This topic is about dealing with leaks from an ileostomy bag, which have started happening after the development of a parastomal hernia. The person experiencing this issue is looking for practical solutions to manage the leaks, which are causing frequent bag changes and increased costs. Here are some helpful suggestions and insights shared by others:

1. Check the type of wafer and the stoma profile:
- If the stoma has retracted, a convex wafer is usually recommended. However, it can be challenging to fit over a hernia.
- A one-piece flat system might be more flexible and better at conforming over hernia bulges compared to a two-piece system.

2. Consider products specifically designed for hernias:
- The Coloplast “Flip” barrier is designed to seal over uneven surfaces caused by parastomal hernias.
- Convatec offers one-piece systems with soft wafers that mold to the contours of the abdomen. You can request samples from Convatec.

3. Use a support belt to stabilize the appliance:
- Major manufacturers provide ostomy or hernia support belts. These belts help keep the wafer and pouch secure and may also slow the enlargement of the hernia. You can get samples and fitting advice from companies like Hollister, Coloplast, and Convatec.

4. Protect and heal the irritated skin around the stoma:
- Leaks will persist if the skin remains red and weepy, as wafers cannot adhere well to such skin.
- Apply a liquid skin protectant, like Marathon or 3M Cavilon Advanced Skin Protectant, before putting on the wafer.
- If the stoma is not retracted, consider using a moldable barrier ring for extra sealing. If it is retracted, a ring might worsen the gaps.

5. Seek professional and manufacturer assistance:
- Contact ostomy-product companies for free samples of one-piece, convex, or hernia-specific barriers.
- Request to speak with their wound-ostomy nurses, as they offer free telephone consultations.

6. Follow up with surgical advice:
- Persistent leaks, severe skin issues, or a significantly retracted stoma might require stoma revision or hernia repair. A colorectal or ostomy surgeon can evaluate the situation.