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

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To Good Health
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Joined: 2009-12-22 07:36:28

Re: Please Help! Are there any rings that last more than a day?

Post by To Good Health »

Hi Ron, could you tell me the name of the Coloplast two piece system you use? By paste, do you mean what comes in a tube or what comes in the strips (I have both but using neither at the moment)? I too have high liquid output and frequent output. I use the Brava strips every time. Thanks.
Merry Christmas to you,
TGH
Chemo/rad Mar 07
APR/ileo May 07
Perm colostomy 2009
Perforated colon Nov 2013
flux
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Re: Please Help! Are there any rings that last more than a day?

Post by flux »

The WOCN in my city said she does not know what I should try, and that I should come on this board instead.

Susan.... Thanks. The Assura and Eakin you mentioned are both hydrocolloid material. When I tried the Eakin, it swelled up like a sponge after just a few hours. See what happens, is the leading edge of the barrier, where you cut, is touching a stoma... so you have a material that's designed to absorb moister, perpetually touching a stoma whose membrane naturally and constantly releases moisture. So I don't see how a hydrocolloid material could ever be compatible or appropriate for this use. (I will try a two piece, even though like you said, it's the same hydrocolloid material so in theory shouldn't be any different.)

Right now I'm experimenting with different glues and industrial products to seal that leading edge of the wafer before putting it on, so that it is waterproof. Let you guys know how that goes. So far what has not worked is Vasaline, Desodin, Calmoseptine, hydrocolloid putty and pastes like Karaya, etc. Next I'm trying New Skin, Urobond III, and silicone for aquariums.

Murph... thanks for the spray idea. does it waterproof? I heard that spray is pretty harsh to the skin when try to remove?

RonMc... for some reason, for me, adding paste or rings under or over the barrier just makes the situation worse. What happens in either case, is the added paste or ring swells up quickly as it sucks up moisture.. this raises everything that's around the stoma to almost an inch high, ultimately making the stoma flush (and the bag on top acting like a dam) thus sending all output under the wafer instead of in the bag.
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ot dave
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Re: Please Help! Are there any rings that last more than a day?

Post by ot dave »

I know that you are trying to find a barrier ring, but just to give your skin a rest, have you considered rinsing your pouch out with water each time you empty? I know this doesn't solve your ring issue, but it may give your skin some rest while you are experimenting. I have a colostomy, and before I started irrigating, I would use the adapt barrier rings, which are made of the hydrocolloid material, and I understand what you are describing about it "melting" away. What I did, when I used them, was to pinch off a piece, roll it out thin, and then placed it around the edge of the opening of the flange. I made sure that I had about 1/8" space between my stoma and the edge of the flange. That way, the barrier never touched the stoma, thus increasing its useful time while in place.
Anyway, back to rinsing. I still have occasional unexpected output. When I do, I get the pouch emptied as quickly as I can, especially if the output is hanging around the opening to the flange. The rinsing with water, in my opinion, makes me feel like I have on a fresh clean pouch, it helps increase the usefulness of the filter, and it helps a lot with decreasing any possible odor.
I hope you find a solution.....

David
stage III rectal CA 12/08 - colostomy 3/09
"Gatoring since 2010"
Psalms 91:2
flux
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Re: Please Help! Are there any rings that last more than a day?

Post by flux »

Thanks Dave, but a colostomy is a completely different situation.
We can not use filters, they clog after a few minutes.
We can not rinse our bags, they refill after a few minutes. (I empty about 14 times a day)
When I tried putting ring/paste material to block the exposed edge of the barrier, it did nothing because it becomes soggy after just 1 or two hours, and then passes all that moisture to the barrier anyway.

I've tried some more things the past couple days, applying it to that leading edge of the barrier that surrounds the stoma.
Although these didn't work, I figured it be useful to post them so it saves others the trouble of trying them, and maybe it will help trigger a new idea from someone reading, and they can post it below. So the past two days I've tried vasaline, Desodin, Calmoseptine, New Skin and Uro-bond III. Anyone know of a solution??
Soccermom2boys
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Re: Please Help! Are there any rings that last more than a day?

