After ostomy surgery, it may take some time to adjust, and it is pretty common to experience ostomy leaks. Thankfully, many ostomy leaks can be managed or completely fixed with some adjustments. We will discuss some of the reasons ostomy leaks happen and provide helpful tips for dealing with them.
Common Causes of Ostomy Leaks
Improper Skin Barrier Fit
The stoma often changes shape and size after ostomy surgery. Right after ostomy surgery, your stoma may be swollen and larger. After some time, your stoma will settle, and the skin barrier you have been using may not lay as flat against your peristomal skin as before, leading to leakage.
TIPS:
If you use a pre-cut or cut-to-fit skin barrier, make sure the hole your stoma goes through has a gap of about 1/8″ around it. If you are using a moldable skin barrier such as the ConvaTec Esteem synergy Flat Moldable Skin Barrier, make sure to choose a size that fits snuggly around your stoma, leaving no gaps. ConvaTec ostomy skin barriers that are moldable provide a personalized and custom fit around the stoma to help protect the peristomal skin. These skin barriers are easy to use since they require no cutting or guesswork.
Retracted or Flush Stoma
Your stoma should stick out just enough above the skin level and have the opening right in the middle to allow the output to flow seamlessly into the ostomy pouch. Sometimes, stomas are not this ideal and can either be flush with the surrounding skin or retracted and pulled back. Ostomy leaks can happen due to an improper skin barrier fit that allows output to go underneath it instead of into the ostomy pouch. Some adjustments to the style of skin barrier can be made to help avoid these ostomy leaks.
TIPS:
If your stoma is flush with your skin or it retracts below the skin, trying a convex skin barrier might be a solution. Convex skin barriers put pressure on the surrounding skin to help push the stoma out further and create a snug seal around the stoma. The convexity also helps fill in any gaps or irregularities of the peristomal skin, ultimately reducing ostomy leaks. Convatec ostomy skin barriers such as the SUR-FIT Natura Two-Piece Skin Barrier with CONVEX-IT Technology. This convex skin barrier is excellent for those with a flush or retracted stoma and features Moldable Technology for a snug fit.
Side Note: While a convex skin barrier can help solve ostomy leaks, it can also result in other challenges.
First, they can be more costly than traditional flat skin barriers. However, they can also save money in the long run since they can usually provide longer wear-time. The longer wear-time results in fewer appliance changes, so you may end up not needing to stock up as much.
Secondly, convex skin barriers can cause damage to peristomal skin. The constant pressure on this sensitive skin can result in pressure ulcers, causing discomfort and pain. Make sure to speak to your doctor about the level of convexity that is right for your unique stoma. There are convex skin barriers that offer low, medium, and deep-convexity, and choosing the right level is critical in preventing peristomal skin complications. Your doctor will advise on which of these convexity levels is suitable for you.
Parastomal Hernia
A bulge or swelling on or around the stoma is a parastomal hernia and is one of the most common complications after ostomy surgery. Part of the intestines protrudes out of the stoma with a parastomal hernia. Parastomal hernias can be painful and contribute to troublesome ostomy leaks.
TIPS:
After ostomy surgery, it is essential not to do any strenuous activity or lift anything heavy for up to eight weeks. Using a flexible skin barrier, an ostomy support belt or ostomy seals are a few ostomy supplies that can help ease symptoms of a parastomal hernia.
ConvaTec ostomy supplies such as the SUR-FIT Natura Skin Barrier for a flexible yet snug fit or the moldable ConvaTec Eakin Cohesive Seal to fill any uneven skin surfaces are a couple of products to consider to help prevent ostomy leaks. The wide variety of Nu-Hope Ostomy Support Belts are excellent choices to form around bulges more naturally and are adjustable to get a perfect fit.
Creases, Skin Folds, and Irregularities Around the Stoma
As we age, we notice changes in our skin. Weight can contribute to skin folds and creases, leading to ostomy leaks from improper-fitting ostomy appliances. Scars from the ostomy surgery can leave the skin with irregularities and not be as smooth as before. Ostomy leaks can happen when there is any opportunity for openings under the skin barrier.
TIPS:
There are products such as stoma paste, barrier strips, and barrier rings that can help address ostomy leaks from various skin issues around the stoma. A ConvaTec ostomy supply such as Stomahesive Paste can help act as a filler for uneven skin surfaces to help protect the skin and help increase skin barrier wear-time. The Hollister Adapt Convex Barrier Ring is another choice that is moldable, flexible, and helps even out skin contours under the skin barrier.
Ballooning Ostomy Pouch
When an ostomy pouch fills with gas, it can be vented to let the air escape. If the gas builds up in the pouch without escaping, ballooning occurs. As the pressure increases inside the pouch, pressure is put on the ostomy appliance, resulting in ostomy leaks. Ballooning commonly happens at night when one is asleep and does not notice gas buildup.
TIPS:
Try using an ostomy pouch with an incorporated filter built right into the bag. One Convatec ostomy pouch that features a filter is the Esteem + One-Piece Drainable Pouch with InvisiClose. This ostomy pouch is available with a filter designed to reduce clogging, ballooning, and eliminate odors.
You can also try using an ostomy accessory like the OSTO EZ-Vent ventilating device. This ostomy product allows for faster air release, fits on any ostomy pouch, and is easy to use.
Reducing the amount of air entering your digestive system is another way to help prevent ballooning that results in ostomy leaks. Chewing food thoroughly, sipping liquids slowly, and taking a probiotic daily may help balance bacteria in the gut and reduce gas.
Not Caring for Peristomal Skin
Skin care products such as lotions, moisturizers, soaps, and oils can cause a skin barrier to not stick properly to the peristomal skin. Additionally, the use of ostomy adhesives may leave residue behind, impacting the skin barrier’s ability to form a secure seal. Anything left on the skin can interfere with the adhesion of a skin barrier, so it is essential to take care of the skin and make sure that it is clean and dry to obtain a good seal.
TIPS:
If you are using an adhesive with your skin barrier, make sure to choose an effective adhesive remover to wipe away all residue that may be left behind. All adhesive removers are not created equal, so it is good to look for one that is alcohol-free and silicone-based to help protect the sensitive peristomal skin as it works to dissolve the adhesive gently. ConvaTec ostomy adhesive removers such as AllKare Adhesive Remover Wipes and Sensi-Care Adhesive Remover Spray are two excellent options.
Other Tips to Consider
These are just some of the most common causes and tips for managing ostomy leaks. Other things to keep in mind when taking preventive actions for ostomy leaks are:
- Regularly monitor and change your ostomy pouch before it gets too full.
- Empty your ostomy pouch and double-check your skin barrier seal before going to bed.
- Try keeping a food diary to track any changes you notice with certain foods and beverages.
- Watch when you eat. Eating later in the evening could be contributing to increased nighttime output.
- Set an alarm at night if you find your pouch fills up quickly. Or, try using a high-output ostomy pouch.
- Consider using gelling agents to control liquid output and help eliminate excess gas.
- Always consult your doctor if you notice significant changes in your stoma or output.
For any questions or help finding the ConvaTec ostomy supplies or other brands of ostomy products we carry, give us a call. One of our Personally Delivered Product Experts is glad to help.
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Disclaimer: Important Notice Regarding Medical Advice
The information provided in this blog is intended for general informational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment.
