Stoma Leakage: Rosemary Brierley

12 January, 2019

I have had my colostomy for over 25 years. I had a couple of leaks soon after my stoma was formed, probably my fault for not making sure that my bag was securely in place. The contents of the bag started to seep out under the flange on one side. I was at home at the time so the problem was easily solved, but it taught me to be prepared when I went out.

Now I always check my bag is secure before I leave the house and, if necessary, change it for a fresh one. Even if I am only going out for a short time, I make sure I take my emergency kit with me: a couple of spare bags, sachets of adhesive remover and cleansing gel, a disposal bag and a couple of flange extenders in case there is need for an emergency temporary repair. They take up very little room in a zip compartment in my handbag. I have only had to change away from home on rare occasions but it is reassuring to have everything with me should the need arise. For years I don’t remember having any leaks, probably because my stoma was well away from my scars so there was a smooth surface to give a good seal between the flange and the skin.

Then a year or so ago, the situation changed. As I got older, I gained a bit of weight especially around my middle and the slight indentation to one side of the stoma became more pronounced. When I sit down a crease forms on the right-hand side of my stoma which occasionally forms a channel for the bag contents to leak out beneath the flange.

On the odd occasion this has happened, I usually get a warning: a slight whiff or a feeling that something’s not quite right. From experience I have learnt not to panic and get to the loo as soon as I can. The first thing I do when I get there is make sure I have a clean bag and a disposal bag within easy reach, and I remove any clothes that might get in the way. Before I take a look, I stand next to the toilet – seat up – with the bag area just over the bowl, just in case there are any drips when I remove the bag.

This strategy has stood me in good stead in coping with the few leaks I’ve experienced over the last year. At one time I had no hesitation in going anywhere with a stoma – holidays abroad, long haul flights or staying with family or friends – but now I have become a bit more anxious. What if my stoma becomes very active on the flight and the “fasten your seatbelt” sign is on, or there is a long queue for the toilet.

I told myself not to be silly, not to worry about something that might never happen; instead to “Be Prepared”:  I always have my emergency kit handy in my handbag under the aeroplane seat, not in the overhead locker. I always change my bag just before boarding the plane and stick extenders (some stoma care nurses call them “bananas” because of their curved shape) around the flange to increase the area of adhesion and allow more time to get to the toilet.

I have experienced a leak in the night at home, and worried that this might happen in someone else’s bed. When on holiday I always check my bag before going to bed and if necessary change it, to be sure the filter will release any wind so that the bag does not inflate while I sleep. Depending on how my stoma is behaving at the time and where I am staying, for extra security at night, I might use flange extenders, wear pants beneath my pyjamas, or place a cot-sized bed-protector (available as complimentary items from some ostomy delivery companies) over the bottom sheet, just in case.

To date, that leak aboard a plane or in a foreign bed that I have spent so much time worrying about has never happened! My holiday confidence has increased.

It’s now quite a while since I had a leak, but what of the future? I still have a few other strategies up my sleeve. If it starts happening again, I could try another bag that might have a more secure flange. I could try washers, also known as seals, rings or “doughnuts”; to create a better seal; they can be moulded to shape and stuck around the stoma, before applying the flange. If, heaven forbid, I put on any more weight and my stoma becomes recessed or flat to the skin, I’ll ask my stoma care nurse about bags with convex flanges designed to make stomas protrude above skin level. It’s always best to get expert advice on these as in the past convex flanges were rather hard on the skin, but I believe the more recent soft convex flanges are less of a problem.

I like to think that whatever the future may bring at least, as far as my colostomy is concerned, I’m prepared.