If your ostomy pouch keeps falling off, it can be due to several reasons related to the fit, adhesion, skin condition, or other external factors. Here are some common reasons why an ostomy pouch might fall off and tips to help you address each issue:
- Improper Adhesion
- Skin Not Clean or Dry: The adhesive on the wafer (the part of the pouch system that sticks to your skin) might not adhere properly if your skin is oily, dirty, or damp when you apply it.
- Tip: Clean the skin around your stoma with warm water and avoid using soaps with oils or moisturizers. Make sure the skin is completely dry before applying the appliance.
- Residue from Products: Skin creams, lotions, or certain soaps can leave a residue that interferes with the adhesion of the wafer.
- Tip: Avoid using these products on the skin around your stoma or ensure all residues are thoroughly washed off before applying the appliance.
- Incorrect Appliance Size or Fit
- Stoma Size Changes: Your stoma can change in size or shape over time, particularly after surgery, weight changes, or due to swelling.
- Tip: Measure your stoma each time you change your appliance to ensure you are using the correct size. If your stoma has changed significantly, you might need to adjust the size of the opening in the wafer or choose a different product.
- Poor Fit Around Stoma: If the wafer does not fit snugly around your stoma, it can lead to leaks and a loose fit.
- Tip: Ensure the wafer is cut to fit closely around your stoma, with about a 1/8-inch (3-4 mm) gap. Consider using a barrier ring or paste to fill in gaps.
- Tip: Certain types of ostomy appliances, such as the D-Ostomy, are designed to avoid problems such as nearby incisions, scars, rolls, folds, bellybutton, or drains, and make it easier to obtain a good seal around your stoma.
- Skin Irritation or Damage
- Skin Breakdown: Skin irritation or damage can prevent the wafer from sticking properly. Moist or broken skin will not hold adhesive as effectively.
- Tip: Treat any skin irritation promptly with products recommended by your healthcare provider. Protect your skin with barrier wipes or sprays, and consider using a different appliance that might be gentler on the skin.
- High Output or Moisture
- Excessive Moisture: Sweat, high humidity, or excessive moisture from showering can reduce the adhesive’s effectiveness.
- Tip: After activities like showering or exercising, dry the area thoroughly. Consider using an ostomy belt or additional adhesive strips for extra security.
- Frequent Ostomy Output: If your stoma has a high output or produces liquid stool frequently, it can cause the adhesive to break down more quickly.
- Tip: Empty your pouch when it is about one-third full to prevent pulling and weight from causing it to fall off. You may also need to change your appliance more frequently if you have high output.
- Physical Activity and Movement
- Physical Strain: Activities that involve bending, stretching, or twisting can cause the wafer to loosen or fall off.
- Tip: Use an ostomy belt to provide additional support, especially during physical activities. Try different positions when applying your appliance to see what provides the best fit for your body.
- Product Wear and Tear
- Outdated or Damaged Supplies: Using old or damaged supplies can compromise adhesion.
- Tip: Make sure your supplies are stored properly and used before their expiration date. If the adhesive seems less effective, it might be time to replace your supplies.
- Inappropriate Product for Your Needs
- Wrong Type of Appliance: Different types of wafers and pouches work better for different skin types, body shapes, and stoma types.
- Tip: Experiment with different types of ostomy products (such as the D-ostomy, convex wafers, extended wear wafers, or different brands) to see which one works best for you. Many companies offer samples so you can try different options.
- Applying the Wafer Incorrectly
- Air Bubbles or Wrinkles: Applying the wafer with air bubbles, wrinkles, or not pressing firmly can prevent it from sticking properly.
- Tip: Smooth the wafer carefully when applying it and hold it in place for a few minutes to allow the adhesive to set.
- Change of Routine or Environment
- Changes in Diet, Hydration, or Medication: Sometimes, changes in diet, hydration, or medications can alter your stoma output or skin condition, affecting the adhesion.
- Tip: Keep a record of changes in your routine or environment and how they affect your ostomy appliance to identify patterns and adjust your care accordingly.
- Use Additional Adhesive Products
- Adhesive Sprays and Wipes: Using an adhesive spray or wipe can increase the sticking power of the wafer.
- Tip: Apply an adhesive spray or use adhesive strips around the edges of your wafer for extra security.
If your pouch continues to fall off despite trying these strategies, consider reaching out to a healthcare provider or a Wound, Ostomy, and Continence (WOC) nurse. They can provide a thorough assessment and recommend specific products or techniques tailored to your needs.
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.