My low profile stoma in a belly fold solution UPDATED Now 6 days!
Posted: 2025-07-08 21:03:33
Overview
This method has been over two years in development. I am now achieving close to a 100% success rate with a consistent 5+ day wafer wear time, even with a hinged stoma located in a belly fold, and with minimal pain. Given the difficulty of this type of stoma, this is likely close to the best achievable outcome. I'm always improving and update this post to reflect that.
This process is personalized to my body contour and an oval-shaped stoma. Some adjustments will almost certainly be required for others. That said, it should provide a strong starting point for anyone dealing with a similar stoma configuration. The instructions are detailed and thorough—please read carefully and take your time.
Number #1 help was losing weight and eventual calming of the abdomen area to reduce swelling and causing the stoma to finally protrude 3/4" out above the skin surface. I now weigh myself daily to keep within an ideal weight as not to submerge the stoma again.
Note: The heavy pressure with the tube may not be ideal yet for those with recent surgeries or still have scabs. For that unfortunately requires more frequent wafer changes until the scabs heal up.
---
Diet Timing and Output Control
Wait until the stoma has quieted by observing the pouch and ensuring output has slowed.
Eat small, nutritious, non–diarrhea causing meals throughout the day.
Eat more during the morning and early afternoon when the bag is fresh. About every 4 oz every 4 hours until daily nutritional needs (RDA) are met.
Eat and drink less later in the day or when a bag change may be needed soon, allowing the system to clear. (About 4-5 hours) however don't be hungry or the system does a bile flush.
Diet balance that works best for me:
High protein
Medium carbohydrates
Low fat
Lower fluid intake (but still urinating normally)
No artificial ingredients, salty, fatty, fried, overly spicy, type foods, no alcohol or hardly any caffeine. Rather plain meals like TV dinners often work very well for me. Hard boiled eggs, Greek yogurt, whey isolate protein powder mixed in with lactose free protein, low fat milk, binder foods like pancakes and some oatmeal
No solid fruits or vegetables, only juices, sauces or soups. Low fiber. Nothing that can't fit through a straw enters my mouth, even if chewed well because we all miss something and then one has a clog which is very painful and may result in an ER visit. Avoid nuts, seeds and tough parts of meats, even baked potatoes (skinless and mashed is best) unless very tiny like ground up into powder etc.
Mornings are generally the best time for a bag change, before breakfast. But waiting still for awhile (about 3 hours) for the paste to set is best because if you move it can leak right away. So I'll usually have a meal next to the bed so after the bag is on I don't have to get up.
As long as one gets enough RDA of calories, protein and nutrition for the day it usually wards off any hunger for the remainder of the day thus giving amble opportunities for bag changes.
---
Products Used
Brand: Coloplast
Bag: Sensura Mio convex drainable one-piece, 2" wide (unfiltered)
Accessories:
Brava No-Sting Paste
Brava Skin Protectant Spray (smoother and less holding power but covers a larger area) or PREP Dabber Bottle (creates a rougher surface around the stoma for better barrier adhesive hold)
Stoma powder (thin dusting to create a dry crust on leak wounds, must secure afterwards with skin protectant or PREP Dabber.)
Extra-large moon-shaped barrier strips
Tools & Supplies:
Ostomy scissors
Small plastic trash bags
Plastic or metal butter knife (for paste removal)
Toilet paper
Additional Items:
Oil-free eye makeup remover (shake before use) available in the cosmetic isle of supermarket or drug stores.
Cocoa butter–based lotion (for skin and scar tissue)
Petroleum jelly to coat the inside of the bag through the wafer hole opening.
Two toilet paper tubes nested together or similar (for even wafer application pressure around the stoma) important!
Coffee stir sticks to apply lotion to scar tissue under adhesive when I can't get my fingers greasy like before handing barrier adhesive strips.
