Guide
Living with an ostomy: the practical guide
Fit, skin, leaks and supply — the four things that decide whether an ostomy is manageable.
Fit is everything
The barrier opening should match the stoma with only a very small clearance. Too large and output sits on skin; too small and the barrier presses on the stoma. A stoma also changes shape in the weeks after surgery, so an opening that was right at discharge may not be right a month later.
- Measure the stoma regularly in the early months.
- Flat, convex and deep-convex barriers exist because abdomens differ — a retracted or flush stoma often needs convexity to get a seal.
- Cut-to-fit, pre-cut and moldable barriers all have their place.
- One-piece is simpler; two-piece lets you change the pouch without disturbing the barrier.
Peristomal skin
Healthy peristomal skin looks like the skin everywhere else. Redness, weeping, itching or pain is not something to tolerate — it almost always means output is reaching skin, and it will get worse.
- Remove the barrier gently, with an adhesive remover, pushing the skin away from the adhesive rather than pulling the adhesive off the skin.
- Clean with warm water. Skip soaps with oils or moisturisers — they leave residue that stops the next barrier sticking.
- Dry thoroughly. Adhesive will not bond to damp skin.
- Use barrier rings or paste to fill uneven contours rather than hoping the wafer bridges them.
- Barrier powder plus a sealant handles weepy skin.
Leaks
A leak is a fit problem until proven otherwise. Common causes: the opening is too large, the abdomen has a crease or scar the flat wafer cannot bridge, the stoma is flush or retracted and needs convexity, the wear time is too long, or heat and humidity are degrading the adhesive.
Florida heat is a genuine factor. Barriers do not last as long in summer, and belts and barrier rings help.
Supply
Keep the manufacturer reference number from your box. It specifies the size, the convexity and the coupling exactly, and it is the fastest thing you can give a supplier.
Everyday things people worry about and should not
- Showering. You can shower with the pouch on or off. Water does not harm the stoma.
- Swimming. Yes. Barrier tape strips help, and there is no reason to avoid a pool.
- Odour. Modern pouches contain it. Deodorant drops exist if you want them.
- Travel. Carry supplies in hand luggage, more than you think you need, and keep them out of a hot car.
Related
About this guide
This is general information written to be useful, not medical advice, and it is not a coverage determination. It does not replace what your own clinician has told you about your own situation — where the two differ, follow your clinician.
We deliberately publish no prices, allowables or fee-schedule figures. Those vary by plan, state and year, and a stale number is worse than none. Call (800) 304-7030 and we will verify your actual benefit.
Not sure where to start?
Call us and tell us what happened — a surgery, a new diagnosis, a discharge date, a supply you keep running out of. We will tell you what is usually needed, check your benefits, and ask your prescriber for the order if you do not have one yet.