Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

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susan f
Posts: 1163
Joined: 2005-10-01 21:26:14

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by susan f »

Hi Flux,

If you used to get a week, and now it's hours, can you think of something that has changed? Weight gain or loss? Diet change?

When I started having a Crohn's Disease flare up, my wear time went down and I erratically got leaks. I broke down barriers faster too.
UC Diagnosis 1981
J-Pouch 1988-2002
Permanent ileostomy 2002-now
Crohn's Disease Diagnosis - 2015
pnoteye
Posts: 2
Joined: 2018-03-31 21:56:41

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by pnoteye »

Was a solution ever found about this? I seem to be having the same damn issue - Had ilieostomy a year ago.. was going a week easily, now Ive been slowly shortening that over the last few months to 2 changes a day! its driving me nuts!

Flux, did you ever find a solutuion?
DarellFromCalifornia
Posts: 1
Joined: 2018-04-24 13:26:54

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by DarellFromCalifornia »

I just found this forum after searching about the same problem. I am another active person with an illeostomy, since 1982. I have always used Convatec (Stomahesive) 2 piece systems. Over the last several years at least, it seems like the wafer/barrier material is much less durable. I began using convex inserts long ago but, even with them, the wafer material around the stoma gets eaten away within 24 hours, leading to long-term skin degradation and worsening the seal. I am a university research scientist and am very frustrated with the huge impact this seemingly simple problem has had on all of our lives. There are 2 basic lines of explanation: One set revolves around changes in the person -- weight gain /change in body shape (not my issue), change in GI chemistry making your discharge more acidic than it used to be, etc. The second line is about the barrier materials themselves. It seems to me that a 'barrier' material marketed for illeostomies should be resistant to the discharge from illeostomies! That is the crux of it. It appears that the companies came up with materials that work well enough for colostomies, and they sell the same stuff for illeostomies. Is it rocket science to develop a material that works as it is marketed to work? In other words, a barrier material for illeostomies that adheres to the skin and is non-allergenic, like the colostomy materials, but is not dissolved by the normal range of small intestine acidity? And doesn't swell up and change shape ('turtle-ing'), which just compounds the problem? I'm pretty frustrated too, and am going to try to push on this front with Convatec and maybe some other manufacturers for awhile. It may be helpful to get a bunch of our names together at some point to try to press the point with a little more clout. Any ideas are welcome, thanks
incidentally2
Posts: 6
Joined: 2019-03-22 16:33:52

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by incidentally2 »

flux,pnoteye, DarellFromCalifornia
(Please note that I am the one who deals with the Ostomy (ordering/taking pouch on and off, etc) for my husband, so I feel ownership, and thus my use of "I".
Did you ever find a solution to the barrier rings dissolving? I am having the same problem and could use a few suggestions. Currently using SensuraMio Deep Convex Ostomy pouch with Adapt barrier ring. Have recently added an extra barrier ring (Adapt Slim) on top of all this. I get about a day with this process. When I look at the pouch I've taken off, you can see that the ring is pretty much mush, and there is a breach. Any suggestions are appreciated.
Button
Posts: 3616
Joined: 2017-10-10 22:14:15

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by Button »

Incidentally:
There is a brand named “Trio” that makes a line of silicone-based ostomy products, including a silicone-composite barrier ring.

You can Google “Trio Ostomy Products” to get to the Trio homepage and learn about their products.

I have used their silicone adaptic barrier ring and found it to be very comfortable and less subject to erosion from digestive enzymes.
Karen
Intestine perforation, sepsis, ileostomy, 2012
Addison’s disease + endocrine failure
Palliative Care
incidentally2
Posts: 6
Joined: 2019-03-22 16:33:52

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by incidentally2 »

Karen, thank you. I've ordered a sample. Their rep tells me they go back to original form easily. This may be a problem for me since stoma is oval/irregular shaped. Hope it arrives soon!
Button
Posts: 3616
Joined: 2017-10-10 22:14:15

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by Button »

Incidentally:
Trio products are made of a high quality medical grade silicone.

An adaptic barrier ring can be modified to be other than its prefabricated round donut design.

