Adjusting Barrier Ring Size for Ileostomy Care

Hey y'all,

I'm 3 weeks post-op from a loop ileostomy and doing pretty well with the current system (Hollister 2-piece with a barrier ring, all changed every 4-5 days).

However, I think I was cutting my flange a tiny bit too big because I was getting quite a bit of itching and burning. I changed my appliance today and there was a little redness but nothing raw or too painful. I decided to cut the new one a bit smaller and so far it's been about 5 hours and significantly less itching/burning. But I'm terribly anxious now about it being too small because my barrier ring turtlenecks so much.

So my question is... can the barrier ring be too small and suffocate the stoma after it turtlenecks, or is the only danger cutting the flange too small? I'm fairly confident I didn't do that... just concerned about the barrier ring. My gut (pun intended) is telling me it's fine since the barrier ring is softer, but I don't see my ostomy nurse for a follow-up until Wednesday, so I thought I'd ask y'all if I can stop my anxiety spiral lol

The rings sometimes expand a bit.

Yes, but are they a concern once they expand/turtleneck? Like, as far as suffocating the stoma?

A few times my barrier ring has "ridden up" my stoma because I did not stretch it out enough to only cover my skin - never thought to call it turtlenecking - - had no issues. The barrier rings are pretty soft on purpose to give a margin of error. To be clear, maybe 2 mm - not the whole stoma side.

Hey there, so I have had barrier rings get too tight and cut off my stoma's circulation. It was actually the Brava by Coloplast that did it. I use the Hollister Slim now and I don't have any issues with it; it's made a bit differently than most, so it doesn't swell the way others do. Also, you should actually be cutting your wafer to the size of your stoma. Make sure after you cut the wafer, it's smooth.

Words of Encouragement from Ostomy Advocates I Hollister

I stretch the ring out just enough to put it around the hole on my bag. I don't put mine directly around my stoma but on the bag. As liquid output gets around it, it expands to keep the stuff off your skin. Just make sure the hole on the bag is cut to the right size and that the ring is not around the inside of the hole but around the edges of your cut on the bag. Sometimes I have to take my finger to push the ring out of the inside of the hole while setting it up if I did not stretch the ring enough. I use the Hollister CeraRing #2.

Hello and welcome artingwithilly.

This journey is one of experimentation to see what turns out best (for you) along the way.
Some people use barrier strips and/or paste and don't concern themselves too much about how big the hole in the wafer is.
For my part I found these too fiddly and messy, so opted for the Salts stoma collar , which is a specially shaped soft rubber 'turtleneck' to protect the stoma, and does that job quite well. (see: www.salts.co.uk ) They send free samples and ship worldwide  but you will need to let them know the size of your stoma as these things come in many sizes to fit many stomas.
I wish you well on this fascinating and sometimes challenging journey.
Best wishes

Bill

Hello there

Sounds like you have a good grip on what you are doing with your new circumstance. Your stoma should shrink in size before too long if it hasn't already, so you may well be making adjustments to the hole as you go forward. Sometimes, if the hole is too small, the appliance can cut the stoma and make it bleed a little. Not such a big deal unless you have really sliced it deeply; a small nick will heal very quickly, so no need to panic.

I find if you try to get too long a time before changing your bag, the ring swells too much and can cause problems. I change twice a week, Mondays for the week and Fridays for the weekend. Works for me. Regards, IGGIE

Salts won't ship to the US. I tried getting samples from them. I got an email saying they don't ship, and then I also contacted them personally, told them about the email I received, and asked them, and they said they don't. Unless that has changed recently.

Hello Beth.
Thank you so much for letting me know about Salts not shipping to the US and  I am sorry that my post was ill-informed on this subject. 
I usually post my DIY ideas on this sort of subject but, as a lot of people are not keen on DIY, I felt that the manufactured goods were a good first option.
 
Taking the concept of the 'stoma collar', I searched the shops for a similar shaped (& sized) plastic container top that would act as a 'collar' for my stoma. (That's the actual container top rather than the screw lid).
I cut the top off the container and it fitted perfectly over my stoma. The one I used was from a bubble bath bottle and  had a wide wafer-shaped flat ring, so the collar and the wafer had a beautifully smooth and rounded join at the turtle neck. This device has been attached to my own DIY baseplate and I have been using it daily for a few months  without any problems at all.
(There are some pictures of this on my profile).
Once again, sorry for the misinformation about Salts shipping arrangements.
Best wishes

Bill

No, they are flexible enough that they will not choke the stoma.

Hey Bill,

Oh no worries, I hope my post didn't come off sounding mean or rude; that was not my intent at all. I am sorry if it seemed like that. I am actually really bummed that Salts doesn't ship here; I really wanted to try it out. My skin is allergic to every brand but one, so when I saw them, I got excited and looked at the products online. And with the DIY, you have good ideas, Bill. These companies can learn a thing or two 🙂

I am 5 weeks out of surgery and having some redness below my stoma where the wax ring leaked a little bit. Also, I was having skin irritation under the wafer.

I am using the Coloplast 2-piece system. I went into my scheduled appointment with the stoma nurse and she checked things out.

She told me to quit using the Cavilon wipes and when they put the new ostomy on, they tightened the belt (from Coloplast) down really tight. This caused the wax ring to turtleneck up my stoma as you described. I just changed the bag today and the skin is clearing up. Also, I didn't notice the turtlenecking causing issues.