Waterproof tape (to hold toilet paper on separate mucus fistula)
---
Wafer Preparation
1. Roll the tail of the pouch up (blue side up) and secure it with Velcro.
2. Enlarge the wafer opening:
Cut vertically to the “30” mark.
Cut horizontally to the line between 30 and 40 (approx. 35).
Round the oval back to 30 and then 35 to complete the shape.
3. Save the cut-out piece.
4. Slightly bend the wafer bubble horizontally to increase flexibility.
4.75 Coat the inside of the bag through the wafer hole using a paste key with a light coat of petroleum jelly. This will reduce paste adhering to the bag later. Keep fingers clean as adhesive is touched later and greasy fingers will ruin it.
5. Remove the backing off the wafer and save to use as a fan.
6. Cut the saved cut-out wafer hole piece in half lengthwise making a couple of rings. Cut larger ring into sections. Place the larger one sticky side up around the wafer hole. Press. Add more cut from the other piece to complete the circle. Press to bond. This reinforces the wafer edge from wobble which causes leaks also to bring the more solid wafer down closer to the skin. Be careful not to touch the petroleum jelly with fingers!
Stack the remaining additional piece halved on top of the other added pieces at the 3 and 9 o’clock positions to fill the horizontal belly fold. This provides lateral support from paste oozing out sideways via belly folds. The wafer cutout pieces are hard and don't melt or run unlike using paste or rings as body fold filler.
---
Removal of Old Appliance
1. If no blowout then hot shower to loosen just the wafer and barrier strips adhesive not the barrier adhesive and wafer! Wash and rinse remaining body like normal while this is going on as it takes heat and time to loosen the adhesive. Leave the barrier adhesive and wafer attached protecting the skin area below it around the stoma from getting water on it. Dry off. Head to toilet. Remove rest of wafer and barrier adhesive using a butter knife.
Or apply oil-free eye makeup remover along the top edge of the wafer and into the crease while peeling downward. Trim hair with a butter knife if necessary. Shower is easier and better though and costs less in supplies. But this way is better if it's a blowout as you don't want output in the shower as it will grow foot fungus (as will urinating in the shower will too)
2. Remove and dispose of the old pouch in a sealed plastic bag.
3. Dry wipe stoma clean of output, use no water around the stoma. Important! If the skin just around the stoma where the barrier adhesive was gets wet, then the oil free makeup remover can't do it's job of entering the pores to throughly clean and moisturizer the skin. Adhesion will be lost!
4. Clean the mucus fistula opening (if present) if required using a rounded coffee stir stick. Sometimes there is mucus ball in there that needs to be dug out (I have a double-barrel ileostomy.)
5. Use the flat side of the butter knife to scrape and remove thick paste stuck to skin around stoma.
6. Wipe residue off butter knife with toilet paper and discard.
7. Use eye makeup remover soaked on toilet paper to soak and thoroughly dissolve remaining paste.
8. Gently remove any stubborn residue with a soft stiff stick (and with a soft scrubby with the plain soap while in the shower later) Skin needs to be clean of any residue at this point. Avoid using fingernails.
9. Massage scar tissue with remover using on clean toilet paper to clean off old lotion and nourish skin.
---
Showering
1. Wash rest of body normally and rinse. Last wash the stoma area with plain, non-moisturizing Ivory-type soap and water using your hands (they need to be clean and oily free themselves) and a scrubby pad, gently. Do this last after other washing.
2. Repeat the soap wash three times in total to remove any residue from the makeup remover or other soaps or conditioner that got onto the area and will affect adhesion. This is important! Hands and stoma area must be clean and oily free.
3. The skin and fingers should feel “squeaky clean.” all around the stoma when rubbed with fingers. This is important!
4. Do not apply other shampoo, conditioner, moisturizing soaps, ointments or anything from putting on or running over the area or on your fingers. Skin must be absolutely clean under the wafer. No need for healing creams etc., the skin will heal itself just fine as long as there is a good bond preventing further digestive enzymes from attacking it. Other items interfere with bonding and cause leaks to continue.