Cut the adaptic ring vertically along its center, creating into two half-moons of equal size. ( and )

Take one of the half-moon ( shapes, place on a firm surface/table, and use the palm of your hand to roll it back and forth, creating a snake/log that is about 1.5 “ in length.

Then lay the snake/log of silicone barrier ring around the oval wafer opening. Using your finger tips, press the snake/log of silicone ring into the wafer to enhance the silicone ring + wafer cohesion. You can also use a hair dryer for 30 seconds/1 minute to heat the silicone to enhance silicone ring + ostomy wafer cohesion. Now you have created an oval shaped barrier ring.

If you end up liking the Trio adaptic ring, you may also want to try some of their other ostomy products. Trio makes an adhesive skin remover that is AWESOME. A few light spritzes at the boarder of a wafer, and the wafer sloughs off with ease - like using the popular kitchen food spray Pam to keep foods from sticking to a pan. Trio adhesive remover is a great product to use where pariatomal skin has been repeatedly irritated in removing an ostomy wafer.

Fingers crossed that the Trio barrier ring brings you new found success in caring for your husband’s stoma and no more leaks.
Karen
Intestine perforation, sepsis, ileostomy, 2012
Addison’s disease + endocrine failure
Palliative Care
flux
Posts: 25
Joined: 2016-12-07 21:13:52

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by flux »

Darell, Karen, Etc.
Original poster here.

Yes, exactly, a "barrier" should be made of a material that is a BARRIER (which there are 100's of materials out there in science that would accomplish that), yet all manufacturers only sell us the ostomy material, that is designed to absorb (and dissolve) INSTEAD of block.

To give you guys more knowledge, that the ostomy nurses don't even seem to know, is that it's NOT acidity. Ileostomy output is actually alkaline (base) with a pH of about 9 (mine was lab tested). The reason the materials are breaking down is MOISTURE (and sometimes combined with skin losing its bond with the barrier). (enzymes are involved as well)

I've had no luck yet in solving the issue.. I get about 10 hours wear time before it starts to leak under the barrier and burn/eat the skin. I have tried about 40 different options, including glues, latex, silicone, rings, pastes, tegaderm, tapes, etc.

I have noticed in my case, that during peristalsis (movement of the intestine) that the skin around the stoma moves a lot (mounds, flattens, mounds again, etc). I believe this causes the skin to lose its bond with the barrier. I would try taking 1/8 of a Coloplast strip paste, roll it into a thin string long enough to make the circumference around the stoma. Apply it to TOTALLY dry skin, then apply the barrier. I found, the less you apply below your barrier the better, because once rings start to absorb moisture, they expand and cause the barrier to be flush with the stoma, and promote leakage. It also helps to leave a little air in the bag after each empting, to prevent the bag from "topping" the stoma like a seal, and thus encouraging the output to pass under the barrier instead of into the bag.
Another thing to try if you have this skin movement, is a barrier with convexity close to the stoma, to help push down and prevent the movement of the skin. The convexity also helps from the bag "topping" the stoma.

If you find anything that works, let me know.
Oh, if output is liquid, try to eat mostly rice, oatmeal, potatoes without skin, bread, bananas, etc.

I've purchased and tried several of the Trio Silicone rings, since they do not dissolve, but can't get them to work.
They do NOT stick to the skin at all, so the output passes right under them within an hour.
I have even tried adding different skin glues, but the glues do not stick to the silicone (0%), so don't work at all.
(the Trio rings are also WAY too thick, so cause flushness and don't move enough with the skin. They should have made them thin, since the whole point of those rings is supposed to be that they do not dissolve, and thus don't need to be thick. If they were thin and stuck to the skin, they would be our solution)

If you find anything that works, please send me an email.
incidentally2
Posts: 6
Joined: 2019-03-22 16:33:52

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by incidentally2 »

Karen, I just read that the SensuraMio wafer and the Trios barrier ring (silicone) are not compatible. I don't know what this means. It doesn't stick?? (my Trios sample still hasn't reached me so I just ordered it online; have not received it yet).
Button
Posts: 3616
Joined: 2017-10-10 22:14:15

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by Button »

Incidentally:
I have not heard that the Trio silicon adaptic ring is not comparable with the Coloplast Mio.

