This topic is about dealing with persistent leakage issues below an ileostomy stoma, particularly when using barrier rings that tend to "turtleneck" or swell upwards. Here are some helpful insights and advice shared by others who have faced similar challenges:

- **Wafer Hole Size**
- Many suggest cutting the wafer to fit exactly around the stoma to prevent leaks, while some prefer a small gap (up to 3 mm) when using a barrier ring. It's important to experiment to find what works best for you.
- Avoid cutting the wafer or ring too tightly, as this can restrict blood flow to the stoma.

- **Barrier Ring Selection & Use**
- Consider using a slimmer barrier ring, like the Hollister slim ring 8815, to reduce swelling and maintain stoma projection.
- Salts barrier rings are highly recommended for their adhesive properties and minimal turtlenecking.
- Stretch the ring to fit the wafer hole and press it firmly for about 30 seconds. Some find warming the ring with a blow-dryer helpful.
- Position the ring slightly back from the wafer edge to allow it to expand inward rather than upward.
- Ensure the ring is wide enough to prevent it from climbing the stoma.
- Some people place the ring on the back of the wafer and press it into the hole to prevent migration.
- Stacking rings or using Coloplast "extender C strips" can provide extra leak protection.

- **Alternative Products & DIY Options**
- Convatec moldable wafers can be effective for runny output, though they may require more cleaning.
- Some users modify products like the Coloplast Assura irrigation press plate for better fit and protection.
- A few have found success by eliminating rings and using custom-shaped baseplates with prosthetic adhesive.

- **Belt, Heat, Pressure & Wear-Time Tips**
- Wearing a tight belt can help flatten rings and extend wear time. Some wear belts continuously, while others only during the adhesion period.
- Warming the wafer or ring and applying firm pressure can improve adhesion.
- Using a low-heat blow-dryer for a final pass can enhance the adhesive bond.
- Clear pouches allow you to monitor stoma movement and detect early seepage.

- **Convexity & Body Shape**
- Soft or light convexity can be beneficial if the stoma is in a dip. Ensure the wafer follows the contours of your abdomen.
- Be mindful of creases or rolls that may open when standing or bending, and adjust belt tension as needed.

- **Danger Signs & Cautions**
- Be alert for signs of restricted blood flow, such as discoloration of the stoma, and remove the appliance immediately if this occurs.
- Monitor for skin reactions to adhesive extender strips, as they can cause allergies.

- **General Encouragement**
- Understand that there is a learning curve, and it's helpful to document your experiences and make changes gradually.
- Communicating with stoma nurses and fellow ostomates can aid in problem-solving.
- With the right combination of wafer size, ring type, heat, pressure, and belt, many users achieve 3–7 days of leak-free wear.