Gastric secretions, like those from a gastrostomy, are the most likely to cause skin breakdown to the surrounding tissue, due to the highly acidic nature of the secretions. Patients who are incontinent of urine and feces are also at risk for skin breakdown, but the risk is lower than with gastric secretions. The patient with a double barrel colostomy is at a higher risk for skin breakdown than those incontinent of feces and urine, but less so than the individual with a new gastrostomy tube due to the less acidic pH.