Adjusting to life after an ostomy surgery can take time. You may be wondering how you will resume your normal activities now that you have a stoma. The good news is that people with ostomies are usually able to do all the things they did before surgery. One of the most important things for getting back to your activities without hassles is having access to products that best fit your unique body, stoma, and lifestyle.
There are many types of ostomy products on the market and understanding the differences can be challenging. In this article, we will discuss different types of ostomy bags – often referred to as pouches - to help you determine what might be best for your specific needs.
Generally speaking, ostomy products are designed for three types of stomas: colostomies, ileostomies, and urostomies. Colostomies are formed from the large intestine, and the output is often thicker or even formed stool. Ileostomies are formed from the lowest part of the small intestine, and the output is liquid stool which can sometimes be more frequent than a colostomy. The final type of ostomy is a urostomy, which is done when the bladder must be removed or bypassed due to injury or disease. Urostomy output consists of urine.
There is no one-size-fits-all solution to choosing the right ostomy bag. Different ostomy bags include different features and options to help you stay comfortable and maintain your lifestyle. Before choosing an ostomy bag for your circumstances, it is important to weigh factors including the type of ostomy, daily activities, and even your budget.
So, let’s start with the basics: One-piece and Two-piece pouching systems.
One-Piece Systems
As the name suggests, one-piece systems are a singular unit consisting of a conjoined bag and skin barrier. For that reason, whenever the bag is changed, then the entire system must be replaced. One-piece systems are discreet under clothing and tend to lay flat against the body. Once placed, the angle of the bag cannot be adjusted without replacing the entire system.
Two-Piece Systems
Unlike the previous type, two-piece ostomy bags consist of two separate components: the skin barrier and the pouch. These components snap together with a Tupperware-like seal or attach together via a built-in adhesive. The skin barrier can remain in place for 3-5 days before requiring replacement, and the pouch can be changed out more frequently if desired. Two-piece ostomy systems offer convenience to individuals who seek the ability to easily switch between bags to suit their activities or time of day. For example, a drainable pouch could be worn at home, and a smaller, mini-pouch could be used while at the pool or on a date. The angle of the bag can also be adjusted without removing the entire appliance.
Now that we’ve covered one-piece and two-piece systems, let’s discuss pouch styles:
Drainable Pouches
Drainable ostomy pouches allow users to empty the contents of their pouch without removing it. There is a Velcro opening or clamp at the bottom that is opened to expel the waste. Most people empty their drainable pouch several times per day into the toilet. Many insurance plans will cover around 20 drainable pouches per month. Typically, these types of pouches are used by people with ileostomies or colostomies, especially if they have frequent output. Many insurance plans will cover approximately 20 drainable pouches per month.
Closed Pouches
Closed-end pouches are often used by people with colostomies, as they are ideal for moderate amounts solid or formed fecal output. There are one-piece and two-piece pouches available. These pouches are not intended to be emptied or reused. Instead, once the pouch is full, it is disposed of and replaced. Individuals can use flushable pouch liners in conjunction with a closed pouch if they wish to reuse the closed pouch. Closed pouches are a good option for people with colostomies who do not wish to deal with emptying a drainable pouch. Many insurance plans will cover approximately 60 closed pouches per month.
High Output Pouches
High-output pouches are designed for people with ileostomies that produce a lot of liquid output. There are one-piece and two-piece high-output pouches available. These bags are slightly larger than typical bags and have a soft tap at the bottom that can make emptying liquid stool easier. This soft tap can also be attached to a larger collection bag at night, which can reduce the need to get up to empty the pouch. Many insurance plans will cover approximately 20 high-output pouches per month.
Urostomy Pouches
Urostomy pouches are ostomy pouches designed for especially urine. There are one-piece and two-piece urostomy pouches available. A urostomy pouch is unique in that it has a small spout with a tap at the bottom that is designed to accommodate emptying urine easily and without a mess. This spout can be attached to a larger bedside drainage bag or leg bag with an adapter and tubing, if desired. This can eliminate the need to get up at night to drain the urostomy pouch. Many insurance plans will cover approximately 20 urostomy pouches per month.
Mini-Pouches
Mini-pouches are a smaller size pouch, so they are more discreet and less intrusive. There are mini drainable pouches, closed pouches, and urostomy pouches available. They come in one-piece and two-piece options. Unlike larger alternatives, mini ostomy bags have a smaller volume, so they may need to be emptied or replaced more often. Mini ostomy bags are often used by individuals with active lifestyles who either perform colostomy irrigation or prefer the option to switch between a full-size bag and smaller bag as needed, such as during for certain activities like intimacy or swimming. Many insurance plans will cover approximately 20 mini-pouches per month.
Conclusion
All pouches have the option to come in opaque or transparent materials, depending on if you want to see inside of the bag or not. Some opaque pouches have a small viewing window, so looking inside the pouch is still an option, but not mandatory. Another selectable feature is the pouch filter. This filter is designed to slowly release and deodorize gas, so the pouch does not balloon. Only colostomies and ileostomies produce gas, so no filter is needed for urostomy pouches.
Talking with an ostomy nurse is a great way to learn about different products and get evaluated for what might work best for you. You can look up ostomy nurses in your area by using this tool: https://www.wocn.org/learning-center/patient-resources/find-a-nurse/
At ABC Medical, we have an ostomy nurse on staff who can discuss product problems and help you find products that may better suite your needs. This can be particularly useful if there are no ostomy nurses in your area.
For additional information on living with an ostomy, consider visiting https://www.ostomy.org/ - an ostomy advocacy group promoting quality of life for people with ostomies and continent diversions through free educational materials, support, advocacy, and collaboration.
Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. For medical advice, please speak with your healthcare provider.
