Wafer leaks on curvy belly

[kaarinademers1]

Hi all, I'm trying to help my mom who has had an ileostomy since early May. Her issue is blowouts resulting from a leak under the wafer. The stoma site is not in an ideal place, near the belly button, and her belly has creases and contours. It seems like there is a direct little crease from the stoma site to beyond the wafer. She is changing her pouch 2-3 times a day this month. Is there a way to solve these leaks/blowouts. My mom and her VNA are stumped and frustrated.
Thanks for helping.
~Kaarina

[cdogtom]

talk with the supplier or the manufacture for help ...and what is a VNA?

[jstl]

Have you checked out Sensura Mio pouch from Coloplast? The company will send you a sample. It's meant to be flexible and work with contours. Also convexity is worth looking at. A wound care nurse (WOCN) might be helpful to you as well.

[ileo73]

Hollister soft convex might also be a try. It's the only one-piece I've been able to use reliably.

[kaarinademers1]

Thanks for the leads! (A VNA is a visiting nurse. But the nurse is different most times and not an ostomy specialist).

[ot dave]

If you could supply us with the procedures she is using to apply the flange, that will help us trouble shoot possible issues. Like, is she using powder? Is she using the ostomy paste? Is she using a barrier ring/seal?
Only use powder when the skin is weeping, and even then, make sure to cover it with a skin barrier like cavilon.
I'd say from the 11 or so years I've been on the boards here, I've only read a handful of times that the paste is something that is used. The paste is a misnomer....It has zero adhesive properties. It's good at filling in dips and divots, but needs to be completely surrounded by the flange material in order to not cause issues.
The barrier rings/seals kind of act like an o-ring in your garden hose. They help keep thing from getting under the flange when placed around the stoma. These can also be used to fill in creases, and in my experience are better than paste in doing so as they have some adhesiveness to them. You can cut them, flatten them, curve them, etc. to make it work for your situation.
Is the flange touching the stoma? Ideally you'd like a 1/8" clearance around the stoma. The stoma continually releases mucous which will undermine adhesion over time.
Is the stoma flush with the surface of her skin or below? If so, a convex flange might be beneficial. If not, the flat flanges should work just fine.
Hope this helps some.

David

[kaarinademers1]

David and others,
Thank you for your replies. As my sister and I are just setting out on this ostomy journey with my mom, you all brought up great ideas and things for us to consider.
I was able to order samples from Hollister and Sensura. We are looking forward to trying them.
I asked my mom's nurse about a barrier ring and he has ordered one.
The nurse also noticed my mom's stool was liquid instead of formed. This is a major contributing factor to leakage, so we need to look at her diet (most likely her wine consumption).

[NEskier]

@kaarinademers1 I see your mom has an ileostomy so the stool will be more liquidy than formed. If you aren't working with a nurse who is familiar with the effects of this procedure, you might be heading down a path that should be avoided. Truly liquid can be bad, and contribute to dehydration which is a concern for ostomates. Just a thought, and hoping others will chime in on this. And yes, diet can/should be reviewed. I will say wine does not affect my ileo at all. Others do react to it. One size does not fit all in any way!

[ron in mich.]

H i K i,ve had an ilieo. for 30 some years and cannot drink wine as it acts like prune juice causing diarhea, things that thicken my output are peanut butter, applesauce, toast, mashed potatoes. To avoid dehydration i sip on water during the day but drink other fluids with meals. good luck

[Kalehue]

I had the same problem and tried every solution that was thrown at me. Nothing helped. I even went to the ostomy nurse with the hope of resolving the issue. The problem wasn't so much that I had a curvy belly, but it had to with the shape and direction of stoma.

cdogtom's and jsti's suggestion is exactly what I finally resorted to doing. I had avoided it for so long because I was certain they just wanted to "sell" me something and already had boxes of supplies. The coloplast rep sent me several free Sensora Mia pouches to try and they were game changers.

Be sure to use powder on any broken down skin and dry it well. This can be a challenge if you (like I was) are dealing with a high output ileostomy. Trying to get on several layers of powder and allowing drying in between was a feat to be accomplished quickly and carefully and only at select times during the day.

I went from having blow outs 4+ times/day to wearing a bag for 3 days the first time I used a Sensora Mia pouch.

That may not be the answer for your Mom, but the reps are very knowledgeable and have so much experience with dealing with these problems and issues. And -- as jsti said -- generally whatever they send you to try is free, so there is nothing to lose.

I truly empathize. I hope you get the issue resolved quickly.