Can You Help?

I have a colostomy, about 1" opening, and for 8 years I had no problem with my pouches. Then for 3 or 4 months I can't seem to have a bag on for more than a day, and there is leakage. What is deep convexity and should I have different kind of pouches that have a deep convexity? Would that help? Thank you.

Comments

Have you lost or gained weight recently? Has your stoma size or shape changed? How about the stool itself- has that changed consistency? Convexity is meant for those who have an uneven pouching surface- like if there are creases and your stoma sits in a divot or valley. Convexity- either light or regular may be enough if you're used to wearing the flat pouches. Sometimes a barrier ring helps to level out the pouching surface and buy more wear time. Deep convexity is a pouch that has more convexity- think dome shaped on the back. For my patients who have deep creases, yes, deep convexity has often been helpful when they have soft bellies. I often recommend to use a belt if you're using convexity...
Good luck.

From anonymous:
A convex wafer isnt flat. It's got like a little cone shape to it. The eakin seals also add convexity which helps prevent leakage.

From Anonymous:
I have the convex wafer and have tried the flat ones. I go through my wafers daily!! Right now I'm wearing a bag that was donated to me because I can't keep up with my shipment of bags. I've tried everything to prevent this but I can't find the problem, only that my stoma is extra warm and breaks down the seal faster. I'm sorry I'm not more help. Hopefully someone will have sound answers.

From Anonymous:
Have you seen an ostomy nurse (WOCN) at your local hospital or outpatient wound clinic? That would be your best place to start.

See your ET or Ostomy nurse nearest you! They can help you.

Be sure your peristomal skin is dry when you apply wafer. You could try a skinprep like Marathon from Medline to improve sticking of the wafer. Sometimes trying a pediatric wafer and pouch works as it is very flexible, especially if you are a petite or very thin person. Call your ostomy supply company and talk to their stoma nurse- Coloplast, Hollister, all the ostomy companies have specialists to help and they can send you samples. Don't give up!

The patient should establish whether s/he has gained weight and how much. If there was any weight gain the patient should establish whether there is a skin crease in the vicinity of the stoma. This may have altered the stoma mouth and peristomal area, i.e, retraction or skin folds. The patient may need some stoma paste to increase adhesion of the pouch.

If any of above mentioned is not the reason, I suggest light convexity and added support with a stoma belt as it might be enough convexity to prevent faecal leakage. Be sure to ascertain that the peristomal skin is healthy and intact. This can be achieved with protective skin barrier spray or wipes. Non sting if there is any skin peeling or excoriation present..

One kind of convexity should be sufficient.

It depends on if your stoma is in a fold or other indentation. Have you gained or lost weight recently? That could cause a change in the contour of your stoma. I am assuming the leakage is under the wafer or flange and that the pouch itself is ok. Has the consistency of your stool changed? I find this most commonly in people where their acidic output has increased either through diet or possibly some new medication. Bulking up your stool and/or increasing your soluble fiber can help. There are also drugs that help such as sandostatin. In terms of appliance, if you do not need the convexity, I find that a ring - such as Hollister's adapt ring #7805, which is sticky on both sides, can be put on to fit exactly around the stoma prior to the wafer/flange/pouch application. This eliminates any leakage through possible gaps in your skin. This is a very broad question and I may not have answered your question. Next time include a photo - that might help answers be more definitive.

The products that i generally use have a consultant number to call. Many times you get a nurse or someone knowledgable that can walk you through some of these issues. Best of all - they will probably send you samples till you find your new set up. I know the company that i use keeps folks on file so they already know who you are-if not sign up with your company.

The stool quality and amount is also to consider. Has your diet changed recently? Is the stool watery and thin, or thicker? Thicker stool does not undermine the way watery stool does. You said you have a colostomy which means the stool should be thicker consistency. If you have thin, watery stool and you have a colostomy, you basically are having diarrhea and are at higher risk of dehydration also. I recommend to my patients to look at the diet and see if what they are eating is causing the looser stools then thicken up the stool with dietary choices like cheese, pasta, rice, and peanut butter. Pectin from the canning aisle at the grocery store also does wonders.

Also see your local ET or WOC nurse

Regards,
Home Care WOC nurse :0)

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