Advice for leaky ileostomy

[dgg]

I hope I can get some advice since recently my ileostomy has been leaking out on one side. I've had my ileostomy for 3 months and never had an issue until just recently. I'm using Hollister 2-piece system. Here's what I normally do to change my supplies:
Remove old bag and flange and then shower and use baby shampoo to wipe skin around stoma. After shower I dry off the stoma and skin around it and then apply a barrier film (3M or Medline brand) I wait a few seconds and then apply a barrier ring to the back of the flange, then put the flange (skin barrier) with the barrier ring over my stoma and press it down around the skin. I remove the tape on the back of the flange before this. Then I apply the bag.

I just don't understand how I was getting 4 or 5 good days of wear and now after 2 days I'm having an issue. Last night it actually came off in bed so quite a mess to clean up. Thanks in advance for any insight or advice about what to do differently or if there are other accessories to try.

 

[DJW]

Hi. Sound like your doing it right. But with your recent surgery the stoma is changing. I'd get in touch with the stoma nurse to see about a visit. Your appliance may need upgrading.

 

[nogutsnoglory]

I have lots of trouble too. If you had better wear time before, did you change something? Is your skin irritated or belly swollen?

I use Eakin rings and paste to provide extra protection.

If your leak is in a certain area usually, you can roll a little Eakin ring piece and plug it by the barrier to create a small dam. I also tape around the wafer like a picture frame for extra security. It's not full proof, I still get leaks but it prolongs my wear time a bit.

 

[2thFairy]

You may have a bad batch of bags.
Since your leak is in the same place, it is also possible that your skin has changed in that spot. I recently started having issues with my bags losing adhesion in the same area, getting only 2 days instead of 4. I thought that particular box of bags was defective and switched to one of my old ones, but still had the same problem in the same spot. I think my skin is getting seasonally dry in that spot and just not able to hold on to the skin. I'm not sure what to do at the moment, since adding lotion to the skin would be an instant fail, so for now I'm just adding Tegaderm to the area that keeps coming loose.

 

[PsychoJane]

For me, the rings and such make my condition worse. I use 2 pieces system without anything else, sometime I'll put some paste on. This was not the way I was suggested to proceed at first, I came to that method through time. Nothing else than the wafer and the bag itself. No use of skin prep, no use of adhesive remover either. I wash with water and soap if I shower without the appliance then dry out and apply, otherwise, I use saline water, plain or thermal water, dry and apply. I only use the paste, spray and powder if I get irritation and this allows me the best wear time. I get the best adherence and longest wear time from coloplast sensura-click (2 piece) system.

I recently received samples from another brand and I was highly enthusiastic to try them and it resulted into plain catastrophe for the 4 attempts I had out of their product... Actually, I was trying paste and ring and collar and stuff... yeah... I did flirt back with the humiliation of ostomy appliance failure mess... My point here, it worth trying all the brands out there. If you have not yet I would encourage you to contact all the companies for samples. Some are quick, other are rather slow at sending them. I don't know where you are at but generally, apart from hollister you might want to contact Convatec, Coloplast, Salts. These are the one that are available where I live and they are generally available worldwide.

Also, do you notice a crease or something where it leaks? I know that at some point I had a little bump next to my stoma and it would encourage leaks by creating a crease while I was sitting down. I solved that at some point by putting a little patch of duoderm before I'd put my appliance on. It helped.

 

[nogutsnoglory]

Psychojane if you don't use a ring or paste doesn't your skin get irritated from the fecal matter that touches it? Even a tight cut will still get some on your skin?

Salts doesn't ship to the US but they do most elsewhere around the world.

 

[PsychoJane]

I have a little irritated zone, maybe 1-2 mm. It gets red only if I extend my wear time to 7-8 days and if I eat let say; nuts, multigrain food and stuff with little seeds as it get stuck there. I do it as a seal,in my case will, for once, never last the 7 days (it gets eaten no matter what), and second it seems to predispose me to quicker leaks (ironically).

 

[nogutsnoglory]

Those seeds can also get stuck in inflamed portions of intestine or scrape your bowels. I'm not sure nuts are the best idea but you know your condition and body.

 

[PsychoJane]

Nuts are only to be avoided if you have an active flare or diverticulis. I don't eat them in excess but they don't harm me as long as I don't: a) eat them in a moderate amount, b) never alone and c) chew them properly.

When they are not soak, the pieces will remain hardish (worst being peanut and almond), that's why they get uncomfortable if they slip around the stoma. It gets itchy. A little handful at a time is fine for me and while you do it, better to drink and eat something like banane/bread/rice as it helps transporting them if it make sens.

Over 2 tablespoons at a time would probably be excess in my case. Everything as to do with moderation.

 

[BowelMeOver]

I hope I can get some advice since recently my ileostomy has been leaking out on one side. I'm using Hollister 2-piece system.

I'm not sure if you are saying that the adhesion of the flange breaks down, leading your output to find the easiest escape route, or if you are actually leaking behind the flange itself.

If it's the latter, then take advantage of one of the great benefits of that 2 piece system you are using, and keep an eye on your stoma and the fit around it on day 2. If you notice any gaps, you can use paste or a piece of a barrier ring to plug in that area. Heck, according to Coloplast, you can even use the whole ring around your stoma on top of the flange to create a better seal.

We are only five weeks out from surgery, and have had these same issues. It's very important to keep a good eye on the shape and size of your stoma, even three months later.

Best of luck in resolving this soon!

 

[jsesaic]

When i had my stoma this happened because the stoma had become flush (flat). I had to use convex bags to stop seeping.