Ostomy 101: Choosing a Pouching System

What is an ostomy/stoma? 

A stoma is a surgical opening (generally in the abdomen) created to eliminate waste out of the body when a section of the small or large intestine is bypassed/removed.

Although an ostomy can be temporary or permanent, it is needed for conditions such as Diverticulitis, cancer, and Inflammatory Bowel Disease (IBD). People born with birth defects, or involved in severe injury/trauma to the digestive tract, would likely need one as well. 

Types of Ostomies

Your operation will likely be one of four types: ileostomy, colostomy, urostomy or tracheostomy. 

Ileostomy: a surgical opening diverting a section of the ileum to an opening in the abdomen (stoma) to eliminate waste

Colostomy: a surgical procedure diverting a portion of the colon to an opening in the abdomen (stoma) to eliminate waste

Urostomy: a surgical procedure that redirects urine to be excreted through the stoma, when the bladder is bypassed/removed

Tracheostomy: a surgical procedure that creates an opening in the throat, making an airway for people who cannot breathe, have difficulty breathing, or have a blockage in the trachea

Diagrams of a colostomy, urostomy, and ileostomy

Choosing a Pouching System 

After surgery, the hospital will likely give you some products designed to work for many people. Once you are discharged, it may be worth sampling different types of pouching systems to determine what works best for you.

One-Piece and Two-Piece Ostomy Pouching Systems

Two different ostomy pouching systems are available. Each has its own advantages, depending on the persons lifestyle needs. Both pouching systems include a pouch and a skin barrier. 

  • The pouch is the portion that collects the waste material. 
  • The skin barrier encloses the stoma, holds the pouch in place, and attaches directly to the body. Skin barriers are also referred to as wafers.
  • Flanges are the coupling component that attaches the skin barrier to the pouch. 

One-Piece Ostomy System 

This system has the pouch and the skin barrier as one component. 

When changing this system, the pouch and barrier are removed together. An advantage of this system is that it is easily applied in one step. Another advantage is that this system stays close to the body, which makes it more discreet under clothing. 

Two-Piece Ostomy System 

This system is more functional because the pouch and the skin barrier are different entities. This allows you to change the pouch without needing to remove the skin barrier. This is advantageous because you can switch out the pouches when you require different capacity levels for different activities. This includes intimacy, swimming, exercise, and travel. 

Drainable and Closed Pouching Systems

There are two types of pouches that one can choose based on their needs. 

Both types of pouches are available in different options such as size, color, and filter. In the hospital, they usually start off with transparent pouches to give the caregiver an indication of what the waste material looks like. These pouches also help with application of your system since you can see the stoma through the pouch. Once discharged, you have the opportunity to discuss different options with your ostomy nurse or a personalized ostomy consultant. 

Drainable Pouching Systems

You can have either a clamp system or an integrated closure system. 

Drainable clamped pouching systems need to be clamped at the bottom, whereas an integrated closure system is a closure integrated into the system (Lock n’ Roll). 

With drainables, you should empty the pouch when it reaches one-half to two-thirds of the capacity. Emptying the pouch is easy, and is more convenient if you have to do this throughout the day. 

Drainable and Lock n' Roll Closed Pouch Ostomy Systems

Urostomy pouches are all drainable, and are specific to urine. They have a tap at the end to allow draining of the urine and an embedded anti-reflux component to prevent urine backflow. During the night, you can attach a night drainage bag that holds more urine so you may have a restful sleep. 

Closed Pouching Systems

These pouches are closed on one end, which you can remove and dispose of, instead of draining the bag.

If your output is more formed (colostomates), or you change your bags infrequently, then closed pouches might be a suitable option. 

Ostomy Accessories

Ostomy accessories are not necessary, however some may find them extremely valuable. Depending on many factors, an accessory can improve fit and seal, as well as provide additional comfort and security. 

Paste

Used as a caulk, pastes improve the seal between the skin barrier and the skin. They fill in gaps, scars, and divots on the skin that may give the abdomen an uneven surface for application. NOTE: this is not to be used as glue/adhesive.

Barrier Rings

Barrier rings fill in gaps and uneven areas between the skin barrier and the stoma to improve fit and protect skin integrity. 

Stoma Powder

Stoma powder is a non-medicated powder used around the peristomal area to wick away and absorb moisture from irritated/moist skin.

Lubricating Deodorant

Lubricating deodorant helps eliminate odour and makes emptying the pouch easier.

Ostomy Paste, Barrier Rings, Stoma Powder, and Lubricating Deodorant

Ostomy Belt

An ostomy belt attaches to a pouch with belt tabs for additional security of the system. 

Skin Barrier Wipes

Skin barrier wipes leave a thin breathable film on the skin protecting it from damage due to output and adhesives. 

Adhesive Removers

Adhesive removers enable you to remove skin barriers and leftover residue without causing trauma to the skin. 

Ostomy belt, barrier wipes, and adhesive remover

Get your supplies at Healthcare Solutions 

As an industry-leading supplier of healthcare products that has been serving Canadians for over 30 years, Healthcare Solutions has a vast selection of different ostomy products and accessories to fit your needs. Whether you choose to shop online at our online store, or at one of our two convenient locations in the Edmonton area, consultation is available to help you. Healthcare Solutions carries the top brands in the industry, including Hollister, Coloplast, and ConvaTec

Healthcare Solutions Provides Personalized Consultation

With the help of an ostomy nurse—and our ostomy consultant—you can be confident in the products that you choose. Reach out to our ostomy consultant today for advice on products that you are interested in. In-person and online appointments are available to help you get all the information you need.

Noor Al-Tamimi — Ostomy Consultant

Phone: (780) 434-4368
Mobile: (780) 721-5779
Email: noor@healthcaresolutions.ca

Client receiving ostomy consultation in health care setting

Common Terms

Ostomy Accessories: Products used to help protect skin integrity and/or enhance the security of your ostomy system.

Adhesive Removers: A product used to remove the adhesive from the skin without irritation. 

Barrier Opening: An opening in the ostomy flange/barrier ring that would be equal to or greater than the stoma size.

Closed End Pouch: A pouch generally used by colostomates to collect waste materials, but is closed on one end.

Colostomy: A surgical procedure diverting a section of the colon into an opening (stoma) used to eliminate wastes produced in the body.

Convexity: A specially designed flange that is curved outward, putting light pressure on the abdomen in situations where a stoma may be retracted or flush with the abdomen.

Flange: The coupling component that attaches to the ostomy pouch in a two-piece system.

Ileostomy: A surgical procedure diverting a section of the ileum in the small intestine to an opening (stoma) used to eliminate wastes produced in the body.

Ostomy: a surgical procedure that creates an opening in the abdomen (generally), used to eliminate waste materials from the body when a section of large or small intestine is bypassed/removed.

One-Piece Ostomy System: an ostomy system where the pouch and flange are attached to one another.

Peristomal Skin: The skin around the stoma.

Skin Barrier/Wafer: The piece of the ostomy system that is against the skin, which has a hole that fits the stoma. Sometimes referred to as a flange.

Stoma: an opening in the abdomen (generally), used to eliminate waste materials from the body when a section of the large or small intestine is bypassed/removed.

Stoma Powder: A non-medicated powder used around the peristomal area to wick away and absorb moisture from irritated/moist skin.

Two-Piece Ostomy System: An ostomy system where the pouch and flange are different entities.

Urostomy: A surgical procedure redirecting urine to be eliminated through an opening (stoma) when the bladder is bypassed/removed.

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