Ostomy Questions

Hi,

I've been using this site for a while now and have had a temporary stoma since June. I have a few questions, please, that I've been dying to ask someone, and now is the right time. I've been finding it hard to cope at times.

1. I use a Cera ring with a drainable convex wafer (Hollister) as I was getting really bad leaks constantly. This was about two and a half months ago; all has been good until today. Before the ring, I was changing my bag twice a day; now it's every other day. Today I had a leak that was quite bad. Why did it suddenly leak? I noticed over the last week or so small amounts of output under the wafer but no leak. The only thing I think I did differently was shape the ring perhaps a little too small?

2. Am I right in thinking that you need to cut the wafer much bigger than the ring? My stoma is 32mm, and my nurse says to go for 34 or larger. I've stuck with 32, as 34 seems massive.

3. Are bags REALLY waterproof? If I change my bag, I shower without a bag on every other day; otherwise, I try to keep the bag dry.

4. Does putting on weight contribute to the fit of a bag? I'm very aware I've put on weight and wondering if this is a factor for me.

5. Is it okay to wear a belt or wrap at night? I wear mine during the day, but when I'm home, I usually don't.

Thanks in advance; I would be grateful for any help. I feel so helpless at times, and when I get a leak like today, out of the blue, it really bothers me.

I've tried over 20 brands of bags and found “SALTS,” the oldest ostomy company in Birmingham, a big game changer! Go for the BE Confidence drainable bags and use two Coloplast Brava XL tape extenders on either side! This is the best combo I've found for a leak-free life! I also bought a long bolster pillow from Dunelm, about 4 feet long, and use it in bed vertically to tree hug it and cock my leg over to take pressure off my bag if I want to sleep on that side (left).

Hope this helps! 😊

What type of ostomy do you have?

Hello Jezal

Different people have slightly different setups; my bag hole is minutely smaller than my stoma, and the ring is minutely smaller than the bag hole. It's just the way I do it. An exposed ring will erode very quickly; the ring needs to be between the skin and the bag for longevity. It's just a trial-and-error thing.

Are you sure your skin is completely dry before applying your setup? Are you using something in the shower that causes poor adhesion to your skin? Sometimes output will weep slightly under the ring but not leak; it is designed to absorb some output.

Don't worry about getting the bag wet; it's a pointless exercise. Just hit it with the hair dryer and move on; it's designed for showering and swimming. I wear a 1" belt that comes with the bag 24/7 because I prefer to. Gaining weight usually increases the diameter of the stoma in most cases. You don't specify if the leak is always in the same place. It appears you had a handle on the setup with no skin issues, but something has changed.

All good suggestions. Re: skin. Make sure the soap you are using does not contain oil. I personally use Dial or Ivory. Good luck. Keep us posted.

Avoiding Ostomy Bag Leaking | Managing Ostomy Leaks with LeeAnne Hayden

Colostomy

Thank you so much for your invaluable advice. My nurse is okay, but it's people like you who've had this experience that really know what's what. The leak is always in the same place, towards my belly button. At its worst, it was always here too. As you can imagine, it's hard to get a seal on this side. I just use pure soap in the shower too.

Thanks very much once again, Axl. You're most kind!

Thank you, Riva. It's kind of you to reply. I just use pure soap.

I have an ileostomy and have had leaking issues from the start. Hollister bags were one of the culprits—I prefer all of their other products, but I switched to ConvaTec bags. You can go to their site for free samples, but I found it more helpful to speak to a representative so she knew more about my issues and ileostomy in general. I apply a 4x4" sticky pad, which I cut in half before cutting the hole, before my ring. I tend to leak on the right side, so I fold the ring in half and double it in thickness before placing it on the right side. During the process, I use Dial soap, then a water wipe, powder, Skin-Tac for extra adhesive, and paste. I cut any holes the exact size of my stoma, as I was told that bigger holes could lead to leakage. Do you have access to a stoma or wound care nurse who can help with troubleshooting? It takes time to find your routine, but hang in there...things will get better!

Thanks very much, Heidi. I would never have thought to fold the ring in half!

I disagree with the advice to cut your wafer larger than your stoma. It sounds like you haven't been doing that, but if you have, then stop. There can be a small gap... like a hair's width, but 2 mm is ridiculous.

The ring should be snug against your stoma. I don't think it's possible to make it too small. My colostomy stoma changes size and shape quite a bit. If it is on the larger side when I change it, I wrap the ring very tight and almost choke it a bit to ensure I have coverage when it shrinks and retracts. This has helped with some sore skin I was getting.

Try different rings; you should be able to get 3-4 days with a colostomy. Salts is supposed to be very good, but we can't get it in the States, so I don't know. But there are plenty of options.

Hollister's wafer is fairly rigid. You might benefit from a more flexible wafer. This is particularly true if your weight is impacting the fit.

I wear my belt to bed. I only take it off to shower and change appliances. I want my belt to help prevent my hernia from getting worse. I can't predict when I might have a hard sneeze or a sudden coughing fit.

Your bag really is waterproof. I have a urostomy in addition to my colostomy. The urostomy bags are made of the same materials. If it is good enough to hold in a corrosive liquid like urine, it won't care about a little water outside.