5. Use a plastic scrubby to gently exfoliate the skin around the wafer area and scar tissue to remove dead skin cells and any residue.
6. Rinse with clean water only
7. Towel dry,
Setup Area on bed so I can rest afterwards without moving
Blow-dry to fully dry the skin and warm it for better adhesion
8. Dab around the stoma with dry toilet paper until completely dry, especially in creases next to the stoma. We want the barrier adhesive sticking very well to this area as it's the first place a leak usually occurs. Any dampness will cause the barrier adhesive not to work. So always dab with a new dry piece of toilet paper each time as to keep the area absolutely dry.
---
Place a towel or plastic bag under you while laying down in case of unexpected output.
If output occurs:
Rinse away digestive enzymes with plain water. Ivory soap may be needed again to remove any greasy feeling. Skin must be squeaky clean.
Do not use spit—it contains salts and will burn, interferes with adhesive bonding.
Dry thoroughly.
Drying at this stage is critical. I usually give one solid minute of drying after every step during bag application process waving the backing from a wafer like a fan.
---
Skin Preparation
1. Address any wet leak wounds:
Apply a single grain-high layer of stoma powder.
Stretch skin to reach creases.
Remove excess powder from healthy skin with slightly damp toilet paper.
Dry thoroughly about 1 minute with a hand fan.
Powder should form a secure crust that does not easily rub off. This is important!
4. Fan-dry again for one minute.
Note: If the leak burns are very shallow and not wet, one can avoid using the stoma powder and just use the skin protectant.
5. Fungal note:
Use antifungal powder only if there is clear fungal itching. An itch so bad that you want to stick something sharp under the wafer to scratch indicates a fungal infection. Do not use fungal powder all the time as it isn't stoma powder and has less adhesion.
6: Lock it down with a light coat of skin protectant. A must for any powder under the wafer. To thick of a coat of skin protectant creates a glassy surface and inhibits skin bonding of adhesives.
Note: If your wounds are more severe, even bleeding. Then bleeding must be stopped first before doing anything. Blood is the worst as it keeps flowing and makes adhesion impossible. Special skin protectant medicine (expensive) like Medline Marathon may be required as will much more often bag/wafer changes (even twice daily) until that skin heals up quite a bit. Why it's important if you feel pain under the wafer is not to ignore it for long as the worst it gets, the longer and more expensive it is get back to normal.
7. Perform a finger test:
Rub around the stoma and then rub fingers together. Any moisture, loose stoma powder or greasiness must be corrected. On both body and fingers. This is extremely important!
---
Barrier and Paste Application
1. Apply either:
If not already applied: Only one light coat of spray skin protectant spray (smoother, less hold but covers a larger area) or
PREP Dabber around stoma, creates a rougher surface for better bonding.
(Never use both—they do not bond together.)
2. Go around next to stoma with PREP Dabber bottle twice in total. Allow to dry for 60 seconds using a hand fan. Creates a rough surface for better barrier adhesive bonding. Very cost effective product. One 2.5 oz bottle lasts about 60 wafer changes. Will sting wounds for a little bit.
2.75 Put a 1/3 cut piece of extra large barrier strip in the left belly button fold area 1/4" away from stoma, cut around belly button off sensitive scar tissue and hold for 1 minute. Cover with PREP Dabber bottle and 1 minute to dry. This is to prevent sweating under the wafer in the belly fold, it grows mold and itches.
3 Cut a thin strip from the cut out piece and place on the barrier strip next to the belly button scar to give it more height.
4.6 Cut the remaining piece in half then fill in belly button hole, off the scar, pressing it down inside. Do not use powders or anything to try to keep air pockets under the wafer dry. Barrier strips pressed down firmly on the skin works great. Using stick apply lotion to exposed scar tissue. Another barrier strip will be applied over it later.
