New Here, Struggling with Stoma Leaks and Feeling Helpless

I have very few issues with the physical aspect of the stoma; my goal is to just go back to my normal quiet life, but I am struggling with leaks. I think that the main issue is that I have a deep scar running vertically within an inch of the stoma. The base plate struggles with this crevice. I am currently using an Oakmed convex drainable system with a belt. No issues overnight. I'm getting up to 27 hours of wear, very rarely, but thick output gets jammed, and some seals last 2 hours because of this.

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Please excuse the photo, and if it is not allowed or offensive, I apologize wholeheartedly. This is the constant pattern. Washers make it 100% worse. Any help at all would be hugely appreciated.

Hi. Welcome. You have a good sense of what's going on.

The photo explains it all. Nothing here is offensive. Pictures tell the story. I was going to return the favor with a photo I had of mine. No reason to, because it's under control. But it looked just like yours in the past. No more today.

A barrier ring worked for me. In fact, by accident, I forgot to use one just the other night. It blew in several hours. I suggest you try a ring. Experiment with thick and thin rings. I believe you heard of Salts ring? I am a firm believer that no ring will cause immediate leakage.

I know you mentioned "washers don't work." Assuming washers are rings, then something is wrong there.

I have a permanent ileo. 9 years. Lots of trial and error here.

There's also a paste, I'm told that helps fill in any cracks or crevices. I never use that.

The flange plate you are using is similar to mine.

Noting skin and skin barrier spray must be dry before installing it.

If I read your profile right, you just received the loop ileo? So you're new to the game. But you do have a good idea of what's going on. That's awesome.

Others will chime in. You keep your chin up. It takes time to find the right set-up. Welcome, again. You are in the right place.

Hi Vev, welcome to the site. Do you wear an ostomy belt? Also, maybe try a flat wafer instead of convex. Good luck.

It looks like your stoma is on your left side and that output is coming out right where the deep scar is. Can you try putting some paste over the scar? Maybe try different rings. Hollister Adapt makes a convex barrier ring. It helped me when I had a period of leaking.

Welcome, I'll try to think along with you and come up with a paste over the scar or a piece of a soft, kneadable ring.

Words of Encouragement from Ostomy Advocates I Hollister

Just to be different... I wonder if your flange needs to be more flexible. I would try different flanges with a barrier ring. I use the Coloplast Sensura Mio and find it nicely flexible, but there are many other options. Experiment with different rings. These are made of different materials, different sizes, and thicknesses. We are very different in what we like, but most seem to agree that the right ring makes a huge difference.

Why are you using a convex flange? If it's because your stoma doesn't stick out far enough, then you may be stuck with convexity. But if it was an attempt to fix the leaks, then switch back to a flat flange. I'm not hating on convex wafers... I use them on both my ostomies, but I have a good reason.

Hi Vevs,

Hubz has a loop colostomy since August, so it's still pretty new.

That being said, we've tried almost every type of convex wafer, as this was strongly recommended for an oval-shaped stoma laying flush with the skin.

Every one leaked almost exactly like yours, moving along the crease toward the bellybutton.

Running out of convex samples, we tried the 2-piece
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Hollister flat cuttable wafer that came in the bag from the hospital and was shown how to break apart one side of a barrier ring and overlap the ends to build up the side with the crease.

It worked great, and we haven't changed a thing since. The flat flange seems to give a wider, more even adhesion to the skin while the ring fills in the space between the skin and flange right around the stoma.

The barrier ring seems to gently expand to fill in the gaps evenly, so we experimented with the various thicknesses to find the one that works best for his nooks and crannies.

The photos are of the technique we were shown to easily shape the barrier ring. After the width is doubled on one side, gently stretch and shape to the stoma. His Ostomy Nurse places it on the skin first, but we've had better luck placing it on the wafer first after warming both the ring and wafer with a blow dryer. We may not need to do this, as body heat will activate the adhesive. It really just makes me feel better!

