There are several reasons why an ostomy may leak. Often, the underlying cause is related to:

1. A poorly fitting ostomy appliance. Measure your stoma regularly, especially in the weeks following surgery, as its size and shape can change. Ensure the hole in the wafer is cut to fit closely around your stoma, leaving about a 1/8-inch (3-4 mm) gap to avoid skin exposure while not being too tight.
2. Retraction of the ostomy. Some people find that a convex flange provides a better seal, especially if they have a stoma that is flush with the skin or retracted.
3. Improper skin prep. Before applying your appliance, clean the skin around your stoma with warm water and a soft cloth. Avoid using soaps with oils or moisturizers, as these can interfere with the adhesive. Make sure your skin is completely dry before applying the barrier.  Consider using a skin barrier wipe or spray to protect the skin and help the adhesive stick better.
4. Skin irritation. If your skin is currently irritated, consider consulting with your healthcare provider for specific recommendations to treat the current irritation and avoid similar problems in the future.
5. Wafer seal issues. After applying the wafer, smooth it down around your stoma and hold it in place for a few minutes. The warmth of your hand can help the adhesive bond better to your skin. Ostomy paste or barrier rings can help fill in gaps and creases, creating a better seal around your stoma.
6. Product wear. Appliances can degrade over time, especially in humid environments or when exposed to sweat. Regularly changing your appliance (every 3 to 5 days, or as recommended) helps maintain a good fit and reduces the risk of leaks. Changing it more frequently if you notice wear or if the fit is compromised can also help.
7. Very thin output. If possible, manage your diet to reduce excessive liquid output, as this can lead to leaks. Certain foods, medications, or hydration levels can impact stool consistency.
8. Overly full pouch. Empty your pouch when it’s about one-third full to prevent the weight from pulling on the appliance and causing a leak.
9. Poor appliance support. Some people find that using an ostomy belt can provide additional support and keep the appliance snug against the body.
10. Anatomical issues. Try to place the wafer on a smooth, flat surface of your abdomen. If there are creases or folds, consider using additional accessories like barrier rings or strips to level out the area. Some specialized ostomy appliances, such as the D-Ostomy, can help avoid problematic, non-smooth areas completely, eliminating their contribution to leaks.

If you continue to experience frequent leaks despite trying these strategies, it may be a good idea to consult with a healthcare professional for more personalized advice. They can help assess any underlying issues and suggest additional solutions tailored to your specific situation.

The D-Ostomy system is created to allow room to avoid overlap of these incisions when an ostomy appliance is placed to minimize pain, leakage, and other complications that can result from an appliance overlapping a wound or scar. In the same way that the straight edge of the D-ostomy appliance can be used to avoid incisions and scars in the immediate post-operative phase, it can also be used to avoid scars, rolls, folds, other dressings, drains, second ostomies, bellybuttons and anything else that may be nearby to your ostomy long term.