trouble with ileostomy leaks

Diseases & Conditions Ostomies
1
I am having a terrible time with breakdown and irritation around the stoma site as well as the wafers ar only holding 2-3 days  and then they pull off and leak.  I have tried hollister and Nu-Hope convex bags.   I have tried stomahesive powder and barrier film spray.  I have tried sotmahesive paste.  The convatec bags that are fit to size the holes are too bag at the start.  My stoma is very close to the incision and it doesn't lay flat.  I am also very thin which makes it difficult.  I was looking at the eakin seal but I think the diamter is too big.  My opening around my stoma is 1 1/4".  Does anybody have any suggestions about supplies, bags, preps.   I amy very frustrated and the stomahesive paste has to stay on al least 4 days or the paste has to be picked off when the bag falls off which is also very irritating.  Help!
 
                                                                  Sharon
 
Also does anyone else have problems with stools from the rectum on a regular basis with ileostomy.  Just had the first surgery on Dec. 13th fro the j-pouch setup.             Thanks
2

Hi Sharon

I am sorry about the leaks, but it seems to be the norm and especially since the stoma size is changing, it will settle down.  I had loads of leaks, and still worry about it alot.  I use the soft convex bags and what really seemed to have settled the skin irritation was cavilon spray.  It also allows the bags to stick, and you do not have to wiat for the spray to dry because as soon as you spray it on it dries withing seconds and then stick your bag on.  I also had stools in the rectum and I still feel like going thru there.  The docs say it is ok and just sit on the loo.  At first I had to use supositories, but check with you doc first.  I change my bag every other day, I do not wait for the seals to break down. I hope this will help you.

Rop

 

 

3

Hey Sharon, I use a lite comvex puoch and the eakin seals. The eakn seal hole is bigger than my stoma too but i just kinda form it a little to make it smaller, It works good and it has helped alot with the leaks.  Do you have insurance that will pay for them? I know they are pretty expensive, iF not I can send you a few to try, that way you wouldnt be wasting money if they dont work out. Just let me know.  also you can get samples to try too.

I have stool that comes from the rectum too, It irrates the fistulas to death. but it wont be long I wont have that problem, ther are taking out my colon and probably my rectum  because the fistulas are so bad and they wont heal.

 
I Just tell myself, it could be worse !!!
          "Even with a Bag!!!"
                Tonia                                                                

4

I use the holister wafers that are thin that feel soft and flexable with a fabric like material. Around my stoma is not flat either and the stomadhesive paste did not work with my iliostomy either. I use the eakin seals (they have 2 sizes) I use the smaller one. My stoma is 3/4" round and I have to stretch the eakin seal a little. Make sure to measure every time before as the size will change and cut away a little at a time because you cant make it smaller if you cut away too much. Make sure you pouch it very close and between it and the eakin seal you should be fine.

Also, don't put any lotions other than those reccomended by holister or such that is made to put under the wafer because the lotions could cause it to come loose quicker. One more thing. After you put the Eakin seal on and the wafer, be sure and press down on the wafer just around the opening of your stoma really good and around the floating flange on the wafer to ensure you have a good seal.

I hope this helps.

5
Dosen't it get kinda expensive changing the pouch daily??  I had my Ilestomy surgery in March 2005.    The first few weeks i was fine, the pouch wasn't leaking and everything was great.  Then i got some kind of infection and it's been down hill after that.  The infection is gone now; but my pouch leaks either every day or evey other day.    On Fri i have an appt to see an ET nurse may be she'll have some suggestions I would like to try the Eakin seals.
6

My wife had an ileostomy in nov 2004 and subsequently developed a "sliding prolapse" which made getting a bag to stick on, a bit of a problem!! to say the least.

As the Stoma varied in diameter from 25mm to 35 mm depending on it's mood, as well as varying in length from 5 mm to 80 mm, when it goes for a walk!

Initially we had bags falling off or leaking after only 5 hours and the skin became inflamed around the Stoma. However, the use of the Eaken Seal, combined with the evaluation of virtually all the bags on the market, has resulted in a good outcome.

We now use either the Convatec or Holister two part bags with the hole prepunched to 35 mm (1 3/8 inch) and rely on the Eaken Seal to take up the gap.In most cases my wife fits the new back plate when the Stoma is retracted and only about 25mm (1 inch ); making the seal a neat fit around the Stoma.

The back plate or wafer normally stays on for about 4 days and is then replaced. Both of these bag systems have very flexible backing plates compared to the other manufacturers.

However , whilst we have now standardised on the Hollister system,we had early problems with the seal on the bottom of the bag letting go and dumping the contents on the floor. However i have made a small plastic clip that has completly solved this problem and given my wife her confidence back !!

7
Thanks for the info.  I went to the ET Nurse yesterday.  She said my stoma looked fine to her and that I should try using the strip paste.  I have a dimple in my skin from the previous temp stoma area.  As soon as  I got home I noticed tht my pouch was leaking.  Which totally pissed me off.  I but another one on,using the same suggestions as the ET Nurse showed me.  This time the area where the charcoal is leaked.  So I just taped tht up.  LIFE JUST ISN'T FAIR.

 

8
I was having the same prob with my colostomy - leaking every day or every few days.  I found a wonderful convex, moldable skin barrier from Convatec.  It sticks well, and the opening is moldable and has a 'turtle neck' affect around the soma.  I LOVE it!!!
9
You may want to try a convex wafer as others have said. It helps to separate the stoma from the skin as it pushes down on your skin a bit, forcing the stoma out.