Final assembly
1. Apply a thick bead of paste directly around the stoma, pressing into the crease next to the stoma. It should stick to the skin as it's coming out of the tube. If not then remove, address the problem if it's greasy, damp or whatever skin so it does stick directly to the skin. No need to touch or use another tool to spread paste, just pinch off end onto the skin like wiping it.
5. Align the pouch exit downward over genital area properly, get this right!
6. Seat the prepared wafer starting from the bottom, pressing upward and centering left and right around the hole.
7. Press around the stoma through the wafer bag to spread paste and seal. Press out any air bubbles of wafer adhesive so it's flat and adheres tightly to the skin.
8. Use the hard toilet paper tube to apply even hard pressure around the stoma for 5 minutes to bond the barrier adhesive.
9. Allow ~¼–⅓" paste ooze on top of the stoma as seen through the bag—this deflects early output and gives more time for the paste to bond to the skin. Extra will drop off later.
10. Press down all wafer adhesive for an additional 60 seconds. Allow NO air pockets or it will grow mold and undermine the barrier adhesive, causes itching.
---
Barrier Strip Application
1. Apply one extra large barrier strip across the bottom: Exhale slightly while applying for light tension, over the hard part of the wafer. Hold for 60 seconds.
2. Apply one extra-large strip around the hard wafer edge on top finishing the circle. Ensure no air pockets.
3. Trap some air into the bag exit and roll up to the top to force the bag off the stoma stuck with oozed out paste. The petroleum jelly helps, eventually any stuck paste will drop off.
---
Post-Application Care
Rest quietly for about 3 hours to allow successful barrier adhesive bonding to skin. Moving or heat can pop the non fully bonded barrier adhesive off the skin.
Putting a new bag on before bedtime works, as long as one is trained to sleep only on their backs. This is easy to do using a pillow under each arm for a few nights. Sleep with upper body slightly raised up as to prevent turnover and also to cause output to flow to the bottom of the bag. Concentrate on a diet that doesn't cause drier stool which clumps or is bulky or doesn't fully digest into liquid or paste. Don't push pancaked material, rather dump, then gently water bottle rinse it away from the stoma.
I do not use a belt because:
It caused wafer distortion and granulomas. It pulls the wafer around because of bending and sitting and laying down movement. Friction from the belt transfered to the wafer and causes leaks.
Barrier strips provide better stability without movement. Slightly stretched out to either side before applying provides downward pressure. If you must use a belt then you must, try to gravitate away if possible.
---
Mucus Fistula Care
Fold toilet paper into quarters.
Secure with one piece of waterproof tape.
---
Exposed Scar Care
Apply cocoa butter sparingly just on the scar using a coffee stir stick.
Cover with 1/2 extra large barrier strip so it's secure on ether side.
Over time, covered scar tissue softens and improves significantly, eventually almost disappearing. It's the clothes irritation that keeps it sensitive and painful.
---
Emptying and Rinsing
Empty when pouch is ~⅓ full.
Rinse with plain water only!
Do not use soap to rinse with.
Do not apply pressure to the pouch—this forces paste out.
---
Warning Signs
Persistent pain, itching, rubbing it or discomfort means the pouch should be changed. You should feel nothing for days on end if the wafer was properly applied. The problem is learning all the little tricks to avoid discomfort, that's the challenging part.
Feeling cold during rinsing indicates a leak—change immediately if possible or as soon as the output has died down and stopped.
Avoid bending over at the stomach aka "crunches" bend only at the hips. The longer one can go without doing this, like crunching out chairs, the better. The problem seems to be requiring to bend over at the belly fold area and lurching oneself up upon ones feet. Stools are better. Keep your feet under your hips.
Daily showers are possible with an ostomy bag, the object is to keep both water and heat away less it loosens the adhesives or causes sweat under the wafer. So quick lukewarm showers work for daily use and long hot showers for bag change times when the wafer is off.
