Help Needed - Ostomy Appliance Leakage with Recessed Stoma!

My mom has a recessed stoma which is situated in a crease in her belly. No matter what I have tried, her appliance keeps leaking. I'm using the Hollister barrier rings and it helps but it doesn't stop the leakage. I use half of a ring to mold into the creases on both sides of the stoma and then I apply a whole ring on top of that. Then I put the appliance on top of that and use a hair dryer to warm everything up to get a good adhesion. Her stool still gets under the bag causing pancaking which causes the appliance to leak. I don't know what to try now. The appliance she uses is a flat one piece. I don't know if posting a picture of her stoma is allowed on here. I'm new. Her stoma nurses are not any help. I've had to teach them what I've learned on how to care for her stoma. Any help would be appreciated. Thanks.

I think you are going to have to go with a deep convex pouch. I have an almost flush stoma. I used a flat pouch for about 25 years with no problems. I suddenly developed leakages...no rhythm or reason. I went to a wound center for the burns...then a series of tests. I had another stoma nurse use this on me and have been using it ever since. Hopefully you will find this to be helpful. I find the Convatec to work best for me.

I used to suffer from leakages too, but I am now in a deep convexity pouch (I use Coloplast Mio Sensura one piece). I also have a little dip on the left side, so I use a piece of Coloplast Brava Strip Paste and then apply a Brava ring.

I can't say that I have totally stopped leaks, but now they are less often (maybe one every 3 months or so).

You can upload a pic too.

Brenda

I was also having leaks and switched to Coloplast Mio Sensura (deep convex - 60). I use the two-piece. Also, what made a big difference was switching from the moldable ring to Coloplast's protective ring (12035). I have also used the Brava strips (half-moon looking ones) to add an extra layer of protection. This has made a big difference. I hope this is helpful.

I totally agree with Schatzi! I'm not entirely sure what the real difference is between the moldable ring and the "protective" ring (other than being able to get it cut to fit) but it makes a huge difference.

Since my last surgery, I no longer have to use the deep convex and have graduated to the regular convex. I do know that there was a sweet spot for getting the skin to clear up as well as it was going to - changing every day was worse, every other day was okay, and any more than that was a disaster. Think about it, with the stoma so close to the abdominal wall, the skin just can't get dry enough to heal. It's really important to keep the consistency rather pasty - too liquid, it seeps right through. I tried everything to help that and the only thing that works is pretzels with applesauce. A lot of people use marshmallows and other things, but it's a real individual thing.

Good luck, I know leakage is frustrating, but you'll happen onto a combination that works for you. V

Tips on Hernia Prevention with Collin | Hollister

Thank you everyone for the advice. Her case manager called and let me know that an ostomy nurse was going to call to make an appointment to come and see my mom. The ostomy nurse says she wants to try a convex appliance. I asked for that two weeks ago but was told by the nurse she had back then that that wasn't what she needed. I feel vindicated now. After reading different posts on this and other websites, I knew this was something we should at least try. I asked for a different nurse because the one she had just wouldn't listen to us. She knew best. Well, she still leaked. I hope the convex one works. Thanks again!

Yes, go with Convex!! I use Convatec moldable and an Eakin ring around stoma and in the bellybutton area and the area that dips and folds. Does the trick. Prep skin really well too.

I had this problem... I had to switch to a one-piece bag that was flat instead of the two-piece.. then we used half a ring around the hole and a thick layer of paste around the very outer edge of the wafer right before the removable adhesive parts... worked perfectly for me

I haven't gotten the convex pouch yet, but they are on order. I think the other problem is the consistency of my mom's stool. It is the consistency of wet cement. It gets under the pouch and lifts it away from her skin, causing leaks. Sometimes I can get 16-18 hours out of her flat pouch, and sometimes I only get a couple of hours. I notice her stool is really thick when it only lasts a couple of hours. If it's more liquid, then the pouch stays on longer. Any suggestions on how to keep her stool a little less solid? She's already on a stool softener and Milk of Magnesia. She's also on Tramadol, which I'm trying to wean her off of. Any help would be greatly appreciated. I feel like I want to scream every time the pouch leaks. Thanks.

Apple juice, grape or even prune juice. Applesauce maybe. Drinking a generous amount of water is always helpful.

I have this problem also. I find things that help - definitely a convex appliance. I use Hollister 1 piece. I use paste and I cut a piece of the pliable ring and put that in the crease with paste. My latest trick is adding a piece of medical tape to the side where the crease runs to my belly button. So far, this has really made the difference.

I find the more liquid output gets under things worse but I know everyone is different. It really is a trial and error process until you find what works for you. I get my advice from here and Internet googling. I have even watched YouTube videos to learn how to use products. My home health nurses were nice and tried to help but were not that knowledgeable about my issues.

Good luck!

I find the same with my mom's ostomy nurses. They try to be helpful, but I've found more answers here and on YouTube than they have been able to provide. Thanks for the advice.

Hello everyone! I have an update. I finally have gotten the Coloplast Mio Sensura deep convex 2 piece pouches and they work great. Thanks to all of you for all of your advice. The first time I used the pouch it lasted 60 hours before leaking. I had used two pieces of the Adapt CeraRing to dam up the two creases. The next time I changed it I did the same thing but then I applied a whole Adapt CeraRing on top of the two partial pieces. This didn't work as well. It only lasted 22 1/2 hours before it leaked. I figured out that the ring expands and blocks the hole in the wafer pushing out the side of the wafer so it leaks. I think the moldable barrier rings only work well on a regular stoma. Because my mom's is recessed it ends up blocking the hole in the wafer. That might be why Coloplast's protective ring works better than the moldable one as two people said on here. I might have to try that at a later date. I have returned to using just the two partial pieces in the creases and it has been almost 3 days since the last pouch change. I think I will stick with this method until it doesn't work. Then I will try and get some Coloplast protective rings. Again, thank you for all of your help.

That's great news that you found a method that's working. Three days is a good start, I'm sure as time and experiments continue you will get to five or more days.

I too had a decreased stoma when I went through revision surgery. I was lucky. You should try a two-piece system. Plus, they have putty that you can fill in the creases. Hollister has deep convex oval rings that are fantastic. Also, I had a problem with my stool. I started taking Docusate Sodium stool softener three times a day. Man, it did the job. Of course, I bought the generic brand. They can be costly. I'm sure you know about getting samples from companies. Maybe you can find the perfect fit for your mother. Good luck.

I wanted to thank everyone here for all your help. I was able to stop the leakage and go a week before changing out the wafer. If it wasn't for the advice I got on here, I don't think I would have been able to resolve the issue. Unfortunately, my mom lost her fight with colorectal cancer last Saturday. We both appreciated the help we got on this forum. Thanks again.

Oh Jedijules, I'm so very sorry to hear about your loss. She was blessed to have you there helping out. I hope there are wonderful memories that help you and your family find peace.

Blessed be,

Vicki

I am so sorry for the loss of your mother, jedijules.

I am happy that you found help on this site.

Hi Jedijules,

My condolences to you and your family in the loss of your mother. May she rest in peace.