Living with an ostomy means having to deal with the occasional leak. But you can prevent discharge by knowing how to care for your stoma and using the right appliances.
Whether you’ve recently undergone abdominal surgery and been fitted with an ostomy bag or have had one for several years, you’ll want to do everything you can to prevent leaks. Preventing discharge from your ostomy pouch begins with knowing how to care for your stoma and the skin around it, as well as finding the right appliance for the shape of your body and stoma. To do that, start by following these five tips to reduce the risk of leakage:
It’s important to get fitted with a skin barrier that fully covers the stoma with no skin showing between the appliance and the stoma. An ill-fitting appliance allows output to seep out and cause a leak. Each stoma shape is unique and it may change over time, so be sure to measure it regularly or have a stoma nurse measure it. You may need a new skin wafer if your stoma has changed size. If you have a recessed stoma, request a convex-shaped skin barrier for a better fit.
Creases or dips in the skin around the stoma may prevent the skin barrier from snugly adhering to the skin. To even out the surface where the appliance will adhere, apply a stoma paste around the opening. Fortunately, there’s a wide variety of ostomy products available. Many manufacturers provide free samples so you should be able to find one that’s right for you.
Red, moist skin surrounding the stoma makes a secure fit more difficult. To maintain healthy peristomal skin (the skin around the stoma), dry the skin completely before you attach the appliance. When cleaning the stoma, use mild soap and sprinkle on a powder specially made for peristomal skin (rather than baby powder). A proper-fitting appliance prevents skin inflammation because fecal waste cannot leak out and irritate the skin. Consult your stoma nurse if you notice broken, inflamed skin that doesn’t heal.
If a bag is weighed down with output, it’s more likely to disattach from the skin and spill fecal waste. A good rule of thumb is to empty the pouch when it’s about a third full. Generally speaking, replacing the bag and skin wafer with a new set should be done twice weekly. However, the type of pouch system may also dictate how often it’s changed. One-piece appliances should be changed daily, while two-item systems should be replaced every other day with a new pouch attached daily. It all depends on your preferences and your stoma.
To avoid irritating the peristomal skin, slowly and gently remove the skin wafer. Start at the top and carefully separate the wafer from your skin. Clean the area with an adhesive remover wipe designed specially for peristomal skin. That ensures a smooth, adhesive-free surface on which to attach a new skin wafer.
Clothes that are too tight may cause friction between your outfit and the stoma and appliance, which may force the barrier to loosen and cause a leak. If you play sports, it’s especially important for the wafer to be secure. To keep the skin barrier in place as you twist and turn your torso, wear an ostomy belt or securely tape the appliance.
Despite your best efforts, leaks sometimes happen. If they occur, find where the leak starts and patch it up with tape or a napkin until you can find a private place to put on a new pouch and wafer. Always carry an emergency kit with your ostomy supplies (wafer, pouch, wipes, deodorant spray) so when leaks happen, you have everything you need to remove and affix a replacement. When away from home, empty your pouch whenever you can in order to avoid an over-filled bag and a possible leak.
The Center for Ileostomy Surgery has helped hundreds of patients lead active lives after an ileostomy. Our staff will guide through the surgery and recovery, and teach you how to maintain your ostomy after your operation. Contact us today and we’ll answer any questions you may have.