Seeking Solutions for Nighttime Bag Leaks

My bag is leaking a lot, especially at night. I have tried stoma paste and seals. Any help would be gratefully appreciated.

Hi Aly.  I'm sure we can offer some help but we need to know a little more about your situation. Colostomy or Ileostomy? Inney or outie? What kind of appliance are you using? Is the surrounding skin flat? All information will help us help you.  Waiting to hear from you,

Mike

Hi Aly ~ I've found that the way I lie in bed affects what happens at night. Before my ostomy, I always slept on my left side, but that's the side my stoma is now on. Because of that and the curvature of my stomach muscles near my stoma, I get leaks if I don't sleep on my right side.
As a small first step, perhaps you can try sleeping in different positions.

Hi...maybe I can help a bit...just for comparison, I am 6' 2" and 235 lbs and a long way from having a six pack. I have an outlet ileo, no hernia. I go seven days on a Coloplast 2 piece and very seldom have leaks. Here are a few procedures I follow religiously when attaching a new wafer.

1. Cut the wafer center slightly less than 1/8 inch larger than the stoma.
2. As the stoma tends to point out but downward, I size the center hole to be slightly elliptical, higher by 1/8 inch top to bottom and slightly narrower across the center.
3. Warm the wafer and the paste.
4. THIS STEP IS CRITICAL... You want the paste to melt and fill in the space between the edge of the wafer and the stoma SO roll the stoma paste between your palms until you have a piece about twice the length of your little finger. Don't flatten it, just roll it around the hole, leaving just enough room to slip it over the stoma.
5. I NEVER use soap... Just baby wipes, shave hair as needed using Coloplast dry powder, wipe clean and always apply a bit of skin protection.
6. ALWAYS tape down the outside edge of the wafer and leave it for 12 hours. This is sooooo important because it stops the wafer from moving about, it forces the paste to spread out towards the further edges of the wafer but most importantly fills the gap around the stoma. In other words, it plugs the escape route or the leak route lol. Also, it forces the wafer tight to the skin and therefore makes it stick to the skin better. If the edges lift at some point during the week, tape them down.
7. If you are wearing a 2 piece, close the bag lock and tape it... I sometimes roll over at night and if not taped, it unlocks and the bag comes off...and crappy doesn't make for happy!!!!

I use 3M Transpore tape, standard in many hospitals...best of luck.

Hi Ali, I wore stoma pouches for 6 months. Then I had to do something else because it wasn't working for me at all. I discovered (from people at the hospital) about irrigation. Irrigation has changed my life a great deal. I irrigate once a day, it's fantastic. Don't get me wrong, I have had a few problems but overcame them. I go out and eat and all the normal things I used to do. Check into this life saver. Your friend.

Hi Scotiaman, thanks for the detail on your procedure of putting on the wafer. I have an ileo and only get 2 and on occasion 3 days max from a wafer using the Coloplast also. I cut mine to fit and have never used the paste? Could you elaborate on the paste and what kind you use? Is the paste difficult to get off? I tried it once a while ago and it was messy and didn't work. The wax rings cause me to leak even quicker. Please let me know more about the paste and procedure. I want consistency to give me peace of mind while I am working and out of the house. Thanks. Penguins7

Hey Penguin, If the rings you mention are Eaken Seals, I suggest you still use a barrier film like Cavilon, make certain the skin is dry and warm the "wax ring" and the wafer with a hair dryer before applying.  Another thing that might cause a problem is the slimy stuff on the outside of the stoma.  I'm not sure but I worry that it would impair adhesion so I dry the stoma with a paper towel before I slide anything over it. Hope I'm making sense.

Mike

Hi Mike, thanks for your reply. What kind of paste were you referring to in your description and how to roll it up? I want to try the paste method so please let me know. Thanks. Rod

Hullo Aly

I have an ileo, and had a lot of problems with leaks, until I switched to a convex pouch. I use Coloplast extended wear convex one-piece, with a Coloplast Brava ring, and I get at least 7 days out of each pouch.

Good luck.

Sandi

Hey Rod, I think it was Scotiaman who rolls the stoma paste and the only rollable paste I'm aware of is the Eaken Seal or, maybe, Hollister's Adapt barrier rings.  One exception might be Convatec's Stomahesive paste that is allowed to dry then becomes formable.  

I hope I'm not confusing aly45.  

It'll all work out for all of us eventually.

Mike

Hi there... The paste I am referring to is the Coloplast strip paste sticks. They come 10 in a box and are 4 1/4 in. long. I usually snip 3/4 of an inch off, but if the flange center hole you cut is larger, you might use the entire stick. I take what is left, roll it into a ball, and then roll it between the palms of my hands to make a piece long enough to encircle the cut-out hole on the flange. (This warms it up and makes it pliable)

The next step after cleaning the skin around the stoma with baby wipes (don't torment the skin with soap or getting it bone dry, it doesn't need it) and nipping off any hair that needs removal, spray the entire area with Cavilon barrier spray (I use it for every change) and without waiting for it to dry, I slip the flange with the attached paste on over the stoma and fix it in place. NOW for the final step, and if you don't want to bother with this, you might as well forget everything I just said... TAPE THE EDGES OF THE FLANGE AND LEAVE IT IN PLACE FOR 10 - 12 HOURS... THE REASON FOR THIS IS THAT 1.. IT REDUCES THE CHANCE OF THE FLANGE MOVING AND GETTING CREASED 2. IT WILL ASSIST THE PASTE IN CONTACTING WITH THE SKIN AND THUS CREEPING IN BOTH DIRECTIONS, IE. AWAY FROM THE STOMA AND THEREFORE HELP BOND THE FLANGE WITH THE SKIN AND MOST IMPORTANTLY IT WILL CREEP INTO THE SPACE BETWEEN THE EDGE OF THE FLANGE AND THE STOMA AND SIGNIFICANTLY REDUCE THE CHANCES OF A LEAK... ALSO... IF YOU ARE USING A 2-PART SYSTEM WITH A LOCK ON THE BAG.. TAPE THE LOCK SO IT CANNOT OPEN WHEN YOU ROLL OVER IN BED OR ACCIDENTALLY HIT IT... MOST OF MY "OH CRAP" MOMENTS HAPPEN BECAUSE THE LOCK IS COMPROMISED BECAUSE I EITHER FAILED TO TAPE IT OR LOCK IT IN THE FIRST PLACE... THE FLANGE SET UP GENERALLY DOES NOT LEAK... And on the occasion it does, it's generally because I was very active, cleaning, rummaging around in the bowels of my boat, or it was very warm and sweaty. In such a case, I normally would tape it because the edges of the flange would tend to break away from the skin... Post any questions you have... I will try to answer them... One last point, I stick to the paste sticks for two reasons. The fancy barrier rings are more expensive than the paste, and in my opinion, they do not provide the volume of material that I want to fill the space between the stoma and the edge of the flange. There is no problem in removing the flange after a week. Take both hands and lift it slowly. You should not have to use any paste remover to clean up under the flange, but you might want to remove some tape glue that will stick to your skin beyond the edges of the flange... And finally, EXPERIMENT with different products and suppliers and PROCEDURES... ET nurses are great, but listen to your common sense.. From person to person, your skin properties, stoma set up, discharge flow, availability of product varies considerably.

Thanks for the lesson, Scotiaman.  I just want to remind aly45 that we're all different and, hopefully, she'll find what's perfect for her by experimenting with others' methods.

Mike