Leakage is probably a top concern for you if you’re an ostomate. It’s pretty understandable. The thought of output leaking and soiling your clothes and bedsheets is indeed dreadful and problematic.
Some patients get frustrated and believe that there’s no way to prevent this – “It’s just natural” they say. However, this is far from true!
There are many ways to prevent ostomy bag leakage. Most of the time, you only need to do some minor adjustments to your routine and habits or your pouching system. We explain you the causes of stoma leakage and ways to prevent it right here:
Stoma leakage can happen whether you have a urostomy, colostomy, or ileostomy. To reduce ostomy bag leakage, having the right ostomy products and a proven ostomy care routine is essential. A healthy hairless skin is required for the wafer to securely seal and prevent the ostomy from leaking.
There are several stoma care products that can help.
Another problem is excess gas, which can stretch the bag and cause stoma leakage. Besides that, watery output can also play a role in ostomy leakage. These can, however, be combated by adjusting your diet and taking a few precautionary measures.
If you’re worried about your stoma bag leaking, we have 20 practical tips for you to prevent it:
1. Find a pouching system that works best for you
Choosing the right ostomy system is essential to reduce stoma leakage. The market is full of different types and models of ostomy bags, but which one is the best?
The best ostomy bag type is the one that works best for YOU. Each stoma is unique, and differs from person to person. You will probably try out multiple brands and models before finding out which suits your stoma best. In the following we will give you recommendations which stoma bag you should choose.
If you’re worried about stoma leaks, choose a stoma bag that has:
- a wafer that’s easily adjustable to fit perfectly around your stoma without leaving uncovered skin
- a skin barrier wafer that’s properly adhesive and prevents minor leaks
- a stoma bag with a gas releasing valve or filter
2. Have the right stoma hygiene routine
Proper hygiene and care of your peristomal skin is critical to prevent stoma leaks. If your skin is inflamed and moist, the skin wafer will not properly adhere to it. This will lead to a leaking stoma bag, and the fluids will cause further skin irritation, and the cycle repeats itself. This is why taking care of your peristomal skin is critical to reduce the risk of ostomy pouch leaks.
If you’ve been an ostomate for some time, you probably have your own routine for cleaning your stoma skin when changing the bag. But are you doing it correctly to ensure a healthy stoma and skin? Check out those 10 steps to perfect your routine, otherwise you risk irritations or supply issues that you don’t even know of!
3. Measure your wafer opening for a perfect fit
The baseplate skin barrier should have a snug fit around your stoma, with a tiny gap of 1.5-3 mm. This protects your peristomal skin from irritation and inflammation from the stoma fluids.
You should regularly measure your stoma diameter, even if you’ve had it for a long time. The skin might stretch or you might develop a hernia at any point, and the size will change. A perfectly fitting baseplate with minimal naked skin is essential to prevent leakage.
Hands – or better – “measuring guide” on! Download our free measuring guide here to check your stoma diameter.
4. Shave around your stoma
Regular hair removal is essential if you want to reduce the chances of your stoma bag leaking. If your peristomal skin is hairy, the wafer will not properly adhere, and feces might leak out. If any remaining hair is pulled along when removing the wafer, it can cause further skin irritation.
When shaving the skin around your stoma, you should use an electric razor or curved-tip scissors rather than a blade or depilatory creams. These can cause skin irritation and ingrown hair. Shave in the direction of hair growth to cause the least irritation possible, and always be careful when shaving right around your stoma.
You might need to shave once or twice a week to keep the hair from growing. The best is to simply use a pH autobalancing detergent which is specifically designed for the proper cleaning of the peristomal skin area – and of course water. Any shaving creams or aftershave might harm your stoma and irritate your skin around it. Make sure to properly moisturize it after in order to ensure a healthy and hydrated skin.
We recommend you to use those specific care products, as they have ONE special characteristic that differs from conventional products: They are specifically designed for ostomies and peristomal skin. That sounds simple, but it makes a huge difference. It helps you with 1. tackling but also 2. preventing any kind issues related to your skin, stoma or appliance.
