Help! Washing stoma without removing adhesive?

I have had my ostomy for one year. I never have trouble with leakage or separation. I wash around the stoma with warm water, no soap, then apply an ostomy wipe before putting on the new barrier and pouch. My ostomy nurse said to never wash with soap.

Dear Glendot,

Can you tell us what products/brands you are using?

As for me, the following is my normal procedure: First off, I use Hollister New Image flanges and bags, the kind (I can't think of the exact model number right off hand) that have a Velcro, fold over emptying drain at the bottom. I change my bag and flange every 4 to 5 days. I have never had to remove the bag to just clean my stoma. I only clean it on my changing days.

On the day of changing, I remove everything, use a stoma cleaning disposable moist wipe to get any residual sealing "putty" that may be left on my skin, then follow up with a paper towel to make sure I get as much of the putty off as I can.

Then, with no appliance on, I take a shower and use soap and water to thoroughly clean the area - not rubbing too hard, be gentle. (I might add that about every other changing session I must shave around the stoma) I have a paper towel torn in 1/4 sitting outside the shower which I put over the stoma just in case anything may start leaking out while I dry off with a towel (the wet skin keeps the paper towel attached).

I then use a hair dryer (which I already have plugged in ready to go since time is of the essence) to thoroughly dry the area around the stoma. Once the skin is good and dry, I use a very small amount of stoma powder on the skin around my stoma and then attach the new flange (I also have it ready to go with the putty ring attached to it). I make sure the flange material is secured to the skin well by using a light rubbing/massaging motion over the flange adhesive-backed material. Then I simply snap the new pouch on and hold my hand flat against the pouch over the stoma area for 1 minute. They told me at the Mayo Clinic this is "giving yourself a hug" and the warmth that is created helps the putty soften and adhere well to the skin.

I have never had any leakage through the flange fabric that adheres to the skin and I have never had the flange come loose, even while sweating. I do not use any additional tapes to hold the flange in place. I did have 1 incident shortly after my surgery when I went through a period when my bag would fill up (and almost burst) with air during the night where I knocked the bag off the flange while waking up one morning. This was before I found out I was supposed to wear the stretchable belt that attaches to the flange (I'm sorry, I meant to say attaches to the pouch). I have never had the bag come loose from the flange since.

I shower daily with the bag and flange in place with no problems of anything coming loose. After the shower, I use a hair dryer to thoroughly (as best as I can) dry the bag paying particular attention to the fabric backing on the bag, as well as the flange fabric.

Like WAB stated above, ask Hollister for some samples. Their customer service is some of the best I have ever dealt with.

Hope this helps.

Hi, my name is Marsha, and I have had my ileostomy for 50 years... since I was a kid of 15. It's a lot of trial and error, and talking to others to see how they are solving issues. You don't have to go it alone, and the ER isn't always the best place for advice...

I read MMSH's reply to you.....and it's really true about how you prepare your skin. I know you want to "clean" your stoma (area), but in a sense it's like trying to clean the inside of your former rectum.

I learned at a very young age to think of "clean" differently. I have very sensitive skin, so I gave up using any kind of soap on the area under the flange. Soap leaves a film, or a residue, that needs to be removed. I wear the flange and pouch when I shower because even shampoo and conditioner can affect the skin. It needs to be dry and "somewhat" tough.....not smooth and baby soft. Figured that out before I was 20!

My procedure is just to remove the old flange....wash the area with very hot water, clean around the stoma....wipe the area with cold water (to close the pores) and then wipe down with a skin prep wipe, and wait until dry. I use some stoma adhesive powder around the stoma. Next, I use a moldable flange (from Convatec) which forms a collar around the stoma...

I have a friend who has had an ileostomy for as long as I have, and she insists on washing the pouch out every time she empties. I started with this when I was 15 and quickly realized that I wasn't always going to have water right at hand....so I put "whatever is in my pouch" out of my mind. To me, it's my external intestine...and I give it no thought at all.

Sometimes, I really do like to shower without the flange and pouch on.....but I know the consequences....soap can cause...Been there, done that...and never want to be there again.

Give yourself time to figure out what works for you. Think of it this way.....do you really want to wash your "tongue" with soap and water. Ok... I do have a weird sense of humor...

