Understanding the Causes of Ostomy Leaks
1. Incorrect Stoma Measurement
The size and shape of a stoma can change, especially in the weeks after surgery. If the opening on the barrier is too big or too small, output can seep underneath the adhesive.
What helps
- Re-measure your stoma regularly
- Ensure no skin is exposed between the stoma and barrier opening
- Adjust the cut if your stoma becomes smaller over time
Even a few millimeters can affect the seal.
2. Poor Fit Between the Barrier and Abdominal Contours
Everyone’s abdomen is different. Folds, dips, scars, hernias, or soft areas can prevent a barrier from sticking evenly.
What helps
- Warm the barrier before applying
- Smooth the skin and hold the barrier in place for 30–60 seconds
- Consider accessories like rings or strips if recommended by a nurse
- Ensure the barrier sits flat without lifting at the edges
An even, consistent surface creates a stronger seal.
3. Output Consistency and Flow Pattern
Thinner, more active output—especially from ileostomies—can travel quickly under the barrier before the adhesive fully bonds to the skin.
What helps
- Empty the pouch when it’s 1/3 full
- Maintain good hydration to support healthy output
- Reinforce the area around the stoma if output is high-volume
Paying attention to flow pattern helps you identify when extra support is needed.
4. Moisture on the Skin During Application
Moisture—sweat, water, or leftover cleansing residue—prevents adhesives from sticking.
Applying a barrier to damp skin is one of the fastest ways leaks occur.
What helps
- Clean with warm water only, no lotions or oily products
- Pat the skin completely dry
- Allow a few moments for the skin to “air dry” before applying
A dry, clean surface is essential for a secure seal.
5. Adhesive Wear Time Exceeded
Barriers naturally break down after a certain period. If the pouch is worn too long, the adhesive may loosen, curl, or erode—leading to leakage.
What helps
- Track your usual wear time
- Change proactively rather than waiting for itching or lifting
- Adjust frequency based on activity level or weather
Finding your personal wear-time rhythm improves comfort and prevents surprises.
6. Stoma Shape or Height Changes
A stoma may become more flush, slightly retracted, or change its angle as swelling decreases or as the body shifts over time.
What helps
- Observe how output flows off the stoma
- Reassess your barrier type if leaks become frequent
- Ask your nurse if changes persist
Even subtle changes in stoma profile can influence which products work best.
7. Physical Activity and Clothing Pressure
Movement, bending, and tight waistbands may pull on the barrier or cause edges to lift.
What helps
- Avoid tight belts or seams directly over the pouch
- Support the pouch during workouts or heavy movement
- Check the seal after sweating or strenuous activity
A barrier that stays stable during activity reduces friction and lifting.
8. Heat, Sweat, and Humidity
Warm climates or seasonal heat can soften adhesives and increase moisture, affecting how well the barrier sticks.
What helps
- Apply in a cool room if possible
- Use drying techniques before application
- Monitor wear time during summer months
Environmental changes often mean slight adjustments to routine.
Putting It All Together
Leaks rarely happen for only one reason. More often, they’re the result of several small factors working together—fit, skin condition, output, and daily habits. Understanding the cause is the first step toward preventing it.
If leakage becomes frequent or starts to irritate your skin, reach out to your stoma nurse. A small change in technique or barrier type can often make a big improvement.
