A range of products and accessories are available to assist patients to overcome a number of stoma problems and enhance their self-care. Used in conjunction with good appliance selection, they help to maintain peristomal skin integrity and promote pouch reliability. For many patients they make the difference between gaining independence in their stoma care, and living with continuing problems. Anna Boyles examines the incidence of problematic stomas, why accessories are used and who should recommend them. A range of problems are examined and the choices available on the market and their appropriate use are discussed.