I use both the Trio adaptic ring and the Convatech Ekin adaptic slim seal with the Coloplast Mio one-piece. I have had no difficulties with the Trio adaptic ring.

The Trio adaptic ring does require a more studied application, I have found. I need to take more time in molding the Trio ring and using a hair dryer to enhance the seal then I do with the Ekin adaptic slim seal.

Some people like the Trio, some people do not like the Trio. The silicon is different than the typical hydrocolloid material and can take some time to get used to.
Karen
Intestine perforation, sepsis, ileostomy, 2012
Addison’s disease + endocrine failure
Palliative Care
Cinder
Posts: 3
Joined: 2019-04-02 23:15:18

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by Cinder »

What kind of bags are you guys using? Flat? 2 piece? My rings never dissolve that seems very weird. Have you tried convex 1 piece bags that keep fluid away from the site more?
incidentally2
Posts: 6
Joined: 2019-03-22 16:33:52

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by incidentally2 »

I am using deep convex sensura mio one piece. And have the ring dissolving issue.
Button
Posts: 3616
Joined: 2017-10-10 22:14:15

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by Button »

Incidentally:
Just a thought . . .

It may be that the deep convexity design is contributing to the disintegration of the adaptic ring. Convexity can encourage liquid output to pool in the configuration/depth of the bowl shape.

You mention that you are using Coloplast. Coloplast has a relatively new design called the Mio Flip. It is designed to contour to rounded hernias and/or a rounded abdomen surface. The Mio Flip might be worth trying.

I have a flush ileostomy stoma. I do not have a generous “spout” of a stoma. A WOCN initially directed me to using a convex wafer. The rigidity of the plastic convex bowl was not a good match for my small frame, as basic everyday body movements would cause tension at the interface of the plastic convex shape and the seal of the wafer. Endless leaks. One leak after another.

When I ditched the assumption that a flush stoma needed a convex wafer I found relief from leaks. What has proven to work with my flush ileostomy stoma is a one-piece design with a low profile/flexible wafer. The Coloplast Mio one piece and CyMed Microskin one piece and two-piece adhesive coupling systems have been my “Go To” pouching systems. A low profile and ultra-flexible wafer allows an more exacting intimate contact with the skin then I was able to achieve with a convex wafer. Enhancing the wafer’s total skin contact was the winning feature.

You could try a similar approach with your husband. Ditch deep
convexity and opt for a ultra-flexible and low profile one piece wafer/pouch (or two-piece adhesive coupling) and see if more intimate skin/wafer contact + ability of the wafer to move as the body moves lessens the incidence of leaks.
Karen
Intestine perforation, sepsis, ileostomy, 2012
Addison’s disease + endocrine failure
Palliative Care
smashms
Posts: 1455
Joined: 2010-10-23 23:18:12

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by smashms »

i have also found that if i use a brava half strip around my barrier i have better wear time. i can usually get 2-3 days out of an appliance before i start itching, and i have a urostomy which is all liquid output.

these are what i use along with an adapt ring and a brava protective seal.

https://www.amazon.com/62120700BX-Brava ... 4736&psc=1
neurogenic bladder and T6 paraplegic ileal conduit 2/15/2011
incidentally2
Posts: 6
Joined: 2019-03-22 16:33:52

Re: Please Help! All the barriers and rings I've tried dissolve after a few hours!!!

Post by incidentally2 »

Thank you for all the helpful suggestions. I will keep them in mind as I need them...

Since samples were taking so long to get to me, I had to keep doing my best with what I had. I think I see success. Last change was 3 days ago! And ring was in tact; not mush. What I did a bit more vigorously was: 1. Make sure I clean off all adhesive remover well (logical, but I had been just going over the area once with warm water). 2. Make sure area totally dry. Not a speck of H2O. Very key for me. 3. Keep my "Bucky" (one of those arthritis pillows one puts in the microwave to heat up) on the pouch for about 1-2 minutes with nice even pressure. Still used Sensuramio Deep Convex (I had heard about the Flip so will keep that in the back of my mind), adapt barrier ring, and yes I also use the extra tape along the outer edge of the wafer.

I am also a bit suspicious of the quality control of all these moving parts! So I am now keeping track of the lot # of the barrier ring I use. Probably coincidental, but I just started a new box of barrier rings.
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