Help with Chronic Diarrhea and Leaking Barrier

Have had a bout with chronic diarrhea and my barrier is coming loose, leaking like 3-4 times a day. Plus, skin is very red and irritated around stoma. Any help or suggestions?

I've been having similar issues with my ileostomy. I'm currently undergoing FOLFOX chemotherapy which has been causing a lot of diarrhea. Today when I was changing my bag, it was just shooting out of my stoma like a geyser, even after taking anti-diarrheals and eating marshmallows.

I'm still fairly new to the ostomy world, but I found that trying different brands of barriers and waxy rings until I got a good fit helped a lot. But now with the diarrhea, I'm pretty much guaranteed that my barrier will leak the first time I change it every time.

I've also learned that everything sticks really well when your skin is dry and when the barrier is warm, so I use a hair dryer on a low setting and just keep drying and warming. I hold the barrier in place for several hours (in between whatever else I'm doing) to ensure a good seal. I try to change my bag in the evening so I can lay around and read or watch TV and let it adhere to my skin.

For the irritation, I've stuck with the "crusting" method, but I use prescription nystatin powder instead of basic stoma powder. And I also apply fresh aloe to the red, irritated skin before I do anything else.

Let me know if you have any questions! And good luck! :)

Thanks, Julianatheory151, for your reply. I am also doing chemo pills. I am fairly new, so I do not know what "crusting" is and also what's up with the marshmallows? Do they help with diarrhea?

DesertRat1943,

Depending on the product you use, and the technique you use to remove the barrier and as Juliantheory151 said, how you apply the barrier can mean a world of difference.

Most 1 or 2 piece systems are designed to last for days without having to change them. And red irritated skin can be pain and as you know can be caused by fecal matter, the skin breaking down from frequent changes or even allergies.

I agree when the stoma is constantly having output, it can be a challenge to change your pouch or wafer. Marshmallows, as Julian suggested, can thicken loose stool along with other food products like rice, pretzels or cereal.

It would help to know where the leak is most frequent in your case, for example, under the wafer or around the weld? Do you use a 1 or 2 piece system? What is the technique you use to remove a pouch or wafer and what is the technique you use to apply one? Do you use a skin prep before applying the pouch or wafer? Does your stoma retract and go under the wafer?

There are several methods and lots of videos on YouTube on changing your pouch or wafer. Just some tips when changing.

When preparing to change, try to keep your stoma positioned either over your sink or toilet so that the mess is minimized. I fold up some tissue paper and place below the area of my stoma and keep myself right up against the sink.

When prepping a pouch or wafer, if you're cutting to fit, make sure you cut the hole for your stoma just wide enough as the widest part of your stoma so it has the freedom to expand and contract without difficulty and minimizes the peristomal skin from being to exposed to the acid in your output.

Take a washcloth and lather it up with warm water and a mild soap bar. With the soapy washcloth, gently push between the pouch/wafer and your skin. You don't want to rip off the pouch/wafer off as this irritates the skin even more and can leave parts of the wafer attached to your skin. The soap isn't going to hurt your stoma and can soothe irritated skin. I thoroughly soap up and wash all of the peristomal skin and gently clean my stoma. Some bleeding from around your stoma is normal.

Once you're satisfied with cleaning, rinse the soap out of the washcloth very thoroughly and wring it out. Use the damp cloth to wipe the soap completely away from your peristomal skin and stoma.

Now the next part, many people have different techniques. I myself take folded tissue and wrap the stoma in case it starts to spit....lol. Some people use condoms but I figure if it starts spitting, I can rinse the sink and wipe it down with Clorox wipes. Anyways, wrap the stoma in some fashion and pat dry the peristomal skin. You can also use the lower cool setting on a hairdryer to dry the skin thoroughly. Once it's dry, apply a skin barrier wipe and or stoma powder and let it dry so it's not tacky to the touch. Time it carefully and place the pouch or wafer over your stoma. Place your palms flat against the pouch or wafer on the left and right side of your stoma and hold in place for at least 30 seconds. Do the same with your palms flat against the wafer on the top and bottom of your stoma. Get the edges of your palms as close as comfortable to your stoma. This will heat activate the pouch or wafer and create a good seal.

If you use a 2 piece system, I would go ahead and attach the pouch to the wafer first before placing my hands over the wafer as to avoid a mess when trying to create a good seal. If done properly and there are no underlying issues (i.e. retracting stoma, weeping skin) the pouch or wafer will last for days.

This is the method that works best for me. Everyone will have their own tips and technique. You just have to find the right method for you. I hope this helps.

Bain

So crusting is using stoma powder and a sting-free barrier wipe. Start with the wipe and dab all over the red, irritated skin. Then sprinkle stoma powder all over the area. Gently wipe away excess powder with a tissue or gauze, then dab with the wipe again. Repeat several times, finish with the wipe, and make sure the area is dry before applying the barrier. This essentially provides a soothing barrier to the irritated area and allows healing in between changes. Since you're having diarrhea, it might help to ask your oncologist for some Nystatin powder to use instead of stoma powder.

The marshmallows help to almost stop output temporarily so you can get through a change easier. The articles I've read suggest eating 3 of the big size ones 15-20 minutes before changing your bag. I've personally had about an 80% success rate with this. nbsp

Getting Support in the Ostomy Community with LeeAnne Hayden | Hollister

Morning Desertrat, do you mean your wafer is leaking as the barrier ring is different? Make sure you use a ring; it does help, especially with seeping. Keep it very close to the stoma all around. But prior to that, make sure your wafer area is completely clean and dry. Use a hair dryer if needed. Add your skin barrier wipe to the wafer and stoma area. Again, make sure that area is completely dry. A hair dryer on warm helps. Place the barrier ring again, just sized big enough for the stoma base. Add your pouch, hold warm hands all around it, and again, a hair dryer helps. Our appliances like clean, dry, and warmth. Warmth helps adhesive...

Hope it helps... Have a great Friday.

Tracy

*Just noticed after posting that this thread was made in 2017... Leaving it up in case someone is having a similar issue.

It should not be coming loose that often, regardless of your poo's liquidity. Press/push down on the barrier-adhesive for at least 10 min after putting on a bag, if you're not already. Experiment with different seals, experiment with adding paste, adding it onto different seals, experiment with melding x amount of another seal into the one on your barrier. Besides all that, the thing which made the largest difference for me in regards to bag longevity is the "Hollister Adjustable Ostomy Belt", $10 on Amazon. It's an adjustable elastic band, basically, that goes around your midsection and clips onto either side of the bag. Tighten it after you put on a fresh bag for at least a few hours, then afterward you can loosen it if you're fairly confident it won't leak, or tighten it if you're worried that it will.

In regards to the red irritated skin, firstly, you can mitigate the pain of putting a bag on that with "Cavilon No Sting Barrier Film". Spray it over the area, wait 30 sec, then put on the barrier seal. Regardless, have either a wound care nurse or your doctor look at the area. It could be two things: normal wound caused by the acidity of poo, or a fungal infection. Is the skin more or less a uniformly irritated red; is it a circle on your abdomen directly underneath the bag? If so, it's probably a fungal infection. I know from first-hand experience that having one degrades the longevity of a bag, too.

I think you may have talked about using the paste before. My husband has had the ileostomy since May. We have great weeks and not so great weeks. It seems like you think you've found something that works, then you have a day where you end up changing it 2-3 times. I tried putting a layer of paste directly on the cohesive slim seal as he does have creases near the stoma site. So far so good. Going to try the belt as well next time. This group is always helpful with great suggestions.