Question: Struggling with Ostomy Appliance Adhesion Near the Stoma

I underwent an ileostomy and have been facing persistent challenges with keeping the flange adhered to my skin, especially within 5 cm of my stoma. Whether the output is liquid or mushy, the soft part of the flange tends to lift, allowing output to get underneath. Any use of paste, strips, or rings results in swelling that blocks my stoma. During my last visit to the ostomy clinic, my concerns and suggestions seemed to be disregarded, and the trial with a thin strip of paste was ineffective. I feel unheard and uncertain about how to prevent this issue without causing swelling. I’ve tried heating the products before application, but it hasn’t resolved the problem. Any guidance on alternative systems or methods would be greatly appreciated, as I’m eager to find a reliable solution.

Response: Exploring Alternative Ostomy Systems and Techniques

Firstly, I empathize with the frustration and discomfort you are experiencing. Finding the right fit and method for ostomy care can be challenging, and it’s essential to explore various options to determine what works best for you.

1. Alternative to Paste: While paste works well for some, it might not be the best option for everyone. I recommend trying a skin barrier that adheres closely to the peristomal skin. This not only protects the skin from stoma output but also facilitates better adhesion of the flange.
2. Contacting Manufacturers for Custom Solutions: Reach out to various ostomy equipment manufacturers. Most have specialists who can provide personalized advice, suggest suitable products, and even send free samples for trial. You may find a product that adheres better without causing swelling.
3. Specific Product Recommendation: Although I usually refrain from endorsing specific brands, many have found success with “Salts – Flange Extender” infused with Aloe. This product is known for its non-expansive properties, offering a snug fit around the stoma.
4. Application Guidelines: Ensure that the skin barrier is properly sized and shaped to fit your stoma. Apply it carefully, ensuring no skin is exposed between the barrier and the stoma. Regular changing of the ostomy pouch and paying attention to the amount and consistency of output can also reduce the risk of leaks.
5. Skin Barrier Options: Consider different types of skin barriers, such as standard wear for colostomies or extended wear for ileostomies and urostomies. Each has its unique properties and may offer a better solution for your specific needs.
6. System Types: Explore both one-piece and two-piece systems. Each has its advantages and might provide a better fit for your situation.
7. Professional Consultation: Consulting with a Nurse Specialized in Wound, Ostomy, and Continence (NSWOC) can provide further personalized advice and support. They can help assess your situation and recommend appropriate products or techniques.

In conclusion, while it’s crucial to find a system that prevents leaks and swelling effectively, it’s equally important to feel heard and supported by your healthcare providers. Don’t hesitate to seek a second opinion or contact other ostomy care professionals for advice.

Wishing you success in finding a comfortable and reliable solution.

Sincerely,

Jo-Ann L. Tremblay
THE OSTOMY FACTOR Blog – joannltremblay.wordpress.com
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Author of “The Self-Coaching Toolbox” , “Better With A Bag Than In A Bag” , “Another BAG Another DAY”, “BAGs Around the World”, Why Buttercup Wears a BAG!”, “The Sibs Gang Cave of the Golden Heart”
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