Wafer wear times now 6 days.
Last updated March 17 2026
This method has been over two years in development. I am now achieving close to a 100% success rate with a consistent 5+ day wafer wear time, even with a hinged stoma located in a belly fold, and with minimal pain. Given the difficulty of this type of stoma, this is likely close to the best achievable outcome. I'm always improving and update this post to reflect that.
This process is personalized to my body contour and an oval-shaped stoma. Some adjustments will almost certainly be required for others. That said, it should provide a strong starting point for anyone dealing with a similar stoma configuration. The instructions are detailed and thorough—please read carefully and take your time.
Number #1 help was losing weight and eventual calming of the abdomen area to reduce swelling and causing the stoma to finally protrude 3/4" out above the skin surface. I now weigh myself daily to keep within an ideal weight as not to submerge the stoma again.
Note: The heavy pressure with the tube may not be ideal yet for those with recent surgeries or still have scabs. For that unfortunately requires more frequent wafer changes until the scabs heal up.
---
Diet Timing and Output Control
Wait until the stoma has quieted by observing the pouch and ensuring output has slowed.
Eat small, nutritious, non–diarrhea causing meals throughout the day.
Eat more during the morning and early afternoon when the bag is fresh. About every 4 oz every 4 hours until daily nutritional needs (RDA) are met.
Eat and drink less later in the day or when a bag change may be needed soon, allowing the system to clear. (About 4-5 hours) however don't be hungry or the system does a bile flush.
Diet balance that works best for me:
High protein
Medium carbohydrates
Low fat
Lower fluid intake (but still urinating normally)
No artificial ingredients, salty, fatty, fried, overly spicy, type foods, no alcohol or hardly any caffeine. Rather plain meals like TV dinners often work very well for me. Hard boiled eggs, Greek yogurt, whey isolate protein powder mixed in with lactose free protein, low fat milk, binder foods like pancakes and some oatmeal
No solid fruits or vegetables, only juices, sauces or soups. Low fiber. Nothing that can't fit through a straw enters my mouth, even if chewed well because we all miss something and then one has a clog which is very painful and may result in an ER visit. Avoid nuts, seeds and tough parts of meats, even baked potatoes (skinless and mashed is best) unless very tiny like ground up into powder etc.
Mornings are generally the best time for a bag change, before breakfast. But waiting still for awhile (about 3 hours) for the paste to set is best because if you move it can leak right away. So I'll usually have a meal next to the bed so after the bag is on I don't have to get up.
As long as one gets enough RDA of calories, protein and nutrition for the day it usually wards off any hunger for the remainder of the day thus giving amble opportunities for bag changes.
---
Products Used
Brand: Coloplast
Bag: Sensura Mio convex drainable one-piece, 2" wide (unfiltered)
Accessories:
Brava No-Sting Paste
Brava Skin Protectant Spray (smoother and less holding power but covers a larger area) or PREP Dabber Bottle (creates a rougher surface around the stoma for better barrier adhesive hold)
Stoma powder (thin dusting to create a dry crust on leak wounds, must secure afterwards with skin protectant or PREP Dabber.)
Extra-large moon-shaped barrier strips
Tools & Supplies:
Ostomy scissors
Small plastic trash bags
Plastic or metal butter knife (for paste removal)
Toilet paper
Additional Items:
Oil-free eye makeup remover (shake before use) available in the cosmetic isle of supermarket or drug stores.
Cocoa butter–based lotion (for skin and scar tissue)
Petroleum jelly to coat the inside of the bag through the wafer hole opening.
Two toilet paper tubes nested together or similar (for even wafer application pressure around the stoma) important!
Coffee stir sticks to apply lotion to scar tissue under adhesive when I can't get my fingers greasy like before handing barrier adhesive strips.
Waterproof tape (to hold toilet paper on separate mucus fistula)
---
Wafer Preparation
1. Roll the tail of the pouch up (blue side up) and secure it with Velcro.
2. Enlarge the wafer opening:
Cut vertically to the “30” mark.
