Help! Ostomy Leakage Every Day - Need Tips

Hello, I got a colostomy on June 30, 2014 as I had an obstructed colon probably caused by radiation I had from my anal cancer. I had many issues with it, leaking etc., and my skin became raw as could be. I had a second operation the week of Thanksgiving. The surgeon made my stoma larger and raised what he could; however, I'm still having leakage problems on the bottom area. Because of this, my skin around it is totally raw once again. I have to change my device every day at least one time a day. I've purchased so many different kinds of appliances and tools, yet I still have not found something to help me. My routine lately has been when I put on a new one - I clean it using warm water in the shower or sometimes water from the sink, after that I dry it well with a hair dryer. Where my skin is irritated around the stoma, I put a small amount of stoma powder and spray it with skin barrier. I let that dry then I put on the wafer. I've been using a one-piece because where my stoma is on my waist it bends better. I've tried numerous brands of powder and spray. Since my second operation, I have not been using the round bendable moldable ring. My main issue is that I leak from the bottom and side area of my stoma because the bottom is flat and the side is where my body bends and there are creases there. Right now I'm using Coloplast and Hollister one piece that bend easily. However, I'm having to change these every single day. My skin is raw, white, and burns and I know it's probably because I'm always having to change this bag. Does anyone have any ideas on leakages? I have a whole bathroom full of supplies and feel like nothing is working. I would greatly appreciate any tips, tricks, ideas, etc. I am miserable! I do have a picture that I took yesterday. So far my doctor has not been very helpful with ideas, nor has his nurse or home health. Thanks in advance!

Hi Nuheart. Your problem may be where your surgeon placed the stoma. My stoma is 3 inches to the right of my navel and about 1.5 inches down from there. My entire flange and surrounding tape are still well above the abdominal crease and never need to bend. I suspect that your issue is improper stoma siting. Check out this article and go and get a second opinion. Good luck!

http://www.fascrs.org/physicians/position_statements/stoma_siting/

 PB

Hello and welcome to the forum. You might try Mylanta for the irritated skin. Until we get that cleared up, you aren't going to get anything to stick reliably. Check your inbox for my phone number and I'll discuss some things that have helped me. Good luck and God bless.

Hi Nuheart313, I am so sorry to hear about your leakage issues. How upsetting and frustrating. As PB mentioned, my stoma is also in a similar position but in the beginning my wafer was too big so it covered my navel causing some problems. I started using a smaller wafer/flange and I actually trim it even smaller near my navel. I am a small person and my stomach area is not very large so the wafers are big on me. I also do what you said...stoma powder and skin barrier prep two times and let it dry completely before I stick the wafer on to my belly. Then, I lie down for about 5 minutes with my hand over the wafer to warm it to help it stick better. So far this routine has been working for me. There is also a product by Coloplast called Brava Elastic Barrier strips and although I have not tried them myself several of my ostomate friends have and they say that they work well. One person swims with them on and her flange stays put for days. If you haven't tried them already, Coloplast is very generous and will send out a few samples for you to try. Maybe this will help solve the leakage issue for you. Good luck and I hope that you find a product that stops the leaks so your skin heals. Take care. LH

My second ostomy, ileostomy, leaked frequently. The skin would itch and peel due to the caustic nature of my poo. The WOC nurses could not come up with anything. I tried many different products. My ostomy was also only a few inches from my navel. What finally worked was something called strip paste, which is something that is a pliable cuttable paste about the size of a pencil. I started packing my belly button with it so the surface was fairly flat. I added tube paste to fill in the holes. I started being able to have them not leak and stick for 5-6 days.

What worked for the skin problems was a dermatologist-prescribed fluocinonide 0.05 solution, not the ointment that makes things slip off. The solution can be put on the cloth part of the bag.

I had a reversal a month or so ago, and the reaction to the bag went away while I was still in the hospital.