Susan, thanks for your advice! It's kind of you to reply. I really felt like cutting the wafer larger was counterintuitive. I'll keep it small as you suggested. The advice you've given me is detailed, and I appreciate it. I'll try getting it wet too!

What type of colostomy do you have?

I've had a sigmoid colostomy for 3 years. Never had a leak or bag blowout. I use a Hollister 2-piece system with a Coloplast Brava ring under the wafer.

I change bags whenever they get really soiled. Change the wafer every 10 to 12 days. Skin around my stoma looks great.

I shower with the wafer/bag on all the time. Doesn't affect wafer adhesion.

I cut the wafer hole bigger than my stoma, leaving space all around it. My stoma is oblong. I cut the wafer hole 44mm x 55mm (1.750 x 2.165 inches). This leaves about 2.54 mm (0.100 inches) clearance around my stoma.

I cut the moldable ring through one side, then straighten it out like a long ribbon. After stretching/molding it, I attach/stick the ribbon around my stoma, right where the stoma meets the skin.

Then put on the wafer. The moldable ring is visible through the wafer hole when looking at the stoma. The ring swells a bit, creating a good seal.

I have a mild parastoma hernia and wear a Nu-Hope Corporation support belt all the time. So far, the hernia has not gotten bigger.

Everyone is different. You have to experiment to find out the products and techniques that work for you. I started out cutting the wafer hole very close to stoma size and didn't use a moldable ring. After a few months, I discovered pressure from the hernia support belt caused the bottom of my stoma to get damaged. Sitting down pushed my abdomen upwards, rubbing the wafer hole against the stoma as the support belt held my wafer in place. Cutting the hole larger and using a barrier ring has alleviated this problem.

Some great replies here and a good reminder that each person finds the setup that works best for them. Here's ours!😊

Hubz's surgery was in August and he has a loop colostomy that is oval-shaped, flush with the skin but comes out to visit occasionally and is placed to the left of the belly button just above where the dip is.

Convex wafers became the automatic recommendation, and samples from various manufacturers came rolling in, but we got nothing but pancaking and leaks.

After working with the Ostomy Nurse, the flat wafer gave more even surface adhesion between the stoma and the belly button, and along with a barrier ring that's pulled apart and overlapped to add thickness on the belly button side, all has been good (knocking on wood right now).

Photos show the technique we were shown to create more thickness on one side of the barrier ring. Once the ends are overlapped, the ring is gently stretched to fit around the stoma opening on the wafer, heated by a blow dryer, and attached to the wafer before placing it on the skin. Some folks place the ring on the skin first, but because his stoma sits below skin level, it's easier to attach to the wafer first.

The other adjustment came from a suggestion on this site to use Cavalon barrier spray over any stoma powder needed for crusting.

The last adjustment to prevent output from pushing out sideways under the wafer was to force a layer of trapped air inside the bag to give room for output to get to the bag. The filters worked so well to pull air out of the bag that output would run into a wall of pressure caused by the vacuum in the bag. We use a piece of waterproof tape over the vent to keep that cushion of air in the bag.

Hollister 2-piece, drainable pouch with medium thickness barrier ring, flat cut-to-fit wafer. Also used wafer extenders but don't
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seem to need them now.

Wow! Thanks for attaching the photos too! There's a lot to try here, folks. I appreciate all the great advice, especially seeing what works best for me. You kind of think it's one size fits all in terms of approach, but it isn't!

Also, hubz had the same concern about showering with a bag on, but after great advice from this site, he showers all the time with it on. He lets it air dry, but we're in a warm, dry climate.

I am going to Dunelm tomorrow 🤓🥳

When I cut my appliance, it is a dime's width from my stoma. I was cutting it bigger at first, and my skin was getting burnt. If you are using a ring, put it around your stoma, not on your appliance. I have a loop colostomy, and my stoma is oval-shaped. Hollister has a printable template on their website that I used to get a close fit. Once I get everything on, I hold it tightly to my stomach for about a minute to make sure I have a good seal. When I shower every 2 days, I remove everything, as I found that if I leave the bag on and the appliance on, I get an itchy rash no matter how fast I dry it. The only time I wear a belt is when I go out or am doing more strenuous housework.

The only leaks I've ever had are right in that spot. I'm pretty sure it's from pressure while sleeping on my side, and it kind of creases there, if that makes sense. The most comfortable and usually longest-lasting setups I have are when I cut the hole a bit bigger than my stoma. I line that cut hole with a barrier ring and then apply it all at once. The barrier rings usually swell a little and fill in the gaps. I really don't pay too much attention to it unless I really mess the placement up and get some of the setup on my stoma. Then, my OCD kicks in, and I've got to change it right then.

Thanks, Kyle. This is pretty much what I do. I was told to hold it in place for 5 minutes. I found the same thing with the rash!

Just warm your bag and skin up with a hair dryer on hot, and when you slap on the bag, run the heat around the outside of the flange! It's much better than holding it with your hand, and it activates the adhesive more and makes it stick much better! A big game changer for me! 😊