There are so many ways to get there; this is just the way that's currently working for us!

Good luck!

Hello,

Good that you posted a photo. I don't think there's anything that would gross us out. A picture's "tell the story."

Is your convex base plate "hard" convex or soft? I recently learned about this. If yours is hard convex, you could try a soft one to see if it seals the scar area better.

Ostomy supply manufacturers provide free samples and have ostomy nurses on staff to help you. Look them up on the internet, then call them. Major companies are Coloplast, Hollister, ConvaTec, and Salts Healthcare. Medical supply distributors also offer help.

After getting an ostomy, it takes time to discover the products that will work for you. It is "trial and error."

I started out just sticking the wafer on. My stoma is oblong. It took me quite a while to cut the base plate hole to closely fit around it. I didn't get leaks, but it was uncomfortable walking around, and I developed irritated skin around the base plate hole from rubbing. Then... I discovered moldable barrier rings, skin barrier protectant, stoma powder, and support belts. A game changer for me.

Now I cut the base plate hole larger, use stoma powder to "crust" problem areas around my stoma, use skin barrier spray, put on a moldable ring... then put on the base plate (also known as a wafer). Then I wear a Nu-Hope Corp. support belt. It's comfortable, secure, and I can run around and not worry about leaks or irritation. I use the Hollister 2-piece system. Bags (pouches) snap on the base plate (wafer). So when a bag gets really soiled, I snap it off and snap on a new one.

Good luck, and let us know how you're doing.

When I get a leak, it presents itself in a way similar to your photo. I have a low spot next to my stoma. I fill in that crevice with paste. I then use a thin, foldable ring over that and around the stoma. Finally, I use a pre-cut convex wafer. I'm getting pudgy in my old age, so convex works well for me. I normally go 7 days between changes. Sometimes longer.

BTW, welcome to the group. 😀

Daniel

Filling the gap with paste is the answer.

IGGIE

I use a barrier ring also. I have a colostomy on my left side and use Hollister products. I usually use the closed-end pouches and sometimes the drainable ones. I sometimes get a rash under the wafer, and then I use a powder that my doctor prescribed for the rash.

I had a terrible time with leaks until I found the right bag. My stoma was inverted. What finally worked for me was a two-piece bag from Hollister. I also used a small barrier ring.

Try different bags until you find what works for you.

Hi!

So I have an interesting skin/connective tissue condition that makes adhering the ostomy appliance to my skin extremely difficult. I have paper-thin skin with scars running every which way. I would suffer from "pancaking" if I used a bag with a filter, and the backed-up output would blast the bag off or cause an insidious leak. My skin was sloughing off each time the appliance was removed because my skin was absorbing the adhesive. It was awful.

Now, even with a malfunctioning colostomy, I can get a week or even more out of my appliances, and leaks are practically non-existent now. I have tried so many different products and systems, and what has worked for me may also give you a little relief. I hope. 🙏

I use a Coloplast appliance called SenSura Mio Flex in light convex (deep convex actually pulls away from my skin because they're so very rigid and my skin is very fluid), stoma powder only directly around the stoma or very lightly dusted onto any weeping areas. The trick to using stoma powder and having the appliance adhere fully is two-part. After applying your powder, you must seal it with a barrier liquid such as Cavilon, making sure to coat all skin, creases, etc. The other super important step is to make sure this layer is DRY by using a blow dryer on low-warm. My blow dryer is my best friend when it comes to ensuring a great seal with no leaks. Warm your appliance and your skin before placing the appliance on your prepped skin. The adhesive surface will react to the warmth and allow the skin to adhere more fully, down into the tiny imperfections. I also use a protective seal made by Coloplast that has been a complete game changer for appliance adherence. It's called Brava Protective Seal, and this one isn't thick and bulky. It's 3 inches across and very thin, so it doesn't add bulk underneath the appliance, but it does melt and mold to the skin surface as body heat reaches it, filling creases and sealing the appliance to the stoma. You can even tear a ring into pieces and use it as putty to fill in the scar line you mentioned. I take a piece and roll it into a thin "noodle" and press these into any deep scars or creases. Make sure not to overfill these areas. Warm it with the blow dryer after you fill the crease, and the material will melt into the imperfection, making a smoother surface for the appliance. You can fill the creases AND also use a full seal if you find that you need more coverage. I roll mine out with a small clay rolling pin to ensure there are no edges to create tiny air pockets for output to escape through.

