This topic is about managing leakage around a shrinking ileostomy stoma, particularly when using Hollister wafers. The person experiencing this issue has noticed that as their stoma has become smaller, leakage is occurring under the wafer, causing skin irritation. They are seeking advice on using wax rings and other tips to prevent leaks.

Here are some helpful suggestions:

1. Resize the opening: Custom-cut the wafer each time you change it to fit the current size of your stoma. This helps reduce gaps caused by shrinkage.

2. Switch to convex products: Consider using Hollister convex barriers and convex rings. These products gently push the stoma outward, directing the output straight into the pouch and preventing it from pooling at the wafer.

3. Use a barrier ring or wax ring: Hollister rings, made from wax or pectin, create a snug seal around the stoma and protect the adhesive from digestive enzymes.

4. Consider stoma paste: A pectin-based paste is more pliable and can be applied around the stoma or in skin creases before attaching the wafer or ring. Many people find it effectively stops leaks.

5. Application technique tips:
- Cut the wafer hole slightly larger than the stoma when using a ring.
- Warm the new wafer and ring against your body before applying to improve adhesion.
- Clean the area with plain warm water (avoid lotions; Dial soap is recommended if soap is used), dry thoroughly, apply paste, stretch and flatten the ring, press firmly, then attach the wafer.
- Stay still for about 10 minutes after application to ensure full bonding.

6. Avoid using barrier wipes or any skin prep that might interfere with adhesion.

7. Thicken the output to reduce the impact of watery effluent on the seal:
- Medications like Imodium (loperamide) or Lomotil (diphenoxylate/atropine) can be used, with doses increased gradually under guidance.
- Foods such as mashed bananas, white bread or cake (low-fat), noodles, rice, and marshmallows can help thicken output. Marshmallows are noted as a rapid "emergency" thickener.

8. General reassurance: Controlling leakage improves with practice. Stay positive and keep experimenting with different products and techniques.