This topic is about dealing with stoma pouch leakage issues, even when using stoma paste. The person experiencing this problem has a physically demanding job and is looking for ways to prevent leaks, which sometimes require changing the appliance up to three times a day. Here are some suggestions and insights that might help:

1. Investigate the leak pattern and stoma site:
- Pay attention to whether the leaks occur in the same spot each time. Consider if your work clothing might be putting pressure on that area or if the stoma is located in a belly crease. These observations can help identify the cause.
- Check out the "Collections" section on the forum website for troubleshooting guides.

2. Consider switching to convex wafers or bags:
- Convex products can help by pressing the skin around the stoma inward, creating a tighter seal, especially on uneven or creased skin.
- For example, some users have found success with SenSura Mio convex pouches by Coloplast, especially when used with paste instead of barrier rings.

3. Try an alternative paste-application method:
- Instead of smoothing the paste, form a ring around the stoma opening and leave it raised.
- Apply a similar ring on the wafer, let both set for about a minute, then join the two rings and warm the wafer with your hand for another minute. This method has reportedly eliminated leaks for months for some users.

4. Adjust the timing and technique of changes:
- Changing the appliance before bedtime rather than in the morning has helped some users reduce leaks, possibly because the skin is drier and there is less movement afterward.
- Make sure the skin is completely dry before applying a new wafer.

5. Customize the fit:
- If the stoma's size or shape changes with your diet, cutting the opening to fit each time can improve the seal compared to using pre-cut wafers.

6. Sample different products:
- Request free samples from manufacturers like Coloplast, Hollister, or ConvaTec to find the best wafer, pouch, or level of convexity for your body and activity level.