Dealing with Leaks and Skin Issues in Ostomy Care

Hi

I need help. Output has been getting under my barrier ring and my skin is stripping. It hurts pretty freakin bad. So I did a change out this morning. I washed it with head and shoulders. I wiped it with calamine lotion. I let everything dry for a while. I used a barrier wipe then my ring. It lasted 5 minutes before I could feel something wasn't right. I was already leaking under my wafer. What am I supposed to do?

The Ostomy specialist told me to reach out as soon as I am red and sore. He told me not to wait forever to say something. When I emailed him the picture of it he only commented on the skin stripping but nothing else. No direction. I'm so frustrated today. 

Hi S,

  You need to figure out exactly why your barrier is leaking.  When you removed the barrier could you tell where the leak started?  You'll need to tell us what products you're using...........meaning is your barrier flat or convex, are you using a ring around your stoma and what is your skin like in that area..........flat, rounded, are the skin folds or anything preventing the skin from being flat all the way around your stoma?  Also, is your stoma below, even or above skin level?  Sorry to hear your ostomy nurse is a shithead, but the whole ostomy world is a bit of a clusterf&*k, if you know what I mean.  

  As for the irritation itself.............your skin needs a break (obviously), but will heal all by itself if you can keep it dry and not in contact with your output.  I'm hoping your ostomy nurse explained how to 'crust' with stoma powder.  That will help your skin heal, as will a membrane barrier........but you have to get the leaking stopped or nothing will work.  Shout back when you can.

;O)

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The above are instructions found in the index on crusting techniques. Someone will come on here with lots more advice for you.

Thank you. I use a flat 2 piece Mio Click drainable bag with a barrier ring. I was fine until I pushed it 3 days when I knew I should have changed it after 2. The skin to the left that looks raw is now 5x worse and wet. The bag I put on this morning didn't feel right and I looked to see, it already had output under the barrier ring on the raw skin. 

My skin has grooves from stretch marks after 4 pregnancies. It's not flat at all. 

I tried a protective sheet but that won't stick either. It just immediately comes off where the skin is raw. 

The Ostomy nurse did not tell me about crusting or anything. He said less is more. 

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Hi S, that looks like a double barrel stoma with 2 openings and it shouldn't be covered. Otherwise, the skin around looks good.

Words of Encouragement from Ostomy Advocates I Hollister

What is the name of the barrier ring?

Your stoma nurse is not street stoma smart. The smarts you get from us usually supersede whatever the nurse tells you, going by a book, not experience.

Hi, thank you for helping! It's a loop ileostomy. Double barrel I assume you're correct but I haven't heard that one yet! 

If I don't cover it...I'll spill output everywhere. Lol. 

I figured it was best to come on here for help! 

I use Coloplast barrier ring 2.5mm and the Coloplast Mio Click 2 piece drainable bag. 

I tried crusting but I don't think barrier wipes are all that great. In desperation I went to CVS and got some New Skin-skin tac stuff. I also got rapid dry wound gel to seal the raw areas. I hope those are ok to try. I did order paste last night and I probably won't get that until tomorrow. 

I had to change it twice today because of leakage. 

This picture was from Monday. The raw areas to the left is double the size now and weepy. I used stoma powder on the areas where the skin is stripping. Not sure if that was correct. 

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Hi Smnard, you say you're using a flat barrier. Have you ever tried a convex barrier ring? I have always leaked pretty quickly with a flat ring. I would recommend trying a convex one. It just might be the game-changer it is for so many of us.

I'm concerned about how this stoma looks.

Did it split in half? Or does something look like it's trying to push itself through?

I might need glasses. Sorry.

Your skin appears to be better than mine. Pretty clean and clear. You mentioned an area was irritated. It doesn't go completely around the stoma?

You and shamrock have these folds or ripples. It makes adhesion difficult. He is trying paste to fill in the gaps.

I would suggest that after your skin heals.

You also gotta step up, Hon.

That stoma nurse you emailed? Be aggressive with him. Call him out on your issues.

Being your own advocate is part of our new norm.

Welcome to the site! Glad you're here. You will be glad too.

Thank you for this! It sounds like I'll have a hard time using paste. Crusting doesn't work, you are right. 

My stomach is always pouchy and has flub. I saw there is a Mio flip which is for bellies that are round. I wonder if I should ask for a sample. I always have trouble applying the wafer because I'm pouchy. I'm unsure if I have a hernia🥴 but I do use the belt to help support the bag. The weight of it bothers me. 

I purchased some rapid dry wound gel that seems to work good but that was just a test on my arm. I did get spray on band aid stuff but that shit is gonna burn and at this point...maybe I don't even care. 

No matter what I do...output and bile leaks out, spews out, drips out, flows out. Squirts out. I've tried 7 marshmallows before and it didn't even help😔 Even when I do it first thing in the morning before I eat or drink anything. Sometimes I go through a whole roll of paper towels while I'm trying to get the ring warmed up and stretched. I always precut my wafer. Doesn't matter much because I end up going through 4 rings just to get it right. I waste so much because it gets wet and gross just trying to get on a new appliance. I feel hopeless. My husband keeps telling me that I'm changing it too much but he doesn't understand that I can't wear it for more than 2 days because of the wafer/ring break down. 

Have you tried the spray below, practice on the back of your hand first, less is more. Or get some micropore tape from the chemist, cut pieces and place it directly over the raw skin then apply your appliance as usual, it will give you some relief until you get a handle on your set up. It simply goes between your skin and the appliance.

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G-Day S,

If you have a loop ileostomy, you cannot cover one of the outlets. You have to let the contents from both openings go into the bag. You also look like you need a convex base. Please make sure that your sealing ring fits on the outside of both openings, then fit the convex base and then fit the bag. Regards, IGGIE

Hi S, I had the impression that you were covering the lower part of your double stoma and that was why the output was getting under the wafer. I agree with others that a convex wafer is probably better. Good luck.

Instead of the spray on bandaid stuff, try Marathon no-sting cyanoacrylate skin protection.

This helps me out a lot, and I have a soft belly with folds and a retracted stoma, so my skin gets irritated often. This product really does protect my skin and helps the device adhere better to my skin. I also use a convex device recommended by Convatec after I talked with a person on the phone; their sample really worked perfectly for my skin and soft tummy issues.