One other thing that I have noticed with getting a good seal is that it seems that the appliance will pull away directly at the stoma edge, and this is usually where a leak will occur, so I kept trying different ways to get a good seal directly at the edge of the stoma. I figured out that for me, if I place the Brava Seal directly onto the appliance itself and make sure that the edge of the seal is 1/16th-1/8th inch away from the cut edge of the appliance, there is much less retraction directly around the stoma, and it also won't swell up and potentially cover the opening or choke the stoma. This allows the ring of stoma powder to do its job and gives more room for the hydrocolloidal adhesives to swell with fluid collection, reducing the pressure placed on the stoma itself.

I really do a lot of prep to make sure I don't have leaks. I warm each part with the blow dryer before I adhere anything. I prop the blow dryer up and set it to blow onto the appliance while I prep my skin. When it's time to place the seal onto the appliance, I make sure to warm the seal first, and then I place it down onto a hard surface and use a small clay rolling pin to flatten the edges so no creases are made in my skin because these tiny creases cause air to be trapped in tiny pockets around the appliance, and this is a way for output to escape, causing a leak. By reducing any edges, you will also reduce the leaks because your skin will be more fully adhered to the appliance. As I place the appliance, I have my blow dryer on to keep my skin and the appliance warm, and once it's placed, I warm all around the edges of the appliance and my skin for about 30 seconds. I cover the stoma so it doesn't get a blast of hot air, or you can do this after you adhere the bag to the appliance.

I've tried pastes, clays, various types of barrier rings, and extended wear items from many different manufacturers, and the products that I use now are the best that I have found to solve my issues. At one point, I was using a skin barrier sheet, a barrier ring, and paste to try to heal my ulcerated skin, and it just seemed to get worse, so I started testing every product I could get a sample of to see what would actually work for me.

Don't be shy about asking companies for sample products. They are happy to send samples and have wonderful ostomy nurses on hand to help answer questions and find solutions.

I hope you're able to find a good solution soon! Leaks blow 😮‍💨

Don't be surprised when your stoma changes shape or size. I had my ileostomy in September, and I have a deep scar running through my tummy button downward that gets irritated by the bag. I use the additional ring and now cut it down to size and attach it to the bag, not me first. I found this stopped the leak. I use the powder on the skin burned by the leak, and this is helping.

The naked shower is my favorite time. Take note of when your stomach changes shape; it is least likely to be active, and it allows your skin to actually have air. I have found it is usually good first thing in the morning, but DO NOT drink tea or coffee beforehand, as otherwise, your stoma starts misbehaving!

Good luck. This site has been my savior 🤪

Hi, I have a long vertical scar about 1.5” from my ileostomy; it has settled in now after 3 months. I've developed a crevice on the side of the scar and find that if I use my barrier ring and then a quarter to a half of another barrier ring to build up/fill in my crevice to get it as flat as possible, I don't get the leaks - no idea if this is encouraged, but it works for me and my scar indent. I also do something really naughty and trim a crescent shape off my wafer on that side so I can treat my scar more freely while wearing my bag. Good luck x

P.S. I also stick my barrier rings in my bra while I'm doing my change to get them nice and soft before fitting them.

FYI, using barrier rings like this is very much encouraged. The other option is paste, but that can get messy and is not as easy to do.

Good job figuring out something that works for you.