Loop Ileostomy Help: Struggling with Wafer Fit and Skin Irritation

My daughter has a loop ileostomy (so two stomas) and it is impossible to get the wafer to fit well. It is shaped like a sideways number 8, so I try and cut the wafer to fit, but it doesn't fit well and her skin where the two stomas meet is constantly irritated and it is impossible to get anything to stick and the output is so watery that it is impossible and just seeps on that area constantly. She has cancer and is going through treatment and going to bone marrow transplant next month so I am desperate to try and figure this out to protect her from infection. Thank you....

Try Ekin rings, they are formable and pliable or stoma paste. You can Google both to see their benefits and drawbacks. Or go see a WOC nurse, they are full of great ideas.

Good luck, I will be praying for you guys.

There will be others to respond shortly, so no worries.

I have a loop ileostomy too, and yes, the shape is a bit awkward. My sister was visiting recently and saw my struggles changing the wafer. She measured the thing and made a stencil out of a piece of cardboard-like material. So now, every time I go to change it, I trace the stencil on the wafer and cut before I even take the old one off. I've actually started using an X-Acto knife (box cutter) to cut the wafer. I place it on a clipboard and slice away. It's accurate but SHARP, so be very careful; always cut away from you. This process saves a TON of frustration with the thing deciding to "go" mid-change and throughout the change. My nurse practitioner told me to eat a marshmallow prior to change to slow down output. I haven't tried that yet; I usually just starve myself the morning before I change the thing. A little stoma powder dries things up. I use a Q-tip to apply this ointment called Calmoseptine on any areas of concern and a thin smear around the stoma in general (moisture barrier ointment that protects, soothes, heals irritations from urine, diarrhea, perspiration, wound or fistula drainage, diaper rash, minor burns, cuts, scrapes, chafing, chapping, or itching - this is what it says on the package). It has worked like a charm and fairly quickly. Website on the package: calmoseptine.com

Now I wouldn't think you should put it directly on/in the middle of the holes but around it on the skin if it's breaking down. A small dust of powder to dry it up first so the ointment sticks. Let that dry a little, then use another Q-tip to smear some "cohesive paste" around it that's also a barrier and helps the wafer stick. Followed by dabbing a barrier wipe over it all for additional stickiness. This seems to work well for me.

Hugs and prayers for you both.

OMG, thank you, thank you, thank you! Getting online to get all of this and will try marshmallows!

I too have a loop ileostomy which is oblong - could never get the cut right and the area around where the cut was wrong would get sore. I finally gave up and cut a round hole and basically stuff both into the round shape but making sure the functioning stoma has free range - the sidekick gets covered a bit. I have little or no output in the morning so this is when I do a change. My procedure is to cut a round hole, shape a slim barrier ring onto the hole matching the round shape, put stoma powder around outside of loop (stoma and sidekick), tap stoma powder with barrier wipe, place bag snugly squeezing both stoma and sidekick but making sure stoma is clear to function. Whew, hope this makes sense - hugs to you and so sorry you are having issues with this. jb

Hello D

You don't say if you use a ring and/or a barrier spray. When you cut the appliance to fit, keep the peel-off plastic backing until the next change. When you manage to get an accurate cut that works for your daughter, you can use the backing for a template for the next cut.

You're so very welcome! It makes my heart sing to be able to help in any way. ❤️

I have an oblong stoma too. I have given up on cutting a precise wafer hole to fit perfectly around my stoma. I now use a barrier ring that I form (by squeezing, stretching. Use gloves) around my stoma. After fitting it, I press both hands on the ring to warm it up so it sticks well to my skin. Next, I cut a large hole in the wafer that has space around my stoma. Then put on the wafer, then the bag.

After doing the above procedure, you could try this:

After putting on the wafer, put a barrier ring on the wafer, molded around the stoma. Now you will have two barrier rings and the wafer seal to protect against leaks: one barrier ring on the wafer, one on the skin around the stoma.

Good luck

Thank you!