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May 02, 2018

Struggling with new ostomy - need advice on managing leaks!

This topic is about dealing with night-time leaks after getting a new ileostomy. The person is two months into their journey and is struggling with waking up to an overfilled pouch, despite trying to manage their eating habits. They feel frustrated and misled about how easy living with an ostomy would be. Here are some helpful tips and insights to manage this situation:

1. Emptying and Scheduling:
- Set alarms to wake up every 2-3 hours to prevent the pouch from overfilling. Over time, you might naturally start waking up before it gets too full.
- Try to stop eating and drinking 2-3 hours before bedtime. Some people find it helpful to stop by 7 p.m.

2. Sleeping Position and Equipment:
- Train yourself to sleep on your back or left side, avoiding sleeping on your stomach.
- Consider using an adjustable bed or recliner to keep you semi-reclined, which can help reduce rolling and pressure.
- Use wedge or body pillows, or a small travel pillow, to keep you from rolling onto your belly.
- Try the "golf-ball trick" by sewing a golf ball into the front pocket of your pajama top to wake you if you roll onto your stomach.
- Use under-pads or double Depends to protect your sheets while you experiment with different solutions.

3. Belts, Wraps, and Support Garments:
- An Ostomy Armor belt can provide firm support, prevent the wafer edge from lifting, and extend wear time.
- Standard elastic ostomy belts or fabric wraps can help hold the pouch flat and contain minor leaks.

4. Pouch Choice and Customizing:
- Consider using convex wafers, especially after the swelling goes down around the three-month mark, to maintain a tight seal.
- High-capacity "overnight" or 14-inch ileostomy bags are available for managing heavy night output.
- Re-measure your stoma at every change until its size stabilizes.

5. Reinforcing the Seal:
- Coloplast Brava Elastic Barrier Strips can reduce leaks significantly by acting like "band-aids" around the wafer.
- Use 3M Micropore Surgical Tape to "picture-frame" the wafer, which can give you a warning before a full blow-out.
- Applying Vaseline on the front of the wafer and inside the pouch, or closing the Sensura vent tabs, can reduce vacuum and pancaking.

6. Output Thickening and Gas Control:
- Absorbagel powder sachets can thicken watery output, making it behave more like pudding and less likely to run if a corner lifts.
- Minimize high-gas foods before bed and release gas whenever you wake up to prevent ballooning that can pop the seal.

7. Alternative Methods:
- Some people with high output switch to irrigation sleeves at night for larger capacity.
- Others choose to sleep in a recliner instead of a bed to stay upright and immobile.

8. Mindset and Adjustment:
- Many people find the first few months challenging, but leaks tend to decrease significantly once the right products and routines are found.
- Acceptance takes time, but focusing on the health benefits, such as being pain-free and avoiding flares, can help with the adjustment.
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