Causes of Ostomy Bag Leakage: What Are They?

Causes of Ostomy Bag Leakage

  1. Improper Central Hole Cutting Leads to "Leakage"

    When changing the ostomy bag baseplate, factors such as cutting the central hole too large, not matching the shape of the stoma, or lack of skill in cutting can all result in a gap between the baseplate's central hole and the stoma. This gap can allow feces and urine to flow onto the skin around the stoma, causing leakage. It is important that the central hole size matches the shape of the stoma, especially at the base, and is slightly larger by 1-2mm to avoid friction and reduce gaps between the stoma and the central hole.

  2. Changes in Stoma Height Leading to "Leakage"

    A stoma that is flush or recessed can lead to leakage if the stoma's intestinal nipple discharge is not elevated enough, causing waste to accumulate around the stoma instead of flowing into the bag. To illustrate, think of a faucet mounted on a wall; if the faucet's outlet is too close to the wall, water will soak the wall, keeping it constantly wet and eventually causing the paint to peel. Similarly, prolonged leakage can lead to skin redness and even breakdown. A shorter or recessed stoma may require external support to push it out as much as possible, allowing waste to flow directly into the ostomy bag rather than collecting around the stoma. This reduces the risk of leakage and minimizes irritation to the skin.

  3. Changes in Abdominal Shape Around the Stoma Leading to "Leakage"

    Every person with an ostomy has a unique abdominal shape, ranging from a lean abdomen to one with excess fat or multiple folds. Especially when abdominal fat increases, the stoma can easily be hidden within the "muffin top," and bending over or sitting can cause the baseplate to tilt, leading to leakage. If abdominal shape changes lead to leakage, consider using a baseplate that suits your abdominal shape. After changing the baseplate, it's best to lie flat and apply gentle pressure from the stoma root outward to ensure proper adhesion. If you notice any tilting of the baseplate, you can reinforce it with elastic adhesive strips to increase the adhesive area, which is an effective way to prevent leakage.

  4. Other Factors

    Excessive sweating in hot weather can lead to moisture on the skin, affecting baseplate adhesion and causing leakage. Therefore, during summer, it's important to change the baseplate frequently to prevent leakage. In cold weather, improper storage of the baseplate can lead to decreased adhesion between the baseplate adhesive and the skin, also resulting in leakage. For ostomy patients in extremely cold cities, warming the baseplate adhesive by placing it under the armpit before applying it can make it more pliable and secure.

Prevention is Key!

No matter the cause, ostomy bag leakage can be prevented in various ways to reduce skin issues. It's crucial to:

  1. Recognize Leakage Early – Regularly check the condition of the skin under the baseplate and monitor changes in the adhesive of the baseplate to detect leakage promptly.

  2. Preventive Skin Care – When changing the ostomy bag, remove the baseplate gently to avoid skin damage, and use adhesive remover for a gentle removal process.

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