This topic is about managing leakage and skin breakdown for someone with a nearly-flat loop ileostomy. The person is experiencing issues with liquid output seeping under the barrier ring, which is causing skin irritation and pain. Here are some helpful tips and advice to address these challenges:

1. Use a sealing washer that fits snugly around the stoma, such as Hollister #8815 thin ring or Eakin rings. Make sure the wafer opening is slightly larger to prevent it from rubbing against the stoma.

2. Ensure each layer—skin, powder, barrier, and wafer—is completely dry before applying the next one. Instead of using a hot hair-dryer, gently warm the wafer with your hands or by rubbing it for about 30 seconds to avoid damaging the adhesive.

3. Experiment with different brands and styles of wafers and pouches:
- Try a flat Hollister 2-piece wafer with a 2" barrier ring for inset stomas.
- Consider Hollister CeraPlus wafers, which contain ceramide for added skin comfort.
- Use Hollister convexity for liquid output, and switch to a flat wafer if the output thickens.
- Coloplast SenSura Mio deep convex wafers can provide extra support, though some users report issues with pancaking.
- Convatec convex pouches are another option to explore.

4. Barrier rings often last longer than paste for filling in dips. While paste can be used to create a raised barrier, many find that it breaks down more quickly on its own.

5. To heal and protect raw skin, try the "crusting" technique: lightly dust stoma powder on the skin, tap off the excess, and seal with a skin-protectant wipe or spray like 3M Cavilon or Marathon. Repeat this 1–2 times until the skin looks matte, then apply the ring and wafer.

6. For dips on one side, cut or break the ring and overlap or thicken that section before placing the wafer.

7. Warm the applied system with your hands or a heating pad for about 10 minutes to improve adhesion.

8. Check the back of each removed wafer for signs of leakage. If it starts from a specific spot, reinforce that area with extra paste or a sliced/stacked ring segment.

9. Attend local ostomy support group meetings where you can get hands-on fitting help and free samples from WOC nurses and supplier representatives from companies like Hollister, Coloplast, Convatec, and Eakin.