Husband had LAR on Monday, ileostomy bag continues to leak please help

[wifeandmother]

David had his LAR on Monday and is vey depressed and upset that his bag is constantly leaking. Excuse my current lack of knowledge of correct terminology, but it is leaking from the site that is attached to his skin. Twice the contents of the bag leaked so bad they went under the dressing on his wound and got in direct contact with the wound. Not good. He had an ostomy nurse coming by once a day but in the meantime the other hospital nurses are trying to help him and nothing is working to prevent the leaks. Does anyone have any tips??? I should add he has oily skin which is possibly not allowing the tape to stick as well, and he is having big output at the moment. The bag needed to be emptied every 1.5 hours at night. He also had developed a small wound beside the ostomy that I assume is from the tape and acidic contents of the bag.

Thank you for any insight. His spirits are broken and I am desperate to help him with this leaking bag.

[Lydia666]

I am sorry you are dealing with this. I have a bag too and i hate it- lots of output and leaks but less so than in the beginning. I think the actual hole/ stoma changes, becomes smaller and causes less trouble with time. I had it for 3 months now, less than 5 months to go!
Just research the forum, people have lots of tips for ileo. For me , time improved things. I used to have horrible leaks, now they are very rare.

[texazgal]

Two things come to mind. The oily skin is definitely a cause of leaking. You need to be using a nonfatty soap on it, like Ivory. Clean and dry with a hair dryer set on med temp. At one point, I even cleaned mine with Joy dishwashing detergent(much to the dismay of the ostomy nurse). And rinse well. Also, I have found a few products that work well for most, simply will not adhere to me. So call around, get samples from other companies and try to find something that will work for him. The one I was sent home from hospital didn't work for me and caused many leaks. I tried the Convatec moldable durahesive and it is my go to for a full week of leakfree time. Use of a powder or spray can cause adhesion problems. Also, try using a barrier seal such as Eakins as an extra. Coloplast and Hollister make good seals as well and they aren't as expensive. Finally, go to the UOAA site and read the forum there. There are all types of ostomates on there with a wealth of information.

[stevieb]

There is a paste that you can use that helped me tremendously. Ask the ostomy nurse about it.

[EverySunriseCounts]

Lydia,

PLEASE look into this product: http://www.amazon.com/gp/product/B00JWSFT3Y
It's called Sure Seal (if the link doesn't work). You can buy it through Amazon.

It's basically very strong, sticky, waterproof lightweight plastic that you put on OVER the ordinary seal. It's a PITA to put on, but once it goes on it stays. Drastically reduced leakage incidents for my sweetie.

Hope you find something that works!

(It's weird, the product was developed by a guy with an ostomy, it's not sold by any of the normal companies).

[JudeD59]

I had nightmare problems with leaking after my ileostomy. The first question I'll ask is if your husband's stoma sticks out from his abdomen or is almost flush with his skin. And when the bag is off, have you ever noticed any output coming from the side of the stoma instead of just from the top? If the stoma doesn't protrude enough or has a small second opening in the side (as mine did) he will need to use a convex wafer that pushes the stoma out and above the wafer. Otherwise, the output is able to sneak under the wafer and leak out. You should be able to ask the stoma nurse to give you a convex bag to try.

There are wipes you can buy that are specifically for ostomies that remove any oil, soap, feces, adhesive, etc. from the area before you apply a new wafer. I use Safe and Simple No Sting wipes at every bag change. I then let the area dry completely before putting the wafer on. If the leak is always coming from the same spot, you can ask the nurses to put a piece of HY tape or other strong waterproof tape across that part of the wafer to hold it down more securely and prevent feces from reaching the incision. I had to do this after my bag leaked into my open incision several times.

Another thing I've found that can cause leaks is not emptying the bag often enough. You said he's having high output right now. When the bag fills up more than halfway and gets heavy, it can pull at the wafer and loosen its grip on the skin. I try to empty mine when it is about a third full because of all the problems I've had. And when it's really full and I'm walking to the bathroom, I put a hand over it to give it some support so there is less pulling on my skin.

Another option is called stoma powder. It's a light, talc-like powder that I brush on with a makeup brush before putting the wafer on. It has to be a light coating, almost see-through, but that should absorb any oil left on your husband's skin. The nurses should have that on hand for you to try, too.

