Question

I have had an ileostomy since 2015. I am seasoned and understand everything about bag options and changing flanges etc. In August (1 year ago) i had stoma relocation surgery from the right side of my stomach to the left, after 3 hernia correction surgeries. After the relocation, my flange would not fasten to my stomach and i had constant night time leaks for 5 months until January of this year when it went away. Well, as of two weeks ago they have stopped sticking and i am 100% sure it is a result of either acidic stool, or secretion from around the stoma. Have you heard of this happening before? what are my options? it should be noted that i have lost considerable weight in the last 3 months, so i thought at first it might have been because i ahd a concave flange so i got new flat flanges and am still having leakes every night. I use a Holister flange and bag, with a coloplast ring. I used the ring for months after surgery while having this issue between August and January of last year. I stopped wearing the ring around April of this year with no leeks between April and end of July, and have put it back on in the last week, but have had little to no success stopping the nightly leaks. it is worth mentioning that the leaks only happen at night. Anyway, i really hope you can help me because my surgeon and stoma nurse at Mount Sinaii don’t believe me and think I dont know what i am talking about.  

Response

I am sorry you are having leakage and unpredictable wearing time and insecure pouching system.  Since you are experienced living with an ostomy, you are well aware that leakage is not to be tolerated.  The goal of ostomy living is to have healthy skin, no leakage and reliable wear time. One excellent resource is the Peristomal Skin Assessment guide, it is a stress by step guide to help you assess your skin, abdominal contours and pouching system.   Please see the link https://psag-consumer.wocn.org/#home When doing the assessment guide you may want to assess your abdominal contours while lying down and comparing the contours when you are sitting and standing.  Looks for dips or undrawing of your stoma or a moat around your stoma or a bulge as your abdominal contours change as your position changes from sitting to lying down. If you have a dip or moat around your stoma, does the flange match that contour? That is, if you have a deep moat, a convex flange will fit and full in the moat to give you a good seal.  There are different depth of convexity provided by different ostomy manufacturers.   The assessment guide will help you with this. Are you using any powders or sprays on your skin on a routine basis?  If so, there may be a build up of protective barrier spray or too much powder preventing your flange from sticking. I hope these tips help.  Please let us know and we can work on solving your leakage problem together.     Andrea Manson Andrea Manson RN, BSN, NSWOC, NCA All-round nice person, now retired ????           NSWOCC Logo Our friends over at Nurses Specialized In Wound, Ostomy And Continence Canada (formerly called The Canadian Association for Enterostomal Therapy (CAET)) have renamed their handy look-up page on their website. It was formerly called “Find An ET Nurse” and is now called “Find a NSWOC“. Click on the image to the left or link here to go to their site.
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