Topic Explanation
The forum discussion centers around a new ileostomy patient experiencing leakage issues around the wafer sooner than expected. The patient is using a Hollister 2-piece system and has been changing the wafer almost daily due to excrement getting between the paste and wafer. The patient is seeking advice on whether more paste is needed or if the stoma does not protrude enough.

Advice and Insights

1. Use of Barrier Rings Over Paste:
- Many users recommend switching from paste to barrier rings, such as Hollister CeraRing, Adapt ring, Coloplast Brava moldable ring, or ConvaTec Eakin Cohesive Seals. Rings are generally more effective than paste in preventing leaks.
- Apply the ring directly to the skin around the stoma, ensuring it fits snugly against the stoma.

2. Cleaning and Preparation:
- Clean the stoma area with unscented, non-moisturizing soap like Dial, Ivory, or Cetaphil bar soap. Avoid soaps with fragrances, lotions, or dyes.
- Use adhesive remover wipes to carefully remove any residual adhesive. Ensure the area is thoroughly cleaned and dried before applying new wafers.
- Avoid using hand lotions or certain shampoos and conditioners that can interfere with the wafer's adhesion.

3. Application Techniques:
- Warm the wafer by holding it against your stomach before applying it to ensure better adhesion.
- Consider using a support belt to secure the bag and wafer, especially after a change. Hollister and Nu-Hope Corporation offer various support belts.
- When applying the wafer, hug it for at least 30 seconds to ensure it adheres well.

4. Monitoring and Adjustments:
- Regularly check the fit of the wafer and adjust the size as the stoma may change size over time.
- If experiencing leaks, take the barrier off before it starts leaking to identify the source of the problem.
- Ensure the stoma does not retract below the height of the ring and barrier, as this can cause leaks.

5. Additional Tips:
- Avoid letting the bag get too full, as this can cause output to push up around the stoma and lead to leaks.
- Be mindful of gas in the bag, as squeezing it can force gas between the barrier and skin.
- For those with limited dexterity, consider alternative methods for managing the bag, such as