Cut horizontally to the line between 30 and 40 (approx. 35).
Round the oval back to 30 and then 35 to complete the shape.
3. Save the cut-out piece.
4. Slightly bend the wafer bubble horizontally to increase flexibility.
4.75 Coat the inside of the bag through the wafer hole using a paste key with a light coat of petroleum jelly. This will reduce paste adhering to the bag later. Keep fingers clean as adhesive is touched later and greasy fingers will ruin it.
5. Remove the backing off the wafer and save to use as a fan.
6. Cut the saved cut-out wafer hole piece in half lengthwise making a couple of rings. Cut larger ring into sections. Place the larger one sticky side up around the wafer hole. Press. Add more cut from the other piece to complete the circle. Press to bond. This reinforces the wafer edge from wobble which causes leaks also to bring the more solid wafer down closer to the skin. Be careful not to touch the petroleum jelly with fingers!
Stack the remaining additional piece halved on top of the other added pieces at the 3 and 9 o’clock positions to fill the horizontal belly fold. This provides lateral support from paste oozing out sideways via belly folds. The wafer cutout pieces are hard and don't melt or run unlike using paste or rings as body fold filler.
---
Removal of Old Appliance
1. If no blowout then hot shower to loosen just the wafer and barrier strips adhesive not the barrier adhesive and wafer! Wash and rinse remaining body like normal while this is going on as it takes heat and time to loosen the adhesive. Leave the barrier adhesive and wafer attached protecting the skin area below it around the stoma from getting water on it. Dry off. Head to toilet. Remove rest of wafer and barrier adhesive using a butter knife.
Or apply oil-free eye makeup remover along the top edge of the wafer and into the crease while peeling downward. Trim hair with a butter knife if necessary. Shower is easier and better though and costs less in supplies. But this way is better if it's a blowout as you don't want output in the shower as it will grow foot fungus (as will urinating in the shower will too)
2. Remove and dispose of the old pouch in a sealed plastic bag.
3. Dry wipe stoma clean of output, use no water around the stoma. Important! If the skin just around the stoma where the barrier adhesive was gets wet, then the oil free makeup remover can't do it's job of entering the pores to throughly clean and moisturizer the skin. Adhesion will be lost!
4. Clean the mucus fistula opening (if present) if required using a rounded coffee stir stick. Sometimes there is mucus ball in there that needs to be dug out (I have a double-barrel ileostomy.)
5. Use the flat side of the butter knife to scrape and remove thick paste stuck to skin around stoma.
6. Wipe residue off butter knife with toilet paper and discard.
7. Use eye makeup remover soaked on toilet paper to soak and thoroughly dissolve remaining paste.
8. Gently remove any stubborn residue with a soft stiff stick (and with a soft scrubby with the plain soap while in the shower later) Skin needs to be clean of any residue at this point. Avoid using fingernails.
9. Massage scar tissue with remover using on clean toilet paper to clean off old lotion and nourish skin.
---
Showering
1. Wash rest of body normally and rinse. Last wash the stoma area with plain, non-moisturizing Ivory-type soap and water using your hands (they need to be clean and oily free themselves) and a scrubby pad, gently. Do this last after other washing.
2. Repeat the soap wash three times in total to remove any residue from the makeup remover or other soaps or conditioner that got onto the area and will affect adhesion. This is important! Hands and stoma area must be clean and oily free.
3. The skin and fingers should feel “squeaky clean.” all around the stoma when rubbed with fingers. This is important!
4. Do not apply other shampoo, conditioner, moisturizing soaps, ointments or anything from putting on or running over the area or on your fingers. Skin must be absolutely clean under the wafer. No need for healing creams etc., the skin will heal itself just fine as long as there is a good bond preventing further digestive enzymes from attacking it. Other items interfere with bonding and cause leaks to continue.
