There are a wide range of stoma bags available and there are constant changes and improvements being made. While it’s great to have plenty of choice, the amount of stoma bags available can cause some confusion over which you should choose. Stoma bags are available in different types of styles, shapes, sizes and colours, so it is often down to personal preference. We’ve put our guide together below to help you select the right one for you.
Types of stoma bags
The first and most important part of selecting the right appliance for you, is knowing whether you need a closed bag or a drainable one. This is dependent on the type of surgery you have had, what type of stoma you have and most importantly the type of output. Following bowel surgery, most people will require a drainable bag which can be left undisturbed for 24-48hours to help the stoma recover and the surrounding skin to heal. In the following days and by the time you are home from hospital, you may need a different type of bag. Your stoma nurse will guide you through this.
For those who have had an ileostomy formed, part or all of their small bowel (ileum) may have been removed or used as a diversion, therefore your output will be a soft or porridge-like consistency. It may be that you will need to drain the contents of your bag 4-6 times within a 24hour period and a drainable bag will enable you to do this easily without disturbing your skin.
For those who have a colostomy formed, part of the large bowel may have been removed and therefore the output from your stoma is usually semi-formed to a formed stool and the frequency may go back to how it was prior to your surgery. Thick or formed stools can be difficult to drain out of an appliance, so simply remove the entire closed bag as required.
For a urostomy, urine is diverted from the ureters through your stoma. The bladder is either removed or bypassed. You will require a urostomy bag which has a stopper or tap at the end, to enable you to drain the liquid/urine down the toilet or into a jug. Don’t forget to look out for a leg or night bag that will fit your appliance or go for a larger bag which will have a larger capacity overnight.
One-piece or two-piece ostomy appliance?
A one-piece ostomy appliance is a bag which is attached to the flange/skin barrier. It is applied as one and removed the same way. A one piece ostomy appliance is often found to be discreet compared to a two piece ostomy bag, so those who practice sport or wear tight fitting clothing may prefer these. The disadvantages are that each time you have to change your stoma appliance, the whole system needs to be removed and therefore it can lead to skin irritation if this is done often too often during the day.
The two-piece ostomy appliance is when the bag and flange/skin barrier are separate, allowing you to change the bag but leave the flange/skin barrier in place. They are generally more gentle on the skin as the flange/skin barrier can stay in place for 1-3days. The one big advantage is that you have the choice of changing the bag for different situations i.e. larger bags overnight and small ones for swimming or intimate moments. The down side is that they tend to be slightly more bulky than the one piece.
You’ll often find most bags are available in standard size. Other sizes are larger such as the maxi bag and there is a slightly smaller range called the midi bag. These are available in both the one piece ostomy bag and the two piece ostomy bag
Paediatric or mini bags are a smaller option designed for children, but can also be used by adults. The capacity will also be smaller so remember they will need to be emptied or changed frequently.
Stoma caps are smaller still and are a very discreet closed bag. As they are a closed bag, they can only be used for short periods of time, sporting events or intimate moments.
Flanges and wafers:
The part of the appliance that adheres to the skin can be referred to as a flange, skin barrier or wafer. This is an important part of the ostomy bag system as it protects your skin from bodily waste and keeps the bag in position.
Flanges are available in different shapes and sizes which is dependent on the size of your stoma. Your stoma care nurse will help measure your stoma and advise what size the flange should be, so it sits neatly around your stoma. Your flange can either be cut to the right size for your stoma or you can use a mouldable system which “turtle necks” around your stoma to save on the cutting.
The ingredients of the flange are very skin friendly, as this is the part which has direct contact with your skin and stoma. They vary slightly with some being extra thin to fold easily with the contours of your stomach such as the microskin flange, or there are some flanges made with manuka honey or aloe vera which can help with sensitive skin, or flanges containing alginate can help soothe your skin when it has become irritated and is particularly good for those with very sensitive skins or undergoing treatments such as chemotherapy.
For troublesome stomas which may be retracted or have a smaller spout, there are convexity flanges, which have a soft or hard convex area, which goes around your stoma to help with leaks and sore skin. These must be initiated and monitored by your stoma care nurse.
Stoma bags are all very similar in style and shape. They are designed to follow contours of the body/stomach and should hold enough capacity for your stoma. Bags are available in a soft material in either closed, drainable system or urology system.
Most bags these days, with the acceptance of urostomy bags, have a filter near the top or the sides of the bag to let gas escape. Bags are available in a clear material so you can see through them easily, you may want to use these if your stoma needs to be monitored closely, especially after stoma surgery or for people with poor eyesight. For those who don’t want to see their stoma or the contents, opaque bags are popular. Newer option are available with a split screen/window where you can choose to lift the material of the bag slightly to see through stoma and contents if you need.
Bags now range in colour from the popular beige, white, off white and black material. Again this is down to personal preference.
Here are some of our tips to help finding which is the best stoma appliance for you:
- Try to identify what you need and want from your appliance before you search
- Look at your lifestyle to help you decide what you need
- Try not to be influenced by a friend/relative as they may have a very different stoma and lifestyle to you
- Keep up to date with the products by speaking regularly with your stoma nurse and attending patient open day and support groups
- Trial some new products by ordering a sample first to see if you like them before changing your prescription details with your surgery. It is helpful for you to let your stoma nurse know if you have changed to a different appliance, so your records can be kept up to date. You can order your free samples here.
- You may want to try a mixture of one piece and two piece ostomy appliances
- Remember comfort is an important factor in your decision
- Also try to choose one which will be easy to manage on a day to day basis.
- Remember nothing is set in stone and you can change your mind about your products at any point.