Choosing the Right Ostomy Pouch

There are dozens of types of ostomy pouches: different styles, different brands, different functions. How do you know which is right for you?

When choosing an ostomy pouch, think about comfort, security, appearance, and ease of emptying and changing it. Expect a process of trial and error as you figure out which kind of pouch works best.

Pros and Cons of a One-Piece Ostomy Pouch

In a one-piece ostomy system, the skin barrier and the pouch are a single unit. Every time you change the pouch, you’ll change the skin barrier too.

Pros: One-piece systems lie flatter, so they’re easier to conceal. They feel more secure, too, because you know the bag can’t detach from the skin barrier.

Cons: Repositioning and reapplying the skin barrier every time you change the pouch can be difficult, especially if you’re not at home. This process also can irritate your peristomal skin.

Pros and Cons of a Two-Piece Ostomy Pouch

A two-piece ostomy system allows you to change the bag while leaving the skin barrier in place. Typically, a skin barrier is changed twice a week. The frequency for changing the pouch varies depending on the type of ostomy you have and your personal wear time.

Pros: Two-piece systems allow for greater flexibility and speed, so you can easily change pouches on the go. Less-frequent barrier changes can be easier on your skin. You can buy skin barriers and pouches separately, creating a system that’s customized for your body. Just keep in mind that the flange size of the skin barrier must be the same as the flange on the ostomy pouch.

Cons: Two-piece ostomy systems are a little bulkier and more expensive than one-piece systems. While it’s simple to securely lock the pouch into place, there’s the ever-present worry that it might come undone. Also, because you’re changing the skin barrier less often, you might not spot a leak until it’s already damaged your skin.

Pros and Cons of a Drainable Ostomy Pouch

A drainable ostomy pouch has an open end that unfolds, unrolls or unclips so you can empty it into the toilet.

Pros: Being able to empty the pouch throughout the day prolongs wear time and saves money. People with constant or more frequent output from the stoma, as well as those with more liquid output, will benefit from being able to empty the pouch often.

Cons: The process of emptying an ostomy pouch can be messy and tedious.

Pros and Cons of a Closed-End Ostomy Pouch

When a closed-end pouch is 1/3 to 1/2 full, it’s removed and thrown away. Or you can use a disposable liner to collect output and flush it, and then reuse the pouch. A closed ostomy pouch is preferred by many people with more formed or solid stool.

Pros: There’s no chance a closed-end pouch will leak from the end, so this style may be best for swimming, intimacy or other physical activities. With a closed pouch, disposal is easy and quick.

Cons: Frequent replacement of a closed-end pouch can get expensive. When traveling or away from home, you’ll have to make sure you have a good supply of extra pouches.

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