I don't know what brand of bag your hospital provides, but mine provided Coloplast and it was a nightmare for me. Even after I got my problems resolved, I tried Coloplast again and the problems started back up. I now use Convatec Esteem Synergy two piece bags. The wafer is more of an almost wax-like material that molds to your skin as it warms. The center hole also turtlenecks around the bottom of the stoma as your body heat warms it and that also prevents leaks.

It's really a game of trial and error at first to see which products work for you. And all the products and suggestions can be overwhelming. Don't let the nurses change his bag unless it has leaked. Changing it too often can cause skin irritation, which causes the skin to weep, which causes the wafer to come loose, and more leaks. If the bag has leaked, it needs to be changed quickly to prevent the stomach acids from irritating the skin, but don't let nurses change it repeatedly just to check on it or to demonstrate to you how to do it. Mine was changed about five times in the first week for no good reason and I ended up with bloody patches from the irritation. Also, when it is removed, always push the skin away from the bag gently with your fingers instead of pulling the bag away from the skin.

It will get better, I promise, and this is coming from someone who had major problems in the beginning. There are lots of people on this board who are here to help.

Judy

[chrisca]

I found Coloplast barrier film stuck better than the others out there. If the skin around the stoma has wrinkles or is uneven, barrier rings may also help. They are made of a soft and squishy material that molds to contours. I ended up cutting them and attaching them to the wafer to make a better seal in the low spots around the stoma. No one manufacturer makes a product that works for everyone. You may need to use wafers from one, barrier film from another, etc. But keep at it and you should get to the point where things are manageable. Reducing sweating will also help keep the seal tight. That may involve cooler clothing, room temperature, etc. Some drugs can increase sweating and skin oils and it's worth checking to see if that's happening.

If skin is hairy, be sure to shave carefully. Use a magnifying glass if needed to get any hairs that are right around the stoma tissue. I had a couple of them that were nearly invisible, but seemed to be the first source of the leaks. I used a curved fingernail scissors to trim them. After that, leaks were less of a problem.

[Sams wife]

Did the ostomy company send you any samples yet? If they did, maybe they sent a wax ring
( barrier ring) or 2. We didn't know what to do with ours when they sent samples. Or hubby didn't want to change from what ostomy nurse said to do. But these rings are pretty sticky compared to the paste. Maybe it will at least stop it from leaking to the outside.

My husband had blisters. Maybe 3, after surgery. We assumed it was from the tape. Fast forward to now, ostomy nurse thinks he will be allergic to the tape on back of wafers. He ended up with an itching burning rash that kept spreading. I didn't think an allergy would come this late but I guess it does. Be careful that he isn't allergic to them. And 6 months down the road too. His itching was all over tho. Legs back belly.
Hope they've figured something out by now

[chrisca]

One thing I forgot to mention is the reason I went with the barrier rings instead of paste was that I was allergic to the paste. It's possible to be allergic to a particular chemical formulation of anything in contact with the skin. Once an allergy starts, it can increase leakage. In that event you'll need to try different manufacturers and/or methods to find what works for you. It also helps to be meticulous with getting the hole in the wafer exactly the right size, and to account for a stoma that's irregularly shaped (oval rather than round). I made up a template from a piece of cardboard that was exactly the size and shape I needed and cut the hole in the wafer to match it by tracing it with a pen onto the backing paper for the wafer. Over time, I had fewer leaks.

[wifeandmother]

Thank you so much to everyone who responded to my post. I'm sorry I was late in writing back-In dealing with everything going on with David I have become a bit of a recluse and don't want to talk to or see anybody other than my little family. All of my energy is spent caring for our child and David and I have nothing left for anyone else. I'm feeling a little bit better lately though.
Anyways, so his bag is currently not leaking and I'll share what worked for us. David's stoma does extend slightly past his body, so a concave wafer was recommended. His output comes from the bottom of the stoma-he has a loop ileostomy. He also had two "divits" on his stomach where the wafer rests so we cut two small pieces off a wax ring to place on those divits. This was done so the wafer could sit flush on his skin. Also his stoma was changing in size regularly (getting smaller post surgery) so re cutting the wafer to a perfect fit over the stoma worked well to prevent leaks.