UOAA Discussion Board

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.


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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.

Eat less later in the day or when a bag change may be needed soon, allowing the system to clear.

Newly digested food can take approximately 4–5 hours to pass through.

Meals of 4 oz or less, spaced about every four hours, works well. Gives more lull times for a bag change without it spewing.

Drink or eat nothing in advance of any bag change, it just pushes out the old to make way for the new.

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 enriched milk works great.

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. Nuts, seeds and tough parts of meats, even baked potatoes (skinless and mashed is best)


Mornings are generally the best time for a bag change, before breakfast. The body has had all night to clear out the system. 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 bah changes. However if hungry the bag can fill up with plain bile.



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Products Used

Brand: Coloplast
Bag: Sensura Mio convex drainable one-piece, 2" wide

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 with skin protectant or PREP Dabber.)

Extra-large moon-shaped barrier strips, but now using smaller standard sized 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)

Two toilet paper tubes nested together or similar (for even wafer application pressure around the stoma) important!



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Wafer Preparation

1. Roll the tail of the pouch (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.

5. Remove the backing.

6. Cut the saved cut-out in half lengthwise.

Place sticky side up around the wafer hole. Add more to complete circle. Press together hard to bond. This reinforces the wafer edge from wobble which causes leaks.

Stack the remaining additional piece halved on top of the other added pieces at the 3 and 9 o’clock positions to fill the belly fold. This provides lateral support from paste oozing out sideways. The wafer cutout pieces are hard and don't melt unlike using paste or rings as body fold filler.

7. Apply one continuous bead of paste around the wafer hole, approximately ¼" away from wafer hole.

8. Set aside.

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Removal of Old Appliance

1. If no blowout then hot shower to loosen just the wafer and barrier strips, not the barrier adhesive! Wash and rinse remaining body like normal while this is going on as it takes heat 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.

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.

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.

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.

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 fingernail or scrubby if needed. Skin needs to be clean of any paste or adhesive residue at this point.

9. Massage scar tissue with eye makeup remover to soften, nourish and increase flexibility.


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Showering

1. Wash rest of body normally and rinse. Last wash the stoma area with plain, non-moisturizing Ivory-type soap and water using a washcloth. 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.

3. The skin should feel “squeaky clean.” all around the stoma when rubbed with fingers. This is very important!

4. Do not apply other shampoo, conditioner, moisturizing soaps or anything from putting on or running over the area. Skin must be absolutely clean and clear of anything. 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. Rinse with clean water only.

6. Occasionally use a plastic scrubby to gently exfoliate the skin around the stoma if needed to remove dead skin cells.


7. Towel dry, then blow-dry to:

Fully dry the skin

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 dry piece of toilet paper each time as to keep the area absolutely dry.

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Setup Area

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.


Dry thoroughly.

Drying at this stage is critical. I usually give one solid minute of drying after every step during bag application.

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Skin Preparation

1. Perform a finger test:

Rub around the stoma and then rub fingers together.

Any moisture or greasiness must be corrected.

2. Address any 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.

3. Powder should form a secure crust that does not easily rub off. This is important!

4. Fan-dry again for one minute.


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.

Lock it down with skin protectant. A must for any powder under the wafer.

Do not use fungal powder routinely—adhesion is reduced. Stoma powder works better for adhesion and blocking enzymes with better barrier adhesive support.


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Barrier and Paste Application

1. Apply either:

Only one light coat of spray skin protectant spray (smoother, less hold but covers a larger area) or

PREP Dabber on wound areas
(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 (or bag with a one piece) changes.

3. Apply a half-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.

4. Apply a thin light coat of cocoa butter lotion to just the sensitive scar tissue on belly button so wafer adhesive does not grab it. Also a bit on exposed chest scar tissue that will later get a covering of a barrier strip to protect it and aid in its healing and disappearing. The object of the lotion is to prevent the adhesive from bonding to the sensitive scar tissue only, not the skin on either side.

4.5 Use a 1/4 piece of standard barrier strip in the left belly fold area about 1/4" away from the stoma. Apparently this area often creates mold by an air pocket which undermines the barrier adhesive and itches, gets only 2 days wear time. So the way to combat it is by covering the skin with a barrier strip. Ensure it's pressed down firmly and secured to the skin well.

