How to Prevent Ostomy Leakage Before It Starts

If your ostomy bag keeps leaking, you’re not alone. Ostomy leakage is one of the most common and distressing challenges for people living with a stoma. It affects your skin, confidence, sleep, social life, and overall quality of life.

The good news? With the right knowledge, products, and routine, you can often prevent ostomy leakage before it starts – instead of constantly reacting to problems after they happen.

What Causes Ostomy Leakage?

There are many possible ostomy leakage causes, and they often overlap. Understanding them is the first step to prevention.

Common reasons your ostomy bag might be leaking include:

Poor fit around the stoma
Changes in stoma size or shape
Irregular or creased abdominal skin
Liquid or high-volume output
Hydrocolloid (adhesive) breakdown
Excessive wear time
Sweating, movement, or physical activity

One of the most important (and often overlooked) contributors is hydrocolloid breakdown.

Hydrocolloid Breakdown: The Hidden Root Cause

Most ostomy appliances use hydrocolloid adhesive to create a secure seal around the stoma. This hydrocolloid is designed to stick to the skin, absorb some moisture, and protect the area.

However, when corrosive stoma output sits on the hydrocolloid, especially liquid output, it can start to erode and break down the adhesive. Once the hydrocolloid is weakened, small gaps form and output can seep underneath the seal.

This leads to:

Leaks underneath the wafer
Red, sore, or damaged peristomal skin
Shorter wear time
A vicious cycle of irritation and repeated leakage

People with ileostomies, urostomies or high-liquid output are particularly at risk for fast hydrocolloid erosion.

Step 1: Make Sure Your Ostomy Appliance Fits Properly

A good seal starts with a good fit. If the hole in your wafer or seal is too big or the wrong shape, output can easily slip onto your skin and under the hydrocolloid.

Tips to prevent leakage with better fit

Measure your stoma regularly – especially in the first 6–8 weeks after surgery, as the stoma can shrink and change shape. If you’re unsure how to do it, this video demonstration may be helpful.
Cut or order the right size – the opening should be snug around the stoma, without squeezing it.
Check for gaps – after applying, gently press around the stoma to ensure full contact.
Ask your stoma care nurse – if you notice changes or new leaks, you may need a different type of ostomy bag or accessories.

Step 2: Prepare and Protect the Peristomal Skin

Healthy peristomal skin (the skin around your stoma) helps your adhesive perform better and last longer. Damaged skin can reduce adhesion and make leakage more likely.

Before you apply your ostomy bag:

Clean the area with warm water (avoid oily or heavily perfumed soaps).
Pat the skin completely dry.
Avoid applying creams or moisturisers under the adhesive.
Use wipes or sprays if recommended by your nurse, especially if your skin is easily irritated.

Step 3: Prepare and Protect the Peristomal Skin

The type of output from your stoma plays a big role in ostomy bag leakage:

Watery or very loose output erodes hydrocolloid faster.
Thicker output is generally less damaging to the adhesive.

If your stoma is flush, retracted, or in a skin fold, output may pool around it instead of dropping straight into the pouch. This increases contact with the hydrocolloid and can speed up breakdown.

What can help?

Review your diet and hydration with your healthcare team.
Ask your nurse or doctor about medications if your output is consistently too liquid.
Consider products that support and shape the area around the stoma to encourage better flow into the bag.

Step 4: Use Preventative Products – Not Just Emergency Fixes

Many people only reach for seals/barrier rings, or other accessories after they’ve had repeated leaks. But some products are designed to help you avoid leaks from the start.

Think prevention, not just reaction

Traditional appliances rely heavily on absorption, but there are newer solutions that aim to protect the integrity of the hydrocolloid and direct stoma output away from the skin, instead of simply soaking it up. This can help:

Reduce direct contact between output and the hydrocolloid
Maintain the integrity of the hydrocolloid for longer
Protect against peristomal skin irritation
Improve wear time and peace of mind

This new approach – protecting from excessive absorption and guiding output into the pouch more efficiently – is especially helpful for:

Ostomates with fluidic output
People with skin irritation
Anyone who wants to protect their skin and stop leaks before they start

Ostoform’s FLOWASSIST products use this same principle to help protect the hydrocolloid and minimize leakage. If you’d like to learn more, this webinar walks through the science in greater detail.

Step 5: Review Your Wear Time

Trying to to stretch your ostomy appliance for “one more day” can sometimes backfire. As hydrocolloid wears down, the risk of leakage increases.

Wear-time tips to prevent ostomy leakage

Listen to your body: itching, burning, or a feeling of dampness can be early signs of a leak.
Don’t ignore small signs: tiny undermining can become a full leak if left too long.
Speak to your stoma nurse about a realistic wear-time goal based on your skin, output, and lifestyle.
Consider products that help protect the hydrocolloid and support safe wear times.

Step 6: Reassess Your Ostomy System Regularly

Your body isn’t static. Weight changes, hernias, scars, and muscle tone can all affect how your ostomy appliance fits – and how well it protects against leaks.

You may need to review your system if you notice:

More frequent leaks or shorter wear time
Changes in stoma size or shape
New skin folds or creases around the stoma
Weight gain or loss
Increased activity or changes in your daily routine

Many stoma care nurses suggest a check-up every 6-12 months, even if you’re not having major problems. A small adjustment now can prevent bigger issues later.

FAQs: Preventing Ostomy Leakage

Why does my ostomy bag keep leaking at night?

Night-time leaks often happen because the pouch gets too full, gas builds up, or output sits around a flush or retracted stoma for longer. Emptying before bed, using a larger capacity pouch, and improving how output flows into the bag can help.

Is it normal to have occasional ostomy leaks?

A rare leak can happen to almost anyone, but frequent leaks are not something you just have to live with. Regular leaks often mean your product fit, skin routine, or accessories need reviewing.

How do I know if my hydrocolloid is breaking down?

A soft, mushy, or “melted” appearance
Dark or discolored edges
Output visible under the edge of the adhesive
Itching or burning around the stoma

If you notice these signs, talk to your stoma nurse about ways to protect the hydrocolloid and redirect output.

Final Thoughts

Preventing ostomy leakage is not just about fixing the problem after your bag leaks, it’s about protecting your hydrocolloid barrier, peristomal skin, and stoma area from the start.

By:

Ensuring a proper fit
Preparing and caring for your skin
Managing output consistency and flow
Using preventative appliances that keep output away from the hydrocolloid
Reviewing your wear time and system regularly

…you can significantly reduce the risk of your ostomy bag leaking and feel more secure day to day.

Every stoma is unique. This article offers general information only. For personalized care or if you are experiencing leakage or skin issues, speak with your stoma care nurse or healthcare provider.

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