I had to switch to convex with my current loop ileo.

I use 2pc Coloplast deep convex with Hollister Adapt rings. I actually only use 1/2 the ring and mould it around the opening. I love these rings! I had a lot of trouble before I found them. I also use just a bit of the Hollister Adapt powder directly around the stoma.

Since you are thin, you could also try the Coloplast light convex which is not as deep.

Other suggestions:

If you are using powder, make sure there is not too much, and it is only in the area where you need it. wipe off any excess.

I cut the flange opening only a large as I absolutely have to - which is sometimes a bit smaller than they recommend- just keep an eye on it to make sure you don't stangle the stoma.

Try wearing a stoma belt. It will help keep the wafer attached.

You can also try sure seals. They are a tape-type barrier that goes around the wafer. I have not used these, but many here love them.

The 3M Callion spray is good too for a lot of people. I used it for awhile, but then I found it didn't really help.

There is a solution but it can be difficult finding it. It took me about 9 months or more to find a solution with my end ileo when I first had it. It was easier with this loop as I already knew what worked on my skin.

Good luck!
F/43 • ON, CAN • UC Dx Sep/09- 50cm (far as flex went)
Step 1- Subtotal Colectomy w/end ileo - Nov. 16/11
Step 2 - Pouch creation w/loop ileo - Jan 11, 2013
Step 3 - Take down - April 2013

All UC meds and alternatives failed, including remicade and FT.
10
Cut out the powder and sprays. less is more when it comes to this. I know you have some irritation, but changing so often is probably causing a lot of it. Cut the hole a bit smaller than necessary. You can order smaller ones, they probably sent you the regular size. I had to call and get the smaller size opening too. After you put the wafer on, use the hair dryer for a minute or so to warm it, then press down. Put a sure seal on the filter, it's useless anyway. My filters leak tend to leak towards day 5 or 6, but with the sure seal it keeps it in. Or, if you don't have those, you can tape a piece of toilet paper on top of it and that will help. But order some sure seals that will help possibly help with the leaks also.
good luck
UC for 8 years, before finally kicking its butt and having a permanent ileostomy April 17 2007!
-I have gone to find myself, if i get back before i return, keep me here-
No matter what kind of day you are having, take five minutes to sing loudly and dance like a fool!
11
Hi everyone, just pointing out that the original post was from 2003 so the poster probably isn't around anymore to see your answers :)
Ileostomy for 35 years due to UC. I had my surgery at 10 years of age.

Moderator of the Ostomy and Psoriasis Forums
_______________________________________________

I'm not a complete idiot - some parts of me are missing!
12
Hi everyone...I'm new here. My mother has an ileostomy bag, and is having a lot of problems with leaks. I have read some great suggestions on here, and am going to let her know about them, but my question is: what does one do once your skin is very red and irritated from the leaks? Unfortunately, my mother did not let on how bad the problem was until it was fairly bad...and the home nurses have not been as much help as one would think. Now she is very sore, and the bags seem to be leaking more and more frequently. She also thinks the sore skin is keeping the bag from sealing as well...which then causes more leakage, which then causes more irritation, etc., etc. Please help!
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Yankeetooter7- Sorry your moms having problems. You may want to post this as a new thread since it's easy to miss because this is an old post. I haven't had skin problems but they gave supplies to use if I did. The first is called 'Adapt Stoma Powder'. It looks like baby powder. Anyway, clean and dry the skin like normal. Then put the powder on the affected area. Then you use a second product called 'Cavilon No Sting Barrier Film'. This either comes in a spray bottle or a moisture pad. I have the spray. You have to spray on top of the powder on the affected areas and with your finger rub the spray onto the powder. It dissolves the powder. Once you've done that, let the area dry and attach the appliance as normal. Some people use a hair dryer to speed up the process. I'm sure others on here may have other ideas as well. Hope your mom's skin clears quick.
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I will try reposting, thanks. She has both the powder and the moisture pads, but the application of the moisture pads causes stinging (because of the skin's already being irritated?)

The home nurse is coming Monday with a new solution (we hope!), but she is simply miserable...and I am frustrated because I don't know anything to do to help her...
15
Yeah, you should repost. Just create a new thread and copy/paste your question. Hang in there, I know it's hard on you to. My mom passed last year and I took a leave to care for her. The best advice that can be given is to have a stoma specialist nurse come to see her. The home nursing service I went through only had one and you had to request her specifically. The regular nurses that came just checked my surgical incision and didn't even look at my ostomy. To be honest, they were more of an annoyance than helpful. If her nursing service doesn't have a stoma nurse. Call the hospital, my hospital had an ostomy department that trained new ostomy patients and they told me if I had problems I was welcome to stop by for assistance.

Post Edited (Mossmi33) : 4/27/2013 12:06:36 AM (GMT-6)

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I will let my mom know, thanks. She says it is the "wound specialist" coming out, so hopefully we will get better results.
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Yeah, mine was referred to as a wound specialist to. Those nurses deal with leaks and such on a regular basis and will be very helpful to finding the right fit. This forum has also been very helpful to me. Just ask and people are more than willing to help.
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Thanks...and thank you for all of your advice.