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Jun 30, 2025

Preventing Blowouts: Tips and Advice Needed

This topic is about preventing colostomy bag blowouts, which occur when the contents of the bag escape at the edges, often after starting a meal. The person experiencing this issue noticed that their output became too profuse and soft, causing the seal to fail. They are looking for ways to prevent this, including dietary changes and other adjustments. Here are some helpful tips and insights:

1. Empty before trouble starts:
- Always empty your pouch just before a meal and whenever you notice a sudden increase in output. Ignoring a rapidly filling pouch can lead to problems.
- At night, many people with ileostomies find it helpful to empty their pouch before going to sleep to prevent blowouts while lying down.

2. Keep the pouch light and gas-free:
- Consider using devices like the Osto EZ-Vent to release gas as needed.
- Wear looser clothing while eating to avoid putting pressure on a filling pouch.

3. Check appliance wear time and fit:
- Blowouts or leaks can be caused by poor adhesion, an uneven surface around the stoma, or a retracted stoma.
- If issues persist, try shortening the wear time, using a different wafer, or adding supporting products like flange extenders or C-strips.

4. Barrier rings and seal upgrades:
- Some people find that using Hollister CeraRing Adapt barrier rings helps prevent leaks.
- Make sure the ring is warmed and molded tightly around the stoma with each change.

5. Diet and output thickening:
- If your output is too thin, try including binding foods like bananas, peanut butter, white bread, or marshmallows in your diet.
- Eating 3-4 marshmallows or taking loperamide/Imodium about 30 minutes before a meal can help slow output.
- Identify and limit foods or supplements that trigger issues, such as peppermint-oil capsules in this case.

6. Appliance size and emptying frequency:
- If your pouch fills quickly, consider using a larger-capacity pouch.
- For high-output ileostomies, emptying six times during the day and once or twice at night is common. Colostomates may need to empty less frequently but should do so when the pouch is 1/3 to 1/2 full.

7. Miscellaneous practical tips:
- Always keep emergency supplies on hand, especially when traveling.
- If you experience repeated failures, take photos of the leakage pattern to help stoma nurses identify the underlying causes.
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