Best of luck...

Marsha

I'm very depressed too.

My bag leaks all the time...there's a divot or deformity next to my stoma from bad scarring. I have to try to fill it in with putty or wafers to seal it. The VON did this too. It holds for a while, but I can change bags three times a day. I now use a bit of vegetable oil in the bag to keep feces from sticking near the top, which also helps keep it from going out the hole as much. I've tried Brava paste and strips and adapt wafers etc. Someone needs to come up with a moldable dam that will harden that the flange will stick to.

It's good the ER will help you with changing. My ER sent me home, telling me the Emergency Room was for emergencies. Six days later I'm having emergency surgery for a bowel perforated in at least four places. I don't believe in surgery.

Wish I were dead.

I had a lot of leaks early in my recovery with leaks all the time using the 2-piece bag. I am and have been using a Hollister #8624 which is the best I have ever tried. As for lots of leaks, be careful of what you eat and how much as that is one reason it will pull and cause leaks and of course, I am sure you know this, never drink carbonated beverages--that is the worst!!

As for the stoma area burning, use a non-alcohol barrier called Cavilon no-sting barrier film and I also use stomahesive protective powder by ConvaTec. These things will help to prevent the stoma from burning and getting red, etc.

When you do shower, just use a soft washcloth and wash the stoma gently or just stand under the showerhead and let the water wash it. I never really was overly concerned about washing it a lot as I just wanted to be able to not have any leaks!

I hope this information helps. Don't get discouraged, and if you have questions, call your local hospital and speak to an ostomy nurse who may be able to help.

Good luck and Happy Holidays!

Yes, WAB is correct. Use Hollister pouches. The attachment can be done easily with Hollister skin barrier paste, 79300. First, use skin prep protective wipes, Smith Nephew, 420400. These serve a dual purpose. They wash the skin while preparing it to attach the skin barrier. We do two applications. The first is going over the site to sort of clean the site. The second is a nice continuous application to act as an adhesive. After this dries, apply a thin layer of skin barrier paste. Then, apply the skin barrier and press firmly. Keep your hand on top to provide body heat to set the adhesive. The skin barrier and pouch we use are highly flexible and transparent. Hollister 19203. Janet uses these for a urostomy. She is paraplegic. I have been applying the devices for her. Her surgery was Dec 10. The devices remain sealed for 5+ days when we replace them for sanitary purposes. Take a piece of advice - these things stick and require tape remover wipes to get off. Good luck.

I want you to know that immediately after my surgery and I was awake, the surgeon came by and told me I had a bag to which I replied I want to die!!! And I soooo meant it. But TRUST ME, the shock of having my anus, rectum and colon removed was one heck of an adjustment. Fast forward to 3 years now. I am so THANKFUL I am alive (I even was ready to check out as could NOT EAT, and had colitis and pooped continuously) and I had had it!!! BUT through PRAYERS and support of the BEST HUBBIE ON THE PLANET, I CAN HONESTLY SAY you WILL ADJUST and honestly I cannot remember now what it was like with all my "body parts" as YOU LEARN TO ADJUST S L O W L Y and the more you heal and the better you feel, the DEPRESSION will go away!!

My twin sister died 3 months before with the same surgery so I really had some things to overcome, but did. Do NOT let yourself sit on the "pity pot" but just know millions have gone through an ileostomy and life will be good again!!

Hi Elisabeast, I read your post tonight. I am very sorry that you are having problems with a leaking bag and flange. It is upsetting when the product fails and the failing product can make you depressed. You can't trust the system. Hang in there - things will get better and you will figure out a good routine that works for you. Have you tried the Eakins Seal to stop or reduce the leaks? I have not used them but have several friends who claim they are a life saver. The seal comes in two sizes - regular and thin. You use them with the flange and pouch. It apparently creates a secure fit. Give yourself some time - there is a learning curve. How awful that the ER sent you home... it was an emergency... you needed help with the leaking bag. I was depressed after surgery too. This is certainly a change in lifestyle. It takes time to get used to it... at least it did for me. Eventually, you begin to learn about your body and the way it functions. It just takes some time. It has been almost two years for me and I still have some challenging, sad days. I think it is normal and part of the healing process. Take care Elisabeast and know we are here to listen and help. LH

Thank you for the kind words. Part of my problem is that it didn't have to happen. And I don't believe in surgery.