4.6 Also apply a 1/4 piece of standard barrier strip to fill in belly button hole, pressing it down inside as mold or itching will occur there as well. Do not use powders or anything to try to keep air pockets under the wafer dry. Barrier strips pressed down firmly works great.

5. Align the pouch exit downward over genital area.

6. Seat the prepared wafer starting from the bottom, pressing upward and centering left and right. Basically matching the two rings to paste together.

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.

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. Allow the wafer adhesive to partially fill the belly button divot. But not sticking because of the cocoa butter applied earlier will stop it from adhering.

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Barrier Strip Application

1. Apply one standard or extra large barrier strip across the bottom:

Exhale slightly while applying for tension.

Hold for 60 seconds.


2. Apply two extra-large or standard barrier strips around the hard wafer edge finishing the circle. Ensure no air pockets.


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Post-Application Care

Rest quietly for several hours if possible 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 like vegetables, fruits or leafy greens or absorbs liquid like fiber or bananas. This type of output can collect around the stoma and push the wafer off the skin. It's called pancaking and you don't want it. Don't push pancaked material, rather dump, then gently water bottle rinse it away from the stoma.

Favor softer output consistency but not stuff that causes excessive watery output as salt loss and dehydration can occur.

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. However if you must use a belt then you must, but it's really a crutch in my opinion.


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Mucus Fistula Care

Fold toilet paper into quarters.

Apply a dab of cocoa butter optional.

Secure with one piece of waterproof tape.

Replace daily or twice depending upon output. Can cheat by tearing off some of the soiled toilet paper without removing it the tape entirely. It's mainly to protect clothes from mucus and from shirt friction on the stoma making it too dry and irritated. Saves washing a stoma cap.

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Exposed Scar Care

Apply cocoa butter sparingly just on the scar.

Cover with 3/4 standard barrier strip so it's secure on ether side.

Over time, scar tissue softens and improves significantly, eventually almost disappearing. It's the clothes irritation that keeps it sensitive and painful.


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Emptying and Rinsing

Empty when pouch is ~⅓ full.

Rinse with plain water only!


Optional: toothpaste for odor control of future output so one isn't choking on the smell. May sting the stoma opening though as when rinsing toothpaste oil attaches to the bag and irritates it.

Do not use soap to rinse with.

Do not apply pressure to the pouch—this forces paste out.


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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.

Pure water is best to rinse, a small water bottle works great and can be disposable. If reused always wash it and your hands afterwards.

Practice safe hygiene by not transferring digestive enzymes (or anything else) gotten on by touching the wafer output area. Use different fingers to flush, turn on the tap etc. and wash everything when completing each toilet dump. Inspect and wipe the bowl for any splash damage. Use a drop of two of essential oils like peppermint or spearmint to the fresh toilet bowl water to clean up any lingering odors. Use Potpourri or Ozium to neutralize output odor. Good diet control can nearly eliminate foul smelling output.

Avoid bending over at the stomach aka "crunches" bend only at the waist. The longer one can go without doing this, like sitting in straight back chairs, the better. The problem seems to be requiring to bend over at the belly fold area and lurching oneself up upon ones feet.

If one is laying down or in linclined it's better to turn sideways and push themselves up keeping from doing a belly crunch which pops the wafer off and leaks.

To avoid bending over to pickup up objects I use a grabber arm. Or push it with my foot over where I can use something to hold my arm on while I do a ballerina act on one foot to grab it.

Daily showers are possible with an ostomy bag, the object is to keep both water and heat away less it loosens the adhesives. So quick lukewarm showers work for daily use and long hot showers for bag change times when the wafer is off. As long as one cools down afterwards so they are not sweating anymore, drys off well and enters a dry air area to apply their wafer. Humidity infereres with successfully skin bonding.


Last updated Jan 29 2026

I should note the reason for the stacked 1/4" wafer cutout pieces is to provide something to stop the wafer from squishing all the paste out also to double as a wall of sorts to prevent blowouts through the belly fold sides where the paste is thicker and weaker there.

That and the extra barrier strips placing downward pressure keeps the wafer at the exact height off the skin, keeping the wafer stable and thus not causing the paste to move or ooze exposing skin to output.

That combined with better paste skin adhesion using the oil free eye makeup remover, soap and water wash has helped tremendously to solve my difficulty and causes very few if any leaks to occur.

