This topic is about someone who has been living with a permanent colostomy since August 2012 and is facing several challenges. They are dealing with frequent pouch leaks, anxiety about odor, a large parastomal hernia, and severe abdominal pain. They are seeking advice and support to manage these issues better.

Here are some helpful suggestions and insights:

1. Work with an ostomy-certified nurse. A professional can help identify the causes of leaks, ensure the belt fits properly, manage the hernia, and evaluate any abdominal pain.

2. Be mindful of skin preparation. Avoid using soaps or wipes with moisturizers, oils, or perfumes, as these can affect how well the pouch sticks. Clean the area with plain warm water or a mild cleanser that leaves no residue, let the skin dry completely, and then apply the pouch.

3. Try different seals or barriers to improve how long the pouch stays in place:
- Eakin Cohesive Seals are recommended by many for filling in creases and creating a tight, leak-proof seal.
- Hydrocolloid barrier strips or tapes can be placed around the flange to reinforce the edges and help prevent leaks. You can ask suppliers for samples of different brands.

4. Consider using a simpler pouch style:
- One-piece closed-end pouches, either mini or standard length, can be easier to manage as they don't need emptying, reduce weight, and are quick to change. Used pouches can be discarded in a zip-lock and paper bag to control odor.

5. Keep your routine simple unless additional products are necessary. Some people find success without extra rings, preps, or powders once they find the right pouch.

6. If you qualify, look into colostomy irrigation. This process can empty the colon on a schedule, allowing you to use a stoma cap or mini pouch for up to 24–48 hours, which can significantly reduce leaks and odor.

7. Give yourself time to adjust. Less than a year after surgery is still considered early. With the right system, most people with a colostomy can achieve long wear times without leaks and return to normal activities.

8. Address the hernia by discussing hernia belts, support garments, and potential surgical repair options with your surgeon. Better hernia management can often improve how well the pouch adheres.

9. Report any persistent or worsening abdominal pain to a doctor immediately to rule out issues like bowel obstruction or hernia complications.

10. Emotional adjustment is important. Leaks can increase anxiety, but once the mechanical issues are resolved, acceptance usually follows. Seek support from peers through forums, blogs, or chat rooms for practical tips and reassurance.