Post by Soccermom2boys »

Hey Flux--

This is just a troubleshooting thought that I am just throwing out there. So I am wondering if you take a barrier/protective sheet and cut out a ring that you handcraft to fit around your stoma. Then to ensure it does not come in contact with the stoma as that is what is causing the moisture issue to eat away at the adhesive seal, I would suggest cutting your "ring" in to two semi circles so that you could put them on separately so that you can maneuver them to be just right distance away from stoma to not expose much skin but also not to butt up against stoma and become moist. Then this will allow you to make the opening of your pouch to be a little larger because you know your skin will have the protection from your homemade ring and then also keep the opening from getting moist from the stoma. Not sure if this will fix your problems, but thought I would share in the event it is helpful. Good luck finding a solution! :)
Dx rectal cancer 8/2015 @ 45 y.o.
APR/permanent colostomy 12/2015
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flux
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Re: Please Help! Are there any rings that last more than a day?

Post by flux »

Soccermom... Thanks for offering up another idea. I'm not sure I see what you mean though, because whatever you apply, is either going to be touching the stoma, or else exposing skin. There is no free zone in between those two that doesn't need protection, as the skin and stoma are touching.
I have played around with doing custom rings like you said, but have not found a company that makes one that's not hydrocolloid (absorbs liquid like a sponge).

If it helps, here's a picture taken 2 hours after putting on a new barrier. You can see that the barrier around the stoma is already turning into white gel, and a few hours after that, it's dissolved so much, the output just passes right under it.

https://drive.google.com/file/d/0B32O4V ... sp=sharing

And if I add anything under or over the barrier, it makes it worse because is swells up and makes the stoma flush with the entrance to the bag.
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Jimbob
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Re: Please Help! Are there any rings that last more than a day?

Post by Jimbob »

Good Morning Flux;

In your picture I noticed some wrinkles on the flange you are using, also I see the breakdown of the ring. Frustration!!!!

In my opinion often times less is best.

Let me suggest a new track, It cannot hurt. Try using a Convex two piece product without any additives. Obviously the Hydro rings are not working for you. The flange alone. The convexity will push the stoma further into the pouch and the waste will be eliminated away from the barrier. If it works, big if, the two piece will keep you from having to change the flange so often helping your skin.

Before applying make sure your skin is completely clean, I wash with Dial soap, do not use anything with any aloe or perfumes or lotions etc. Make sure the skin is completely dry, might want to use a hairdryer on low setting, don't burn yourself.
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ot dave
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Re: Please Help! Are there any rings that last more than a day?

Post by ot dave »

Flux,
The rinsing suggestion was to give you another tool to "cool" off your skin. If you're already emptying 14 times a day, what would it hurt to flush/rinse out the pouch with some clean water while you are there to get the output off of the skin and let it be output free until the next time you needed to empty? Another trick to keep your skin protected that I haven't seen you try yet is Tegaderm. It's basically a piece of tape used to cover wounds. It's thin, pretty adhesive, and keeps the skin underneath nice and clean. Another product that is similar is called Duoderm. When I get an abscess under my flange, or a raw spot, I will use these to allow the area to heal. They do well under the flange, but I've not tried them next to the stoma, but I think that they might provide some relief. You can order them on Amazon, and they aren't expensive for a box.
I agree with Jimbob, for me, less is more. I only use my flange. Sometimes a barrier spray on the skin if it is a little raw, but mostly just the flange.

Oh, have you tried heating your flange before applying it? Using a hairdryer to warm it up before application really helps my flange to stick well. Hopefully you'll find something that works soon. You must have the most toxic output on this board!!
Keep us updated, hopefully we can help you come up with something that works well.

David
stage III rectal CA 12/08 - colostomy 3/09
"Gatoring since 2010"
Psalms 91:2
Jamesdee2010
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Re: Please Help! Are there any rings that last more than a day?

Post by Jamesdee2010 »

I don't know if this will help you but usually when you feel you pouch filling, empty it and flush the stoma and area with water from a small plastic irrigation bottle. You can get them on ebay for a couple of bucks. That way you are keeping your caustic fluid away from the stoma and wafer.