As an added note I can pretty much bend over some and sit on long car rides without leaking or detaching occurring because of the extra large barrier strips holding things down and forcing the wafer to bend some as my torso bends some. The thick paste also flexes some and keeps the seal.

The original design of the convex is to be used with an ostomy belt and force the area around the stoma to remain flat which unfortunately doesn't work well in a belly fold. So I was always very stiff all the time and couldn't sit at all less the wafer would detach.

The otosmy belt would move the wafer around and squish out all the paste as well. Now with this design the wafer remains perfectly positioned and the paste can remain that way also. Both will flex some as my body bends some.

Another key to understanding adhesive adhesion is the two layers of the human skin in regards to adhesion. The top layer and the under layer.

The larger under layer of the skin needs to be healthy and moisturized however the top thin layer where adhesion occurs needs to be dry and not as much moisturized so bonding is highly successful.

The oil free makeup remover not only removes the paste residue but moisturizes the skin and the plain soap and water wash cleans just the top level of the skin for the adhesives to work properly.

My latest improvements (included in the original post) are as follows:

1: I now put a bead ring of paste skin side down right around the stoma BEFORE putting the water (with it's three beads of paste) on. What this does is places the most pressure possible right around and up tight around the stoma. I ensue the skin side paste is sticking which I have been missing with the paste on the water pre prepared method

2: I've also no longer using toilet paper in my belly button, it was drying the scar out causing irritation. Just cocoa butter lotion and a piece of thin costed cardboard to protect the scar from the adhesive sticking to it.

Little tweaks but makes a big difference.

Have been having paste separation from the skin and blow outs on the belly button belly fold side.

I was using too much paste.

So reducing that and putting a ring of paste right around the stoma plus some built up in the below fold on that side ensures it's well adhered to be skin.

I've also started stretching the barrier strips by placing them center first over the belt hooks then stretching out to either side creating downward pressure.

Hopefully this will resolve the blowout issues. But most times it's because I ate something that stayed solid and pancaked the wafer. My output needs to remain very liquid or like pea soup consistency. Any chunks block and start pushing output through the paste.

Although my stoma hole is on my left, I try to direct it towards the right or down, away from that weaker left side.

Haven't been doing very well on the wear times, every two days now to occur with a shower seems to be my new routine.

Hardly any leak burns, very small ones.

Okay figured out what I was doing slightly wrong.

What. I was doing was placing a second barrier strip in top of the first one to try to hold the wafer down better since I don't use a belt.

So now the first barrier strips go center down first over the belt hooks and stretched out to either side before bonding to the skin. Since I have a belly fold this seems to do better especially on my left side where it has been blowing out.

Then I put another one along the bottom while exhaled to press the bottom down firmly as well.

I put one on top of the bag itself on the left side to keep it from tilting to the right when output flows and pulling things up.

So it's important with a blue fold to maintain downward pressure within the belly fold so the wafer doesn't separate and pull the paste off from around the stoma.

Usually a belt does this but sleeping and movement was moving the wafer around, so using barrier strips like tape seems to work great.

Another adjustment since my stoma hole is on my belly button side where my belly fold is, so it's been a weak point and thicker output has been pushing the paste.

So now I put a ring of paste, skin side down right up tight against the stoma, then fill the belly fold on my left some with paste then cover it with a half a barrier strip. Three rings of paste on the wafer as well but just a 1/8 away from the wafer hole as I already have a ring around the stoma. I marry the two and press it down for 60 seconds.

So hopefully this will prevent the paste from being pushed away from the stoma on that weak side.

Okay a new modification,

I use the oil free eye makeup remover to remove residue fine film of paste and moisturize the skin. Then wash three times the wafer area with plain ivory type soap to remove the surface layer of the eye makeup remover.

After any crusting, then I squeeze one ring of paste right into that crack going around the stoma. Then on the wafer two rings of paste but slightly away from the wafer hole edge.

This has the benefit of two things, one that I can test right away if the paste is sticking to the skin or not and two makes it easier to line up when the wafer is applied. I now use a toilet paper tube to hold the water down around the stoma for 60 seconds.

Also I have some scar tissue under the wafer that the adhesive was grabbing. I learned using a piece of thin cardboard was not ideal. So now in the hot shower I massage the area so eventually it becomes more pliable and less sensitive. Also I put a thick bead of paste right there so the wafer adhesive can't grab it. Much how I cushion my graneomola on the other side. Why I like paste so much, it's so versatile.