5. Use a plastic scrubby to gently exfoliate the skin around the wafer area and scar tissue to remove dead skin cells and any residue.
6. Rinse with clean water only
7. Towel dry,
Setup Area on bed so I can rest afterwards without moving
Blow-dry to fully dry the skin and warm it for better adhesion
8. Dab around the stoma with dry toilet paper until completely dry, especially in creases next to the stoma. We want the barrier adhesive sticking very well to this area as it's the first place a leak usually occurs. Any dampness will cause the barrier adhesive not to work. So always dab with a new dry piece of toilet paper each time as to keep the area absolutely dry.
---
Place a towel or plastic bag under you while laying down in case of unexpected output.
If output occurs:
Rinse away digestive enzymes with plain water. Ivory soap may be needed again to remove any greasy feeling. Skin must be squeaky clean.
Do not use spit—it contains salts and will burn, interferes with adhesive bonding.
Dry thoroughly.
Drying at this stage is critical. I usually give one solid minute of drying after every step during bag application process waving the backing from a wafer like a fan.
---
Skin Preparation
1. Address any wet leak wounds:
Apply a single grain-high layer of stoma powder.
Stretch skin to reach creases.
Remove excess powder from healthy skin with slightly damp toilet paper.
Dry thoroughly about 1 minute with a hand fan.
Powder should form a secure crust that does not easily rub off. This is important!
4. Fan-dry again for one minute.
Note: If the leak burns are very shallow and not wet, one can avoid using the stoma powder and just use the skin protectant.
5. Fungal note:
Use antifungal powder only if there is clear fungal itching. An itch so bad that you want to stick something sharp under the wafer to scratch indicates a fungal infection. Do not use fungal powder all the time as it isn't stoma powder and has less adhesion.
6: Lock it down with a light coat of skin protectant. A must for any powder under the wafer. To thick of a coat of skin protectant creates a glassy surface and inhibits skin bonding of adhesives.
Note: If your wounds are more severe, even bleeding. Then bleeding must be stopped first before doing anything. Blood is the worst as it keeps flowing and makes adhesion impossible. Special skin protectant medicine (expensive) like Medline Marathon may be required as will much more often bag/wafer changes (even twice daily) until that skin heals up quite a bit. Why it's important if you feel pain under the wafer is not to ignore it for long as the worst it gets, the longer and more expensive it is get back to normal.
7. Perform a finger test:
Rub around the stoma and then rub fingers together. Any moisture, loose stoma powder or greasiness must be corrected. On both body and fingers. This is extremely important!
---
Barrier and Paste Application
1. Apply either:
If not already applied: Only one light coat of spray skin protectant spray (smoother, less hold but covers a larger area) or
PREP Dabber around stoma, creates a rougher surface for better bonding.
(Never use both—they do not bond together.)
2. Go around next to stoma with PREP Dabber bottle twice in total. Allow to dry for 60 seconds using a hand fan. Creates a rough surface for better barrier adhesive bonding. Very cost effective product. One 2.5 oz bottle lasts about 60 wafer changes. Will sting wounds for a little bit.
2.75 Put a 1/3 cut piece of extra large barrier strip in the left belly button fold area 1/4" away from stoma, cut around belly button off sensitive scar tissue and hold for 1 minute. Cover with PREP Dabber bottle and 1 minute to dry. This is to prevent sweating under the wafer in the belly fold, it grows mold and itches.
3 Cut a thin strip from the cut out piece and place on the barrier strip next to the belly button scar to give it more height.
4.6 Cut the remaining piece in half then fill in belly button hole, off the scar, pressing it down inside. Do not use powders or anything to try to keep air pockets under the wafer dry. Barrier strips pressed down firmly on the skin works great. Using stick apply lotion to exposed scar tissue. Another barrier strip will be applied over it later.
