Dealing with Ostomy Leaks - Seeking Advice on Adhesive Rings and Blowouts

New to ostomy. Woke up with one about a month ago after a visit to the ER (perforated colon). Things have been going well and fairly smooth until I had a leak. I was making a 2-hour drive when all of a sudden I could smell it. Investigated as much as I could while driving 70 mph - it was a leak - blowout. Pulled to the side of the road and cleaned up. I didn't have another bag with me (dumb - they are in the car now). To best contain things I had to remove my shirt and drive home in my bra - not optimal - and not fun on an interstate.

It seems that the adhesive ring I use is not holding up. I had another leak a few days later. I was using Hollister Adapt Slim Moldable (from the hospital) but it seems when I received my supplies I now have a larger Coloplast ring. Not sure if the "blowout" is due to the larger ring or if I am doing something wrong. At my last change (2 days ago) I added paste to the ring. Seems like overkill but I'm done with the "blowouts". Any thoughts?

Overkill until it's not. I hate driving in a bra on the interstate 😳. Eakin rings work well for me, but I also wear a belt of some sort (hernia belt or the 1” belts that hook to the pouch). Probably overkill, but it keeps me leak-free. Cuz nobody wants to see a 50ish plumber driving on the interstate in a bra. 
Overkill works.

Cplumber

I'd pay good money to see you driving like that, Mr. Plumber... since it sounds like you have experience doing it. 😄

Review of your opening story: you said it was just a month old? The surgery and having the bag, and you are driving a 2-hour road trip inside 1 month or so?

You brave girl. I would be expecting frequent leaks in that time frame. Plus, sitting for 2 hours is not helping adhesion.

Sitting adds a stress factor on the ring. I think sitting that long invites a blowout.

If you are now using paste, are you also using an adhesive remover? You're going to need that when you replace the appliance.

Hello O

The best setup is the one that works for you. You are only one month in and leaks typically come in the early days until you get a handle on it. Your stoma should be shrinking in size now, which will mean an adjustment in setup too. Where is the blowout: top, bottom, side, same place or different every time, ileo, colo?

Words of Encouragement from Ostomy Advocates I Hollister

😬🤣… ranks right up there with a plumber's butt crack!

Hi Chik, I agree with Axl. The next time you make a change, look at the backside of the wafer/barrier to see where it's eroded the most and add a little paste or a piece of a seal so that it's level and flat. Good luck.

Are you using a flat wafer or a convex one? What is the condition of the area around the stoma? By that, I mean, is your skin taut or is it a bit flabby, like a lot of us ostomates? If not taut, have you tried a convex wafer with or without a barrier ring? I solved my seepage issues by going to a convex wafer with a Hollister 8815 barrier ring. I recommend pre-cut wafers if your stoma is stable in size.

Also, do you have an ileostomy or a colostomy?

Daniel

All good advice you've gotten here. It is early days for you, and your stoma will change. You may need to try lots of different products and combinations of them. All the ostomy manufacturers will happily send you free samples to try. They want you as a long-term customer. Good luck!

Terry

P.S. I should mention, when you call to request samples, they don't need to know you might only be a short-term customer!

I use a Salts ring as I find it the best. I have tried many others. This one is bigger than I need, so I fold it over to shrink it down. I find that easier than stretching out a smaller one.

Yes, I am driving 2 hours at a time, 1 month out. I am feeling great, and my doctors are all 2 hours away (moved to a neighboring state 7 months ago but haven't found new doctors yet). I do use an adhesive remover for the paste. I "think" it is that I am using a different ring adhesive than I did when I first came home. The last 3 bags have had different rings; the last 2 leaked. Thanks for the tips.

Not sure I can answer all the questions. I "think" the Hollister Adapt Slim Moldable is what is working best. Larger Coloplast rings came with my order, so I tried those. As for is my belly flabby - a bit - nothing bad. Haven't tried convex - will look into it. To your question, I have an ileostomy up on the left above my belly button - it is supposed to be temporary with a reversal being looked at for the fall. I have complicating healing factors (meds) that have to be resolved before they can put Humpty Dumpty back together again. Thanks for the tips.

I thought I saw you on the interstate - that was a lovely bra you were wearing. Thanks for the laughs.

Hi. I just want to understand, you said your ileo is on the left-hand side? Because the left side is where a colostomy is located. Ileos are on the right.

I just wanted to clarify because you refer to your stoma as an ileostomy... could you possibly "think" you have a colostomy instead?

Someone can correct me if I am wrong, but these are usually identifiers of the type of surgery one has and what's missing.

The number of times I'm in the E.R., these quacks refer to my ileo as a colostomy bag. I correct them quickly of their error because one type indicates you have a bowel, whereas the other you do not and are likely sewn up down there.

Being handed an enema because the quack missed school that day on the difference between them, I'd point out that enema is for you, not me. And yeah, I'm not pleasant about telling them.

Thank you for asking/mentioning. After a little research and looking where my stoma is located, it seems I have a colostomy, not an ileostomy. Honestly, I really didn't know the difference (now I do). Important to know what I have - honestly, I've been so overwhelmed by everything going on and healing that I haven't taken the time to properly understand my new anatomy. Seems all I do is drive to follow-up appointments and appointments with my rheumy to address an autoimmune condition I was diagnosed with shortly before this happened. One minute I was on a month-long Mediterranean cruise, and the next I was getting emergency surgery. Thanks again for bringing up the difference and noting the importance - I am typically not this dense.

The good news is - colostomy, I believe, is the easier of the two!

I have a colostomy, and my stoma is on my right side.

There must be a functional reason why it's on the right side. Are you absolutely sure it's a colostomy? There are telltale signs, for example, liquid output and excessive leaks are two indicators, but I'm no expert.