Words of Encouragement from Ostomy Advocates I Hollister

How's the reversal going? Hope it's perfect. I think most of us would love to sleep on our stomach again but are a little unsure about going through the pain and everything else that you've been through. Is it worth it?

Thanks everyone for all of your ideas and suggestions. I greatly appreciate them. I went to my surgeon today and he wants me to try using a barrier ring but no paste or powder to see if this will help heal my skin. He also said that I need to eat a high fiber diet as my stool is too runny. I'm a heart transplant patient, so I'm sure my heart meds cause this. I just need to get this skin healed so that hopefully the leaking will stop, so I can at least go out and have a life. This has been an awful experience. Thanks again,

Thank you!

Your surgeon is not too smart. I would suggest you get a second opinion or perhaps talk to an ostomy nurse. Anyone who suggests that any ostomate "eat a high fiber diet" is nuts. Please don't be discouraged when this advice doesn't work. Good luck and God bless you through these early "dark days".... We have all been through them.

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Hi everyone, yes, I agree with MMSH. We have all traveled a similar path when trying to figure out what works with these products and what does not. I will share an experience of mine in the early days post-surgery. My husband and I watched a video on how to change the wafer as I was getting some erosion rather quickly and an itchy rash around the stoma and stitches. The video said to use ostomy powder to help with the rash, so I did. Now the erosion got worse and "poop" leaked under my wafer causing me grief. I was so nervous about this wafer leaking out. I checked it all the time. Anyway, time passed and I attended a National Ostomy conference and met with a wound care nurse one-on-one. She asked me to show her what I did. And, she asked, "Who told you to add the powder and attach the wafer?" I said the video. She said that it was wrong. I needed to end the process with the skin barrier instead of the powder. The powder at the end of the process was causing the erosion and non-stick. How would I have known unless I demonstrated my ostomy change procedure to someone who did know? Take care and good luck. Keep posting as someone here may have an idea that will work great and solve the problem. LH

Yes. Sleeping on my stomach was one of the things that I missed most.

Reversal is going better than expected, all scars healed, some minor aches that are new, especially when I am "full". I was scared going into the reversal because of all the horror stories floating around. I have discovered that I really can't drink beer anymore because it gives me diarrhea, other alcohol is okay.

I am also eating just about everything in sight, gained back some of the weight that I lost while I was sick. I do have bowel movements about 10 times a day, but since I work from home and meetings are on the phone, I can put mute on and no one knows.

When my stool was too runny, especially immediately after the ileostomy, they made me take Imodium and Lomotil. This was more for slowing it down so that I didn't get dehydrated.

Not sure if this would help in your situation but maybe you need to switch from a flat barrier to one with convexity. This may help with the leaking situation. Of course, you need to get the skin healthy around the stoma first. I've had my ostomy for over 30 years, so I have a lot of experience with leaking problems. Using a convex appliance has stopped leaking problems completely.

Same with me, get yourself either a seal put around your stoma and put the flat pouch on. I use Coloplast shallow baseplate 1-piece pouch, it's great. It will push the stoma out for you. I had the problem after having a reversal, another disaster. Hope all is well and sorted. Be careful of the deep baseplate as I ended up with an ulcer. Yet, getting another reversal, lol, and too many strictures. So I'm now a permanent ileostomy shallow base. OK XXX

Hi. You may have resolved your issue, but here are a few suggestions. Try the one-piece convex by Convatec. At night, remove the protective plastic cover, then apply a thin layer of ADAPT Paste around the opening of the wafer. Let it dry overnight. The next morning, apply a Convatec stomahesive strip over the dried paste, and gently stretch and shape it to fit toward the inside of the circle. Place Eakin Seal around your stoma. Powder the inside area, then place the wafer on.

This technique took me from changing pouches every two days to 7-8 days. Hope this helps.

NuHeart, sorry to hear of your leakage problems. I would ask about irrigation as a way to cut down on when you are filling the bag. If the irritation is being caused by stool then irrigation will help. The irritation could be caused by a reaction to the product and then you develop the leaks. Good luck!