Final assembly
1. Apply a thick bead of paste directly around the stoma, pressing into the crease next to the stoma. It should stick to the skin as it's coming out of the tube. If not then remove, address the problem if it's greasy, damp or whatever skin so it does stick directly to the skin. No need to touch or use another tool to spread paste, just pinch off end onto the skin like wiping it.
5. Align the pouch exit downward over genital area properly, get this right!
6. Seat the prepared wafer starting from the bottom, pressing upward and centering left and right around the hole.
7. Press around the stoma through the wafer bag to spread paste and seal. Press out any air bubbles of wafer adhesive so it's flat and adheres tightly to the skin.
8. Use the hard toilet paper tube to apply even hard pressure around the stoma for 5 minutes to bond the barrier adhesive.
9. Allow ~¼–⅓" paste ooze on top of the stoma as seen through the bag—this deflects early output and gives more time for the paste to bond to the skin. Extra will drop off later.
10. Press down all wafer adhesive for an additional 60 seconds. Allow NO air pockets or it will grow mold and undermine the barrier adhesive, causes itching.
---
Barrier Strip Application
1. Apply one extra large barrier strip across the bottom: Exhale slightly while applying for light tension, over the hard part of the wafer. Hold for 60 seconds.
2. Apply one extra-large strip around the hard wafer edge on top finishing the circle. Ensure no air pockets.
3. Trap some air into the bag exit and roll up to the top to force the bag off the stoma stuck with oozed out paste. The petroleum jelly helps, eventually any stuck paste will drop off.
---
Post-Application Care
Rest quietly for about 3 hours to allow successful barrier adhesive bonding to skin. Moving or heat can pop the non fully bonded barrier adhesive off the skin.
Putting a new bag on before bedtime works, as long as one is trained to sleep only on their backs. This is easy to do using a pillow under each arm for a few nights. Sleep with upper body slightly raised up as to prevent turnover and also to cause output to flow to the bottom of the bag. Concentrate on a diet that doesn't cause drier stool which clumps or is bulky or doesn't fully digest into liquid or paste. Don't push pancaked material, rather dump, then gently water bottle rinse it away from the stoma.
I do not use a belt because:
It caused wafer distortion and granulomas. It pulls the wafer around because of bending and sitting and laying down movement. Friction from the belt transfered to the wafer and causes leaks.
Barrier strips provide better stability without movement. Slightly stretched out to either side before applying provides downward pressure. If you must use a belt then you must, try to gravitate away if possible.
---
Mucus Fistula Care
Fold toilet paper into quarters.
Secure with one piece of waterproof tape.
---
Exposed Scar Care
Apply cocoa butter sparingly just on the scar using a coffee stir stick.
Cover with 1/2 extra large barrier strip so it's secure on ether side.
Over time, covered scar tissue softens and improves significantly, eventually almost disappearing. It's the clothes irritation that keeps it sensitive and painful.
---
Emptying and Rinsing
Empty when pouch is ~⅓ full.
Rinse with plain water only!
Do not use soap to rinse with.
Do not apply pressure to the pouch—this forces paste out.
---
Warning Signs
Persistent pain, itching, rubbing it or discomfort means the pouch should be changed. You should feel nothing for days on end if the wafer was properly applied. The problem is learning all the little tricks to avoid discomfort, that's the challenging part.
Feeling cold during rinsing indicates a leak—change immediately if possible or as soon as the output has died down and stopped.
Avoid bending over at the stomach aka "crunches" bend only at the hips. The longer one can go without doing this, like crunching out chairs, the better. The problem seems to be requiring to bend over at the belly fold area and lurching oneself up upon ones feet. Stools are better. Keep your feet under your hips.
Daily showers are possible with an ostomy bag, the object is to keep both water and heat away less it loosens the adhesives or causes sweat under the wafer. So quick lukewarm showers work for daily use and long hot showers for bag change times when the wafer is off.
Wafer wear times now 6 days.
Last updated March 17 2026