If you are an ostomate or someone who has had any of the three ostomy surgeries (colostomy, urostomy, or ileostomy), then you may need to use an ostomy pouch either temporarily or permanently. This guide can teach you the basics of ostomy appliances and help you choose the right one for you.

There are two types of ostomy systems: one-piece and two-piece pouches. A one-piece ostomy pouch is an appliance where the skin barrier, also known as the wafer or baseplate, and the pouch or bag come as one single or undetachable unit. A two-piece system, on the other hand, has a separate and detachable skin barrier and pouch.

The skin barrier is the part that adheresto your peristomal skin, the area around the stoma, to protect it. The pouch is where the body waste (stool, urine, or discharge) is collected.

Types of ostomy pouches

One-piece and two-piece pouching systems can be closed or drainable. They are also available in different styles and colors and may be opaque or transparent. Some of the styles of ostomy pouches are flat, convex, moldable, filtered, pre-cut, and flushable. And since an ostomy may be needed at any age, pouches come in a variety of sizes including adult and pediatric sizes and variations.

Being aware of the different types of ostomy bags that are available means that you can narrow down the list of pouches you prefer. Some of them may or may not cater to your needs, therefore, it is advisable to try them out..   

Closed pouch

A closed-end bag is a single-use appliance that doesn’t have an opening at the bottom and is ideally discarded once it is about a third full.

Drainable pouch

This appliance includes a bag secured by a clip, seal, or closure, which is used to open the pouch and empty its contents (also when it is a third full). After draining, you get to reuse the pouch. In a two-piece system, you can remove the pouch, drain, clean, then reattach it to the skin barrier.

The pros and cons of using a two-piece and one-piece ostomy bag

Both types of ostomy appliances have their own advantages and disadvantages. That’s why here are a few points that you might want to consider before settling with one type of system:

Advantages of a one-piece ostomy system

  • A one-piece pouch, due to its simple design and lower profile, lays flat on the skin and is less visible. This makes it more suitable to be worn under fitted clothing.
  • It can adhere easier on scarred or uneven skin due to folds, etc.
  • There is no risk of the appliance coming apart, which might help you feel more confident and secure wearing it.
  • There is only one unit to apply on the skin and no other separate parts, which is beneficial for ostomates with dexterity or eyesight challenges since they might find it easier to use. 
  • One-piece pouching systems are generally less expensive than two-piece systems.

Disadvantages of a one-piece ostomy system

  • Frequent removal of the entire appliance and therefore replacing the skin barrier for every bag change increases the risk of peristomal skin irritation, infection, damage, sores, and inflammation.
  • Changing the pouch can be time-consuming and might be inconvenient in a public restroom since you have to make sure that the adhesive is sticking securely to the skin and everything is positioned properly. Incorrect placement might lead to leakage and stoma infection.
  • There may be more dependence on ostomy accessories and supplies, such as powders, pastes, tapes, and adhesive removers.

Advantages of a two-piece ostomy system

  • The skin barrier can be used for up to three or four days, which reduces the risk of peristomal skin irritation.
  • You can quickly and easily change or drain your pouch while the skin barrier stays in place, making it the perfect pouch for ostomates on the go.
  • Using this pouching system gives you more flexibility because you can match your bags with your activity. For instance, you might want a small pouch when swimming or for intimate moments, then change it to a bigger pouch for work or at night.

Disadvantages of a two-piece ostomy system

  • Two-piece pouches can be bulkier because of the separate parts.
  • There is a risk of leakage if the pouch and skin barrier come apart.
  • Leaks might be harder to notice since the skin barrier is replaced only after a few days.
  • This type of pouching system can generally be more expensive.

Choosing an ostomy pouch

Choosing which type of pouching system to use will depend on your lifestyle, stoma output, needs, and preferences. Like most ostomates, you might want to try several types of ostomy appliances first before deciding which pouching system works for you. This way, you will know firsthand how comfortable and convenient every type of bag is for you. 

Seek the assistance of a healthcare professional

Apart from doing your own research and testing out various ostomy bags and supplies, a medical professional is the most reliable person who can help you choose the right appliance. A wound, ostomy, and continence (WOC) nurse is a nurse who specializes in providing direct care, support, and advice to ostomates. 

Continue living your best life

Living with an ostomy bag may require one to go through a learning curve and make some adjustments to their daily activities, but over time the challenges that may come with living with an ostomy can be overcome. You might find yourself changing your one-piece or two-piece pouch faster than you know and doing the activities that you have always enjoyed and loved, such as working out, swimming, and more. 

Being around people who have the same experiences and challenges that you have is a great way to get the support and resources you need. They can also share ideas on how to better navigate this new way of living.Better Health is a community of ostomates, healthcare specialists, and service providers that you can turn to for your ostomy needs. Visit https://joinbetter.com/ to explore what Better Health offers, from ostomy supplies and personalized advice to peer coaching and insurance assistance.

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