Issues with Bag Adhesion and Comfort in Humid Climate

Hi

I am new to this whole bag and all the terminology! But I am about a month in and find that my bag isn't sticking very well to my skin. I have added additional skin tape but find that this causes my bag to pull down and makes it very uncomfortable and pulls sensation on my stoma. Not sure if this makes sense. I have a feeling all this has happened timing-wise since the swelling of my surgery has reduced.

I live in a humid climate if this makes any difference? I have a lot of current product, think it's Convotec? So switching isn't a solution at the moment. Any thoughts?

Thank you!!

Hi Biskitbuster, yes, everything you're saying makes sense. With a new stoma, you feel every little sensation - everything that tugs on the skin around it, the feel of your pants pressing on it, etc. It makes sense that you don't want to put anything extra around it like tape as it feels heavy and pulls. Your stoma is also shrinking in the first several weeks, so make sure you remeasure it to ensure a good fit with your barrier ring (if you use one) and bag hole. It will eventually settle down, and you won't have to measure again. This was at about six weeks post-surgery for me. Are you making sure that the skin around your stoma is absolutely bone dry before you stick anything on your skin? Keep blotting it with tissue, maybe even use a hair blower, and then put the bag/ring on immediately before your stoma can excrete anything wet. Warm up the area with your hair blower. Once your bag is on, use some pressure with your palm over the stoma for about five minutes. Now your bag will have the best adhesion, and the humidity shouldn't matter as much. There are people on here who can go many days between bag changes, but I tend to change mine every other or third day just for peace of mind since I'm pretty active. You'll see what works for you. You'll get the hang of this!

Hello,

What type of ostomy do you have? Each type of ostomy has its own unique challenges.

Ileostomy typically has a more liquid type output that is acidic. Leaks are common and peristomal skin is easily damaged by the stomach acid.

Colostomy has a thicker output with little acid content. This is what I have. I don't have many leaks and output barely affects my skin.

Urostomy is for diversion of urine away from the bladder through a stoma and into a bag or holding device.

Many factors affect having a stoma. For example: underlying disease, how much colon remains, prior radiation treatment, medications, and a person's mobility and dexterity.

What type of wafer/bag system do you have? Non-drainable pouch or drainable? Do you use a barrier ring?

Adhesion tips: When bathing, use soap containing no fragrance or lotions. Those chemicals will interfere with your wafer sticking. I use Cetaphil soap.

Use a blow dryer set on low to preheat the wafer (about 30 seconds is good) before you apply it to your skin.

Don't use a barrier film product. Only use barrier film (spray or wipe) when peristomal skin (skin around your stoma) is irritated. There is a technique called "crusting" used to treat damaged, irritated peristomal skin. Works like this: Using stoma powder, sprinkle powder on the damaged skin area. Gently wipe off excess. Use a barrier wipe to dab remaining stoma powder until moist. Let dry, repeat a couple more times. Then install wafer/bag. Once skin heals, stop using barrier film.

Get a support belt. After I put on a new wafer/bag, I put on a support belt that holds the bag securely to my body. I wear it for an hour or so. Helps wafer adhesive stick to skin. Your ostomy supply provider should have belts available. I use a Nu-Hope Corporation peristomal hernia support belt.

Don't change the wafer too much. This will damage peristomal skin. I used to change the wafer twice a week. But over time, I discovered I can do it every 7 days. I use a 2-piece Hollister system and change "bag only" every 2 to 3 days. Bags just snap on and off easily.

I'm a year post-op. It takes time to discover what does, and does not, work for you. All medical supply companies and device manufacturers have stoma nurses you can consult with over the phone. Manufacturers offer free samples of their products you can try. Hospitals have stoma nurses too. Major troubles... speak with a doctor right away.

Good luck

Also, make sure you're storing your appliances properly. And they don't sit in humidity, heat, sun, extreme cold, or in the bathroom because of the steam.

If it was sticking well and now it isn't, something isn't right. If it has never stuck well, then something isn't right from the beginning. So… 1) Skin must be DRY when putting your new stuff on. 2) Warming everything somehow, I use a hairdryer, is a game changer on how well things seal to your body IMO. 3) You might need some sort of support, belt/wrap so the weight of your output isn't pulling on the seal. 4) If you don't use one, a barrier ring can be a huge help. Maybe tell us your procedure exactly when you change stuff and we can pinpoint something that you may be doing that is affecting your situation.

Words of Encouragement from Ostomy Advocates I Hollister

Let's Talk IBD videos. This lady helped me out since my husband has a high flow ileostomy since April 2023. I do all the changes and I have had severe leaks, difficulty sticking problems, in which I blew through 6 weeks' worth of products in 7 days.

Bone dry skin by using an air-only dryer helps, followed by barrier spray or barrier wipes onto dry skin worked in a circle around the stoma. Then quick dry with the air-only setting hair dryer followed by a little low heat from the hair dryer directly on the flange prior to sticking it on and that's it. Also, start wearing a belt if your flange allows.

 

 

My husband sleeps in a chair all night. Every time he lays down the stoma recedes and breaches.

 

The videos are very helpful in addition to the support you get from this site. I needed everyone and still do in order to keep the leaks and everything else that can go wrong from going wrong.

Do you have a stoma nurse to contact for advice? If not, find one via your stoma supply group or contact the manufacturer. They will have a customer support person who can put you in touch with an experienced stoma nurse and help you via teleconference. (You will need to get proficient with stoma selfies). I use Coloplast, who have been fantastic with technical and practical support. You may need to try different appliance configurations until you get it right. It took me about 4 months to get the configuration right and stop the leaks. 12 months in, no leaks for the past 6 months, and appliance changes last 6 - 8 days.

Best advice I got to make the seal stick to your skin? Use a heat pack for a few minutes after fitting a new appliance. Much better than hand pressure, hair dryers, etc. Your body and stoma will continue to change until you fully recover from surgery and whatever other treatments they subjected you to.

Hang in there, it will get better and there is plenty of help if you know where to look. Rob

Very good advice, RobN.

I like the heat pack idea. Do you have any details on its use? Temperature setting, application time. Maybe a particular brand of heat pack or type.

Thanks

Hi Beachboy,

At home, I use the dry bean-filled cotton bags that are available from most physios for muscle issues. Microwave on high for 30 seconds at a time until you reach the desired temperature. Care not to overcook because they can catch on fire. Hot enough to hold in your hand but not melt the ostomy bag.

I heat a large bag for 90 seconds (1100 watt microwave) before I start my appliance change. 30 minutes later when I have finished the change and have a t-shirt on, I usually reheat for 30-60 seconds then apply to the appliance over the shirt/stoma/seal area while I pack up. 2-5 minutes. Have some air in the bag to insulate against your stoma. If it's uncomfortable, it's too hot.

Like you, I travel a fair bit. When I don't have microwave access, I pack one of those reusable blue gel ice/heat packs available from most large pharmacies (drug stores). Soak in boiling water until the desired temperature is reached, towel dry, then apply as above.

Since I started this, no seal leaks, but you will need adhesive remover spray/wipe to remove the seal.

Hope this works as well for you.

Rob.

 

Thanks, Rob!