away from the hole. That way, it has room to expand, but it doesn't have to take over.

I had a problem with turtlenecking when I left too much space around my stoma. Hollister has a template for oval shapes you can print out. The new template I made for myself shows no skin around my stoma. A little turtlenecking, so I use Adapt lubricant (1 tsp.) at the top of my bag, which keeps the bag from sticking. I use hydrogen peroxide (1 tbsp.) in the bottom of the bag for deodorant. I use 7805 barrier rings as I found the 8805 too squishy.

Hi and welcome 👋

I have a colostomy for about 17 months and use Hollister Adapt Cera Ring 8815, which is a slim ring. Slim rings work better for me. I sometimes get the turtleneck effect where the ring swells up around my stoma.

I do not change my appliance when this happens as I do not experience leaks or irritation. You are so new to this; you will learn to relax if things aren't perfect. I remember when I was first home from the hospital, I went through a ton of supplies in a few days. It takes time to get comfortable with all of this. Give yourself grace and take deep breaths. We have all been there!!!

Yes. Things are different between ileostomy and colostomy. I'm an ileo, so my experience will be different from yours since our outputs will be different and how the various products work together will be too. Plus, as has been said here, everybody's body is different, so it will be trial and error to figure out what works best for YOU.

Definitely, your stoma will shrink every day after surgery for several weeks, so keep re-measuring each bag change; that's critical. Also, I had the same issue after discharge - I think diet and activity levels affect your wear time. Once you're home, you're more active than being in a hospital, so things wear differently.

Everyone here is very helpful, and their advice has helped me a lot to adjust to my new normal.

Lastly, give yourself grace on everything that's going on. You've had a lot happen, and it's a lot to adjust to, but you'll get there, I promise!

Good luck!

Thank you… If I could get 3 days before changing my ostomy bag, I would be tickled to death. Daily has just been so stressful and a constant worry about it…

One thing I had to learn (especially as a guy vs. a gal) is having a “go bag” that has extra ostomy gear to make an emergency change, a change of clothes (T-shirt, underwear, and shorts - just in case - you'll thank me later), and a few small towels (in case of a leak). I take it with me every time I go out so I have the things I need to handle a leak or other issues that may come up.

Hopefully, one of the ostomy companies (or the hospital) will send you a little bag to hold your ostomy supplies - it's very useful and is like a small toiletries bag that you put in your go bag.

Get and use the extender seals until you gain some confidence and good wear time. These are U-shaped seals that go on the outside of your wafer, and 2 of them will go all the way around. This gives you a little more security and more time to catch a leak before it gets out of control.

Then wait to change until it is actually leaking.

If you are experiencing actual leaks every day, you need to see the ostomy nurse again. There is something wrong with your setup. Things have changed from the hospital, such as your diet, your output amount and consistency, how much you move around, and the actual manner of movement. There are a lot of variables that could be causing you problems.

You should be able to schedule your changes and not be responding to leaks every time. Don't worry about how long it is between changes right now. Get to the point where you can take control and get it on a schedule. That will do wonders for your confidence.

Thank you very much. It's hard when they release you from the hospital with only one real training session… Then I am on my own. I was able to make an appointment with a local ostomy clinic, but it takes a week to get in…. I'm counting the days so I can really get some good advice and someone who can look at me and make suggestions. I've lost 35 lbs since being in the hospital, have an odd-shaped stoma, and a deep skin crease on the lower left side, and that's where the issue keeps happening. I've gotten past having the bag as long as I can get proper training and advice on perhaps different products and techniques… one day…. Again, thanks for listening and sharing; it is very much appreciated. There's not much help where I live for a real ostomy nurse…

That deep skin crease is definitely your problem. That is the kind of thing that will be worse when you move around more. There are techniques for dealing with that, and the nurses should be able to get you on a path toward a secure seal.

I'm so sorry you are dealing with this, and they didn't do a better job getting you trained before you went home. There should have been a prearranged appointment for follow-up.

Hang on. It will get better.