5. Change your pouching system regularly
Drainable ostomy bags should be replaced with new ones every 3-4 days. Change your ostomy bag regularly, on schedule, to avoid wear and tear, which can lead to bag rupture and leakage.
The same applies to the wafer if you’re using a 2-piece system. You should change your ostomy skin barrier wafer twice weekly. Otherwise, the adhesive tape will loosen and your stoma will leak.
The frequency of changing your stoma bag and skin wafer is not fixed. If you feel like the bag is wearing out, or the wafer is causing itching and skin irritation, then no need to wait.
Change the pouching system when you feel like you need to.
6. Remove your stoma bag gently
“Rip it off like a bandage so it hurts less!”
Unfortunately, this does not apply to your ostomy wafer. The adhesive skin-barrier wafer should be removed very gently and slowly, while pressing the skin under it.
Ripping off the skin wafer vigorously can pull off the outer layer of your skin, causing inflammation, bleeding, and pain. If this happens, the new wafer will not properly adhere to your skin (not to mention that it will hurt like hell). This can lead to stoma leakage and further skin injury.
7. Properly clean and dry your peristomal skin
When changing your ostomy wafer, make sure that the peristomal skin is clean. You don’t want to leave any debris that can prevent the wafer from properly sealing on your skin.
Moreover, if you choose to clean your peristomal skin with a wet cloth, make sure you completely dry it out before applying the new skin barrier. If your peristomal skin is wet, it will weaken the adhesive tape, and lead to ostomy leakage.
Rough towels or papers can stress the soft and fragile skin. Therefore, it’s best to use a disposable stoma specialized cloth that is soft yet durable to completely dry your skin without irritating it.
8. Don’t leave any skin folds when applying the wafer
When applying a new adhesive ostomy base (wafer), make sure you flatten your belly skin around your stoma where the wafer will be placed. Leaving a skin fold or crease under the barrier will create a small space through which stoma contents can leak out.
If your skin is rolled or folded under the wafer, remove it and apply another wafer.
9. Empty your bag before it’s completely full
Unless you like living on the edge, and risking ostomy bag leakage, then the best time to empty your ostomy pouch is when it is one-third to half full. This is true whether you have a colostomy, ileostomy, or urostomy.
The longer you wait, the more likely it is for the bag to rupture. Moreover, as the bag gets heavier and gravity pulls down on it, it will loosen the skin barrier wafer, and fecal contents can seep out. Now, imagine that happening when you’re in public.
10. Use skin barrier rings and strips
Ostomy barrier rings and strips can be used as an add on to make your skin barrier adheres more securely and prevent any leakage.
Skin barrier rings are small and round and are applied right around your stoma. They are malleable and adjustable, and can provide enough convexity and fill out uneven skin contours around your stoma. This way, no output seeps under your skin barrier or leaks out.
Skin barrier strips are round adhesive tapes that go around the border of your wafer to make it hold its place more securely.
11. Heat up the new wafer
To make your new wafer stick better to your skin without leaving any gaps for leaking, you can consider heating it up before sticking it on your skin. Heating the wafer up can activate the adhesive and make it stick better.
To do this, and before peeling the plastic layer off the wafer, you can put the wafer for a minute between your thighs or under your armpit, or you can just rub it between your hands for a few seconds to get it to heat up.
Alternatively, some ostomates choose to use a hair dryer on low heat to heat their adhesive wafer before applying it.
12. Maintain a good posture
If you’re a new ostomate, then you’ll slowly learn to adapt your posture in a way that you don’t put pressure on your stoma bag and cause it to leak.
You will be better off sleeping on your back and sitting up straight. Doing otherwise can loosen the baseplate or cause your stoma bag to break.
13. Wear a ostomy belt when exercising
Physical exercise can put some stress on your ostomy bag. So if you’re an ostomate and you regularly do sports, an ostomy exercise belt can be perfect for you.
It will support your stoma bag, prevent it from moving, and hence greatly reduce the risk of it leaking. Many brands and models are available to fit your needs.
From sleeping, to exercising, to having sex, you’ll find a belt that suit you. You can check out StealthBelt.com and see which one suits you.
