Hints for Using Ostomy Bags

Introduction

I am not a physician. My background is in physics (Ph.D. 1977). I created this webpage to share what I learned through experience with an ileostomy beginning October 2019. I am posting my webpage for patients and nurses who are seeking information. However, what works for me may not be appropriate for someone else. Therefore, I do not provide additional information than what I share on this webpage. See my disclaimer of liability.

Things You Need

Ostomy scissors, to cut a hole in the bag for the stoma. (e.g., Coloplast Nr. 95050}.
Adhesive releaser, to remove adhesive without discomfort. (Comes in a 50 ml aerosol spray container, e.g., ConvaTec Nr. 413499 or Coloplast Nr. 120105).
Paper towels, to clean the skin.
To clean around the stoma, to remove adhesive and fecal material. I purchase generic 91% isopropyl alcohol in quart (946 ml) bottles, then dilute that alcohol with equal parts of tap water, to make approximately 45% alcohol solution. The precise concentration is not important, as 70% isopropyl alcohol is also satisfactory. For travel, I use alcohol prep pads, (e.g., Becton-Dickinson Nr. 326895). Do not put alcohol on the stoma.
Small (e.g., 4 gallon) plastic trash bags for disposal of used ostomy bags, paper towels, and other biohazards. It is handy to have a little polypropylene trash can to hold the trash bag open and upright.

Adhesive Strips

When cutting a hole for the stoma, one is removing some of the plastic flange on the back side of the ostomy bag. This flange is coated with adhesive that holds the bag against the skin. For a stoma that is near the maximum size of the hole in the bag, this can be a problem that leads to leaks of fecal material under the flange on the bag. The solution to this problem is to attach curved adhesive strips around the flange, to extend the adhesive outward for a better seal.

Here are the curved adhesive strips that are available in the USA from major manufacturers of ostomy bags:

Manufacture and Part Nr.	Manufacture's Title	Width in radial direction	Length in circumferential direction at minimum radius
Convatec 422163	Ease Thin Strips	30 mm	6 cm
Coloplast 120700	Brava® Elastic Barrier Strip Curved	30 mm	16 cm
McKesson 176-5725	Skin Barrier Strips ½ arc	29 mm	16 cm
Coloplast 12076	Brava® Elastic Barrier Strip XL	44 mm	16 cm

It can be difficult to see the flange at the bottom of the bag when the bag is attached to the abdomen. I attach a Coloplast XL adhesive strip along the bottom edge of the flange, completely covering the flange, before I attach the bag to my abdomen. Firmly press the adhesive strip against the bottom edge of the flange, before attaching the flange and adhesive strip to the skin. This firm pressing makes a good seal between flange and strip, to prevent the strip from detaching from the flange.

Once the bag is in place on my abdomen, I attach Coloplast adhesive strips to the sides and top of the flange, again completely covering the flange.

The adhesive strips should not only completely cover the flange, but also have no wrinkles. Do not stretch the adhesive strip.

If the ostomy bag uses an elastic belt (e.g., Coloplast 16716), then the adhesive strip must go under the plastic tab for the hook on the elastic belt. Do not cover the tab with an adhesive strip.

Leaks

No one wants to talk about leaks of fecal material from an ostomy bag — also called a "pouch" — which leaves patients to discover for themselves how to avoid leaks.

Unless the ostomy bag has an uncommon defect, the bag itself does not leak. Nearly all leaks occur when fecal material travels between (1) the adhesive flange on the bag and (2) the skin.

Common causes of leaks are:

Pressure inside the bag forces fecal material under the flange. This commonly happpens in two different ways:
1. The bag is full and needs to be emptied into a toilet. After a large meal, the bag may need to be emptied every one or two hours.
2. Gas inside the bag causes the bag to swell like a balloon.
The hole in the adhesive flange is too large for the stoma.
The skin was not clean and/or not dry when the adhesive flange was pressed against the skin during the installation of the bag. Adhesive will not stick to wet skin.

In addition to the obvious remedies for these common causes of leaks, I have found it helpful to attach Coloplast XL adhesive strips around the circumference of the adhesive flange, as explained above.

Small leaks can sometimes be repaired by adding a few centimeters (e.g., 4 to 6 cm) of an adhesive strip to cover the site of the leak. However, large leaks require removal of the bag, cleaning of the skin, and installation of a new bag, in order to obtain a good seal betwen flange and skin.

Finally, wear disposable underpants to help contain leaks. Use disposable bed pads (e.g., Medline MSC282070LB) to absorb any leaks during sleep.

Copyright 2021-2023 by Ronald B. Standler

This document is at http://www.rbs0.com/ostomy.htm
created 4 Sep 2020, modified 24 June 2023

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