My doc gave me a bunch of antidepressants this week.

Thank you. I had a splenectomy when I was 16... I've spent my whole life wanting to die.

Thank you for your support. Eakin seals seem to work the best. I have others - samples from different companies...have even tried writing manufacturers asking them if they ever thought of coming up with a self-hardening dam that can be used to level out scar deformities.

I know I'm very depressed, she gave me a bunch of antidepressants. But it's like they don't care that I'm not eating. It's been almost three months...and I didn't have much food for a couple of months before that because I'd started a new job - there wasn't much money. I think I'm quite vitamin depleted.

I had this trouble in the beginning. I found that Coloplast click system works the best and I use a Coloplast ring under it. I also use the Coloplast barrier strips that go around the outside of the barrier. It reinforces the barrier. If you start to get a leak, they will hold it back for even a day or two before it gets out and leaking onto you. Hollister is the worst on the market! Any product they have leaks.

I too want to tell you to hang in there! Your problems with colon issues sound worse than mine. I've got other medical problems that make the sum total healthcare an all-day process. I've had times that I wished I were dead, but as long as there is life, there is hope! I think God has a purpose for us all. At times I can't see this or feel it. I try to hang onto some faith that there is meaning in the madness. I also think of those I would leave behind and how they would feel if I were gone. It's good that you started some antidepressants. There is reality in depleted neurotransmitters causing biochemical reasons alone for depression. The antidepressants replace these neurotransmitters. I'm a retired doctor. I lost my job, business, home...when I got sick.

I've been on antidepressants before. Just hadn't been for months. This whole thing and the suicide of a family member have thrown things quite off.

I've lost everything too. But I've been there before, I guess. I worked with a bedridden MS patient. Used to have to lift and roll him, even with a bad back...now I can barely lift my cat who is less than 10 lbs. :)

I may be late joining this party, but come on!!! The stoma is a very small part of the small intestine, but it is perfectly acceptable to gently wash it with soap and water, but just the outside or top - never inside! This will have no effect on the "balance of bacteria" or flora inside the intestine, because you did nothing to the inside, only the exit. Even if you did "clean" the last foot of the inside of the intestine, it may irritate the area slightly, but all the "clean" would be immediately flushed out by the normal activity of the intestine. I wash mine in the shower every time I change the skin barrier. No wash cloths, just soap, water, and my hands. It is impossible to clean the skin next to the stoma without touching the stoma!! That skin must be clean, too!!

As for 2 - 3 weeks wear time -- REALLY? We are all different, but my skin would be raw by day 7 or 8! I change every 4 - 5 days. According to the Coloplast website, when a skin barrier is removed, if the skin side of the skin barrier has any leakage visible around the stoma, you waited too long to change the appliance. When I learned this, I started changing a day earlier, and my skin has gone from good to much better. If you can go 2 - 3 weeks between changes, good for you!! It would never work for me. My output is too aggressive on the seal.

Not sure if it's the same as ileostomy bags, but if it's drainable, empty it before showering. While in the shower, have a squeeze bottle with you and flush out the bag. Squeeze warm water into the sealed bag, swish it around, and push the water up. Repeat this a few times to clean the stoma. I do this at least once per day while sitting on the toilet. I add a little baby oil to the water - it smells great, cleans, and lubricates the bag, helping everything fall down. Hope this helps! Give it a try - your stoma will thank you and it saves changes in between.

Tracy

Not sure if it's the same as ileostomy bags, but if it's drainable, empty it before showering. While in the shower, have a squeeze bottle with you and flush out the bag. Squeeze warm water into the sealed bag, swish it around, and push the water up. Repeat this a few times to clean the stoma. I do this at least once per day while sitting on the toilet. I add a little baby oil to the water - it smells great, cleans, and lubricates the bag, helping everything fall down. Hope this helps! Give it a try - your stoma will thank you and it saves changes in between. When showering, make sure you cover your filter with a sticker or tape to prolong the filter's duration.

Tracy