Ostomy chick here just learned she has a colostomy simply because it's on the left-hand side.

You are saying your stoma is on the right and it's a colostomy.

Very strange location, but it might be due to a medical reason.

Wonder if other members are set up that way?

Some colostomies are from the ascending colon. Although, I personally don't know or understand why they wouldn't just do an ileostomy. The output is probably pretty much the same. Liquidy. I am sure there is one or more good reasons to do it that way.

Thanks for that info, Daniel. I wasn't aware of the exact locations a stoma can exist on the large intestine.

Ascending would be on the right... transverse? Dunno. Descending? Left side, I guess.

Really gotta know the road map before the trip.

Hopefully, others will add to this topic. And it becomes more educational.

The ascending colon goes up the right side of your body. The transverse colon goes across your upper abdomen. The descending and sigmoid colon go down the left side of your body to your rectum. Ascending colostomy typically goes on the right side of your abdomen. Descending colostomy typically goes on the lower left side of the abdomen. Sigmoid colostomy is also typically on the left side of the abdomen. Transverse colostomy will typically be somewhere across the upper abdomen. I have a transverse colostomy, and it is "officially" said to be in the upper right quadrant of my abdomen. It looks to me to be in the upper center of my abdomen. Most colostomies are attached to the sigmoid colon, which is probably why you hear colostomies are on the left. Persons with descending or sigmoid colostomies have more predictable output, and they are also able to irrigate. Many transverse colostomies are temporary, as mine was intended to be, but due to the complications of prior surgeries along with input from my family and surgeons, I have decided to forgo reversal. The fact that I am able to easily manage my stoma made the decision to forgo reversal a lot easier.

You mentioned that you were using a Hollister moldable ring and now a larger Coloplast ring. The important thing about the ring is that it should hug the stoma. I use a Coloplast ring, the Brava Protective Seal. I am able to keep this ring along with my wafer on for 4 days. Unless you ate a huge meal, 2 hrs should not normally lead to a colostomy blowout. Is your seat belt pressing against your stoma? Is your stoma receding as you drive? Did you ever drive for 2 hours with the Hollister ring? When you say larger Coloplast ring, is the diameter of the ring larger than your stoma?

The Hollister moldable ring is smaller all the way around than the Coloplast ring - it also seems "stickier." I was taught to stretch the ring to the hole that I cut on the Coloplast bag, then apply the bag to my body. The Coloplast rings seem to work OK if I also apply paste (came with my samples and was taught to use it without the ring). When I say larger, the ring is larger and thinner - the hole in the middle is about the same. I did notice some comments about the need to warm the ring before application, so I have been doing that.

I drove for 2 hours each way, so it was 4 hours when the bag let go. The seat belt was on the bag, my waistband was on the bag, and my cover was on the bag. In retrospect, I should have put it over the seatbelt or used the soft pillow between the seatbelt and myself. I have been using a pillow since I am still pretty "fresh" from surgery.

I change my bag every 2-3 days. I know you can go 4-5 days, but I just prefer 2-3.

Thank you for the comments and questions. I'm open to any tips or advice.

Since you are cutting your hole, it is probably best to attach the ring directly to your stoma — this ensures there is no gap between the wafer hole and your stoma. This gap integrity is very important. The following link shows how you should apply the ring:

https://www.coloplast.us/global/ostomy/brava-protective-seal/#section=How-to-use-Brava%c2%ae-Protective-Seal-_362757

Coloplast's Brava Protective Seal is moldable and will hug your stoma if sized correctly. The following link shows what sizes are available. The center hole comes in sizes: 3/4", 1 1/8", and 1 3/8". The outside diameter comes in sizes: 1 7/8", 2 1/4", 2 1/2", and 3". It comes in two thicknesses: 2.5 mm and 4.2 mm.

You want the hole in the center to be smaller than your stoma so it can contract around your stoma. To give a practical example, I use the Brava Protective Seal. My stoma's diameter is 1 1/8". Since I want the hole in the center to be smaller than my stoma, I need the 3/4" diameter hole. Since I am not trying to smooth out a large diameter area around my stoma, the 1 7/8" diameter is fine with me. If I was trying to fill in a deep crevice around my stoma, I would use the thick seal, but since I have no need for that, I will use the thin 2.5 mm thickness. The following link contains a drop-down box to allow you to determine what reference number fits my requirement (3/4" center hole, 1 7/8" outer diameter, and 2.5 mm thick). You will see the reference number is 12035.

https://products.coloplast.us/coloplast/ostomy-care/brava/brava-ring/brava-protective-seal/

I have included a picture so you can see what the dimensions look like on the seal. To get a good seal it is important to match the seal to your stoma.

 

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I am new to this colostomy game, too. Surgery was on April 13. I waited ten days before driving three and a half hours to my upstate home. No one ever told me sitting could lead to "leakage" around my stoma. I settled on Convatec barriers and seals because with Hollister I had three—not "blowouts" but—leakage under the barrier. It led to changing the whole business too often.

My stoma is almost flat. Not much height to it. Could this be one of the problems? I try to squish the barrier tightly around it but... Several times I have noticed the barrier sort of oozing up around the stoma after a day. I have yet to be able to wear the whole thing more than two days.

Thank you for the links and visuals. I "think" I am putting too much product around it, and I have an oblong stoma; it's kind of all in the lower left of the circle. Truly appreciate the help!

If your stoma is almost flat, you probably need a convex barrier. You can contact ConvaTec and ask them to send you samples of a convex barrier. The barrier you have probably comes in flat and convex implementations.

Thank you for the information - after viewing some videos, etc., I am definitely on the flatter side.