Give it a shot, you have nothing to loose.
Jim Markevitch
Grapevine, TX
flux
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Re: Please Help! Are there any rings that last more than a day?

Post by flux »

JImbob... you may have seen the picture incorrectly, as those wrinkles are the bag, not the barrier. Yes, I've tried convex, and it breaks down at the same rate as the flat. (Since it's composed of the same material, it makes sense the convex will absorb the stoma mucus just as fast as the flat barrier) Yes, I only use dial and I use a hair drier to ensure the skin is totally dry.

Dave... I think you're mis-understanding, as rinsing the pouch only removes the output for one or two minutes, then it's back. I also don't think it's the output that's causing the barrier to break down, and so rinsing would make it worse, as it puts more moisture on the hydrocolloid. Yes, I've been using the hair drier on the barrier before application. It helps with sticking, but not with barrier breakdown, which is the problem I'm having.

I now have to change the barrier twice per day.
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susan f
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Re: Please Help! Are there any rings that last more than a day?

Post by susan f »

Flux,

If the edge of the wafer touches the stoma, try cutting it *just* a little bit bigger so it is almost there but not quite. If you are cutting it too small that can also be a problem. I have a very wet stoma and this is something I do. Hydrocolloids like Convatec Durahesive don't work at all for me either.

Convatec Stomahesive and Coloplast Extra Extended are not Hydrocolloid. Eakins is... I'm not sure, its designed to turn to a gel and stay on your skin.

If you are using a one piece, believe it or not, it does make a huge difference even though its the same material (I have proved this to myself over and over).

As you describe your problem more, I have a better visual... Have you tried using just a small, 1/4 inch wide, 1/8 inch thick ring of Eakins? It can provide the protection without creating the thickness.

Find another WOCN, one with a better answer than to come online, that is a terrible response.
UC Diagnosis 1981
J-Pouch 1988-2002
Permanent ileostomy 2002-now
Crohn's Disease Diagnosis - 2015
flux
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Re: Please Help! Are there any rings that last more than a day?

Post by flux »

susan... I've searched for other nurses, but the few other ones I've found in my city, all say that the one I'm already talking to knows more than they do. And that the one I'm talking to, is the only one who talks to outpatients.
gap
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Re: Please Help! Are there any rings that last more than a day?

Post by gap »

Guessing you haven't solved the problem yet? My thoughts are the same as Susan's. Do you leave about a sixteenth inch of space between the Wafer and the vase of the stoma? I agree with her; that is important because when I experimented with a Wafer hole size that was snug against the stoma, the crap immediately worked it's way under the Wafer.
Believe you said you had tried a silicone ring "but it didn't stick." Rings don't have to stick to work. They just have to stay in place long enough to get the Wafer on top of it. Have you tried the Safe n Simple Conforming Seals rings? they are very thin without having to work them at all and in my case, keep their shape longer then Eakin or any other ring I have tried. In short, space between the Wafer and the stoma, and the ring right up against the stoma. Good Luck.
flux
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Re: Please Help! Are there any rings that last more than a day?

Post by flux »

Hi Gap. That's correct, I've not yet solved the issue. It's become a nightmare.
I'm not sure I understand/agree with your statement that "the ring does not need to stick to work"... because if the ring does not stick to the skin, then the liquid output simply seeps right under it and sits there under the ring destroying the skin.
I've tried the Safe n Simple ring, but just like all the other brands, they make it out of a dissoluble (hydrocolloid) material, so it dissolves after a few hours. I need to find a ring that is not a dissoluble material.
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Mara
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Re: Please Help! Are there any rings that last more than a day?

Post by Mara »

Sorry I don't have any real suggestions for you.....however, I have an ileostomy and use an Eakin seal which usually lasts for a week.

I am wondering if you have had your ileostomy for a long time meaning - is this a long term issue or something that happened recently due to some change in your body/health/routine. Sort of important to know to try to find a solution. As other posters have said, there is no reason you have to use a seal.

You might do better by trying to discover why your output seems to be dissolving your seal/faceplate in a few hours. Some type of medication? Diet? Something else?
Ileostomy due to UC - 50 odd years
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