Struggling with Ostomy Bag Leaks: Need Advice

Hello, I am in need of suggestions for leaks. My stomach is small and lies on its side. Therefore, my output goes under the appliance, not into the bag, and leaks. I use a 2-piece system and also an Ostoform flange. I currently change it 2 to 3 times a day.
Thank you.

You might need a convex appliance. I prefer one piece over two pieces, but it's a personal preference.

Many reasons for leakage.

Not cleaning the peristomal area correctly, as in removing all leftover adhesive with adhesive remover and then cleaning the area well with soap that has no oils in it, like Ivory or Dial, and rinsing well with water. Make sure to get all adhesive remover cleaned off. I usually use paper towels to wet and soap up and rinse with. Pat dry with paper towels and wait until the area is totally dry before putting on the new pouch. Getting the hole on the pouch cut to the correct sizing. When putting it on, use a mirror to make sure it's on evenly around the stoma.

Then there is the issue of being careful not to use a moisturizing or oily shampoo, soap, or conditioner in the shower. These things will cause adhesion issues. Also, having hand lotions on your hands will keep the pouch from sticking or sealing.

You may also need to try a barrier ring such as Adapt or Brava ring to put onto the flange around the hole of the flange you cut.

Changing two to three times a day is saying there is some kind of issue with your application or supplies you're using, and you may need a stoma nurse to look as well. I see you're in Ohio. Cleveland Clinic has a great team of ostomy stoma nurses who can help.

Agreed...however, trying to understand her situation here leads me to think...she may need a revision. It sounds like the "stoma" is recessed, so far inside her stomach that obviously something is wrong there. Not sealing.

Now we don't know how long she's had an ostomy, or if this just developed recently. But if she is changing 2 to 3 times a day, her current appliance is wrong or she needs to have the stoma pulled out. - revised.

Agree to all that you've said. 

OK, I figured out she's saying the stoma lays on its side. I guess "stomach" was a typo for "stoma."

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Hi Anni,

As Warrior said, you need a revision. I had a stoma that shot sideways and ostomy products just aren't designed to last in that situation. I was getting one to two days out of my barrier/ring combo, but not reliably. It took me a while to realize my stoma was the problem, but once I figured that out and got a revision, it made having an ostomy not such a big deal. Find yourself a good surgeon with a lot of experience making stomas and get it revised. The revision itself can be a very simple thing if all goes well, and you'll be out of the hospital the next day. If your surgeon tries to pull your bowel out a few inches and can't, then they'll have to open you up a bit to see why, and that can mean a longer hospital stay. But if you have the revision done, you'll be amazed at how much easier it is to have and manage a stoma. Barrier changes will go from a couple of times a day to once every 4 or 5 days, possibly longer, but I don't go more than 5 because I like to keep an eye on things, but it's possible. All I can tell you is that having a proper stoma makes all the difference! The longer you wait, the more you'll be mad at yourself for doing so; it's that big a deal.

;O)

Hi, as a temporary fix, you should consider a convex pouch. Have a word with a stoma nurse; they usually have knowledge of your condition. I use a convex single pouch (53900). Best wishes, Elwick.

Yep.  Revision is the best fix.  Convex wafers will help, but not better than revision.

Let us know what happens.

Colostomy or ileostomy…how long have you had it? In my humble opinion, another surgery would be a last resort for me. Stomas change over time, so if it is new, I would suggest you try different products as a first fix.
I've had my ileostomy for 4 years and just today I am test driving a 2-piece system. I am always on the lookout for a suitable and easy—and mainly a less is more apparatus. So far, my ConvaTec 22771 is a one-piece and works well, but I do change it every other day. It's all a trial and error process, and you will eventually find the answer that works best for you…don't give up the ship! jb

Do you use a barrier ring? That might help. I know it helps me.

I assumed that as well, lol.

Sounds like my stoma exactly.

Okay, you're likely going to need a one-piece convex, stoma adhesive, skin protectant, no-sting paste, extra-large barrier strips, and an ostomy belt.

First, wash the area in the shower using antibacterial dish soap to sterilize burn wounds. Then use moisturizing soap after that. Wait until any stoma spewing stops. Final wash and rinse.

Pat dry using soft dry toilet paper, do not wipe on stoma or it may bleed. Only dab dry.

Use a blow dryer to get the area bone dry until it's rough skin.

Use stoma adhesive just around the stoma in very small amounts (and on any weeping damaged skin) and dry brush remove until it's gone. It will leave an invisible coat.

Cover the adhesive area with skin protectant (I use generic Flonase as it stops the sting) and blow dry well, repeat.

Cut the wafer hole to be just a hair bigger than your stoma, if it's oval cut an oval. Test fit.

Now apply no-sting paste tube around stoma and spread out to 1/2" away from stoma and of course next to it. If you dried well, it should just stick with no problem. If not, remove and fix the issue above.

Now peel backing off convex and the flat area out another bead of paste. Gently press into place and watch that you're lined up correctly with stoma. Press just enough that paste appears in the wafer hole edges evenly all around. Do not press down hard or it just squeezes the paste out.

Allow paste to harden up to form a wall of sorts around stoma. Push wafer flanges down to meet skin.

Put extra-large barrier strips all around and lay on your back for a few hours while the paste sets up, then put on the ostomy belt to give gentle downward pressure.

Sleep only on your back using pillows under each arm. Eat only from AM to about 2 PM, then only small snacks until morning. Avoid skins or tough vegetables and hard meats. No nuts or seeds. Only mushy type foods. Avoid alcohol. Avoid foods that cause runaway diarrhea.

It takes time to learn this process and even years to perfect sometimes, and everyone's body shape is different.

If you have scar tissue, I've learned that just putting a tiny bit of coconut or olive oil-based skin lubricant on the scars will keep them from getting itchy by the adhesive.

Take a hot shower only on bag change days, washcloth bird baths in between because sweating causes the bag to come off.

With a one-piece, you flush and rinse from the bottom on the toilet using a small water bottle and some antibacterial dish soap. This one-piece doesn't disturb the seal as much as a two-piece does. I've made my one-piece last up to 7 days; by then the wafer is usually toast anyway so the whole mess comes off. One piece is usually less expensive as well.

Changing the wafer every 5 - 7 days is normal for seasoned ostomy folks; several times a day is usually only in the case of newbies with scabs and other issues with skin.