The key thing I've learned is keeping my weight down, when I lost weight my stoma became more pronounced and a lot easier to seal than when it was an "innie" so now I monitor my weight that it stays at 200 pounds, because before it was 210-214 and the belly fold became worse.

Now I no longer "stack" wafer cutout pieces and just use one ring of them around the outer edge of the convex wafer bubble. My graneomola has shrunk so much I can barely feel it anymore, so this keeps the wafer slightly off of it.

Also I only use water to rinse the bag, anything I tried using before would cause the stoma to retract and this caused leaks.

So I update my first post with my latest improvements so it can help others who experiencing similar issues.

Okay, the circle of wafer cutout pieces around the edge of the convex bubble wasn't working as well as it should.

Apparently thin paste, about the thickness of a credit card, is supposedly the best method and I've been using paste as belly fold filler.

So now I'm putting 1/2" double stacked wafer cutout pieces in the belly fold on each side, then one on each side and no place else. The graneomola I'm trying to protect is in the belly fold on my right, next to the stoma, so I just put the wafer cutout pieces slightly behind it.

Hopefully this will reduce the height of the paste to the skin and prevent micro channels from forming better.

It really looks like something that's molded to fit would be so much better, then just a slight smear of paste.

ChatGPT has been considerably helpful, especially since I can't find or afford a seriously competent ostomy care nurse.

Definitely a lot better seal, I can feel the improvement.

I was using way too much paste, I've revised my original post.

ChatGPT has been a great help.

Okay ChatGPT said the reason why my wafer cutout pieces wasn't working was because they were placed on the outter edge of the convex bubble, that instead should be around the wafer hole edge.

So my latest improvements are as follows:

When preparing the wafer, using the wafer cutout piece, create a crescent shaped piece about .5 mm in thickness. Then the remaining cutout piece cut into eights the other way.

Three 1/8 pieces on one side belly fold, then three on the other side. With one more stacked on the middle one. I of course have a graneomola near one side so I set those just slightly behind it.

Then the crescent piece is used to fill the top and bottom empty space along the wafer edge.

What's been happening is because it's a cut to fit, the center of the wafer near the hole is flexible so when I'm bending it's lifting up and causing micro channels to form which cause leaks.

So now hopefully with less flexibility of the wafer hole area it shouldn't move as much and stay on place.

Also it advised me to hold the toilet paper tube on the stoma area for 3 minutes instead of 1 minute like I was doing. So we will see how these new improvements will do.

Okay holding the water down with the toilet paper tube for 3 minutes definitely works a heck of a lot better. So does putting the wafer cutout pieces trimmed around the wafer hole reduces it from flexing.

Another problem I was having was pocketing caused by my chest scar and belly button being covered by adhesive which I learned hot air would cause sweating and humidity buildup which was working it's way under the paste undermining it.

So now I've altered how I put the wafer adhesive down, right into the belly button hole on the right and barrier strip on the left with it just covering the other. Thus minimizing air pocketing under the adhesive.

I also noticed my chest scar under the wafer has almost disappeared after two years, but my exposed scar has not, so now I put a 1/2 extra large barrier strip over that part also.

I no longer put a barrier strip on the outside left of the bag to keep it from lifting, apparently it's not needed and could have been causing my pocketing issue. I just make sure the wafer adhesive is down good

So we will see how this goes, I've updated the original post to reflect these new changes.

Okay went around the stoma twice with the Dabbler bottle and held down the paste for 5 minutes instead of three and gained another day of wear time.

Took it off 4 days later and there was only the slightest of a leak wound. So definitely onto something here.

I even sat on a chair for an hour and drove for three days almost on the same bag. Nothing popped off.

Skin adhesion of the barrier adhesive is imperitive.

Okay, identified an issue with one particular belly fold which often creates a mold environment from an air pocket that forms when I move and the wafer flexes some.

I now put a 1/4 cut standard barrier strip into this area 1/4" away from the stoma well adhered to the skin first before applying anything else. I also fill the belly button hole with one as well.

A tight to the skin wafer or barrier strip prevents the skin from evaporation or sweating and thus doesn't produce itchy mold.

I of course use the Prep Dabber bottle on top of it to get a good adhesion of the paste that will partially cover it when the wafer is pressed on.

I've updated my first post with the new method, seems to be working marvelously.