14. Develop a routine to prevent nighttime leakage
One problem that many people with an ileostomy, but also colostomy and urostomy, complain about is their stoma bag leaking at night. Nobody would like to wake up to that.
Unfortunately, there are no effective ways to decrease your ostomy output at night. However, you can:
- Always empty your bag before going to sleep
- Make sure that your pouching system is intact and does not require changing
- Opt to wear a stoma sleeping belt for an extra layer of safety
- Use a higher-capacity pouch for nighttime
- Set an alarm in the middle of the night to check and empty your bag as needed
15. Avoid gassy foods
Gas build-up in your ostomy bag can cause it to rupture or detach from the baseplate.
Sadly, you cannot stop stoma farts and gas accumulation. You can, however, avoid gassy-foods such as beans, green veggies, milk, oat among others.
You should also vent your stoma bag when possible to reduce the pressure and prevent any leakage. Some ostomy bags have a built in filter to release the gas, so these might be a good option to try out.
16. Try using a convex wafer
The ostomy wafer is usually flat. However, many people don’t have a flat belly, rather a slightly curved one (or a very curved one). Using a flat baseplate might not be effective in such cases, as it will not securely adhere, and can lead to leakage.
Luckily, several ostomy bag manufacturers provide convex baseplates to fit every need.
These convex ostomy plates are also usually recommended to ostomates who can’t stop their ostomy bag from leaking or have an atypical stoma shape, and they can be very effective.
17. Check the expiry dates on your supplies
If you’re one of the million other ostomates who store stoma supplies at home, then this one’s for you.
Many ostomates forget to check the product expiry dates on storable items. Using an expired bag or baseplate would lead to system failure, stoma leakage, peeling off, or even rupture.
The expiry date is there for a reason, so make sure you regularly check it.
18. Avoid Pancaking
Pancaking is when thick stools coming out of your ostomy accumulate right on the opening, and flatten to resemble a pancake. This is a more common problem with colostomies than ileostomies, but can happen with both.
To avoid pancaking you can:
- Use a water-based bag lubricant inside the bag
- Drink fluids and eat foods that soften your stools’ consistency
- Manipulate your bag gently to inflate it
If you took care of those tips but still find your bag pancaking, we got you! We asked ostomy experts (people like you!) for their proven secrets against pancaking – find them here.
19. Keep your skin healthy
By now, it’s probably clear to you just how important stoma skin care is for preventing leakage. A healthy peristomal skin is essential to prevent leakage. The adhesive baseplate will not stick well on inflamed and moist skin, and a leaking stoma would be inevitable.
Here are some skin-care tips for your ostomy:
- Wipe your peristomal skin clean. For this, it is best to use specialized stoma-friendly clothes, like the Bioderm Multifunctional Disposable Cloths. These are excellent to insure minimal skin injury and effective cleansing.
- Also use stoma-friendly cleaning products, like the Bioderm Stoma Plus. This beats any conventional product, as it is preventing and even reducing irritation and speeds up healing of the peristomal skin.
- Keep your skin well hydrated and nourished with specialized stoma creams. We recommend using Bioderm Dermocrema, as it is the perfect addition for your stoma skincare trio. It is free from petrolatum, soaps, parabens and dyes and therefore perfect for sensitive skin, without letting your appliance fall off!
- Avoid regular wet wipes, fragranced soaps, and other skin products (powders and creams) that are not specifically created for stoma care. These can cause further skin irritation and skin inflammation.
That is why we interviewed experienced stoma nurses and stoma therapists to create an expert guide for the optimal peristomal daily skincare. Click here to find the easy-to-follow step-by-step guide to develop the best stoma care routine – and you soon will be master of keeping your skin oround the stoma healthy and free from irritations!
20. Watery outputs? Adjust your diet
Ostomy diarrhea and watery stools are common and irritating. They can quickly fill your colostomy or ileostomy bag and can easily leak out.
Add nuts, seeds, fruits, rice, oat, and other high-fiber foods to your diet to make your stoma output harder.
To sum up: Stoma leakage is a common problem that every ostomate wants to avoid. Proper care and an effective routine are needed to prevent it. As the time passes and you get used to living happily with your stoma, leakage will only be a thing of the past.