Living with an ostomy involves learning how to use a variety of specialized medical products designed to manage waste and protect your skin. An ostomy—whether it is a colostomy, ileostomy, or urostomy—requires a reliable system to collect output while maintaining a secure seal. Understanding the different types of ostomy care products available is the first step toward living a comfortable and active life.
The world of ostomy supplies can feel overwhelming at first because there are so many options. However, most products fall into a few specific categories: pouching systems, skin barriers, and accessories. Each plays a unique role in preventing leaks, protecting the skin around the stoma, and managing odors. This guide will walk you through these essentials to help you find the best solutions for your needs.
Understanding Ostomy Pouching Systems
The most fundamental piece of ostomy care is the pouching system, which collects waste from the stoma. These systems are generally divided into two main categories: one-piece and two-piece systems. Choosing between them often depends on personal preference, activity level, and the type of ostomy you have.
One-Piece Systems
In a one-piece system, the skin barrier (the part that sticks to your body) and the collection pouch are permanently attached as a single unit. Because they are integrated, one-piece systems are often more flexible and lower in profile, making them less noticeable under clothing. They are also simpler to apply since there is only one piece to manage.
Two-Piece Systems
A two-piece system consists of a separate skin barrier and a pouch that snap or stick together. This allows you to change the pouch without removing the skin barrier from your skin. This is particularly helpful if you have sensitive skin that becomes irritated by frequent adhesive removal. It also allows you to switch between different pouch sizes, such as a smaller pouch for exercise and a larger one for sleep.
Drainable vs. Closed-End Pouches
Pouches also come in drainable or closed-end styles. Drainable pouches have an opening at the bottom secured by a clip or velcro-like closure, allowing you to empty the contents multiple times a day. Closed-end pouches are designed to be removed and discarded once they are full, which is common for individuals with more predictable or less frequent output.
The Importance of Skin Barriers
The skin barrier, also known as a wafer or flange, is the most critical part of your ostomy system for maintaining skin health. It adheres to the skin around your stoma, providing a waterproof seal that prevents output from touching and irritating the skin. There are several variations of skin barriers designed for different body shapes and stoma types.
- Flat Barriers: These are used when the stoma protrudes significantly and the skin around it is relatively flat.
- Convex Barriers: These have a curved shape that pushes down on the skin around the stoma. They are ideal for stomas that are flush with the skin or retracted, as they help the stoma protrude further into the pouch.
- Cut-to-Fit: These barriers allow you to cut the opening to the exact size and shape of your stoma, which is helpful in the weeks following surgery when the stoma size may change.
- Pre-Cut: These come with a hole already cut to a specific size, offering convenience for those with a stable, round stoma.
Essential Ostomy Accessories
While the pouch and barrier are the core components, accessories can significantly improve the performance of your system. These products help solve specific problems like leaks, skin irritation, or difficulty with adhesive removal. Using the right accessories can extend the wear time of your pouching system.
Barrier Rings and Seals
Barrier rings are flexible, donut-shaped discs that are placed around the stoma before the skin barrier is applied. They act like “caulk” to fill in uneven skin surfaces, scars, or folds, creating a more level surface for the wafer. This extra layer of protection is one of the most effective ways to prevent leaks.
Ostomy Paste
Similar to barrier rings, ostomy paste is used to fill in skin gaps and create a better seal. It is important to note that ostomy paste is not an adhesive; rather, it is a filler. Some pastes contain alcohol, which can sting if applied to irritated or broken skin, so many users prefer alcohol-free versions or rings.
Stoma Powder
Stoma powder is used to treat “weeping” or raw skin around the stoma. If the skin is moist, the barrier will not stick properly. By dusting a small amount of powder on the irritated area and brushing off the excess, you create a dry surface that allows the adhesive to bond while the skin heals underneath.
Skin Protection and Cleaning Products
Maintaining the integrity of the skin around the stoma (peristomal skin) is vital for comfort. If the skin becomes damaged, it can be painful and make it difficult for supplies to stay in place. Several products are designed specifically to protect and clean this sensitive area.
Adhesive Removers
Removing a skin barrier can sometimes pull on the skin or leave behind sticky residue. Adhesive remover wipes or sprays help dissolve the bond between the skin and the barrier. This allows for a gentle removal process, reducing the risk of skin stripping and irritation.
Skin Barrier Wipes and Sprays
These products leave a thin, protective film on the skin after cleaning. This film acts as a shield against stoma output and prevents the adhesive from being too aggressive on the skin. It is especially useful for individuals who need to change their pouching systems frequently.
Managing Odor and Lubrication
Many people with an ostomy worry about odor, but modern ostomy products are designed to be odor-proof. If you notice an odor while the pouch is on, it usually indicates a leak or a hole in the filter. To manage odors during emptying or changing, several products are available.
Pouch Deodorants
Deodorant liquids or tablets can be placed directly inside the pouch. These products neutralize odors rather than just masking them with a scent. Many of these are also “lubricating deodorants,” which help the stool slide to the bottom of the pouch, preventing it from sticking at the top (a common issue called “pancaking”).
Internal Deodorants
There are also oral supplements available that can reduce the odor of waste from the inside out. However, you should always consult with your healthcare provider or a wound, ostomy, and continence (WOC) nurse before adding supplements to your routine.
Step-by-Step Guide to Applying Ostomy Supplies
Proper application is key to making your supplies last and keeping your skin healthy. While your specific routine may vary based on the products you use, these general steps apply to most systems.
- Prepare the skin: Clean the skin around the stoma with warm water. Avoid using soaps with oils, perfumes, or lotions, as these can prevent the barrier from sticking.
- Measure the stoma: Use a measuring guide to ensure you are cutting the barrier opening to the correct size. The opening should be about 1/8 inch larger than the stoma itself.
- Apply accessories: If you use barrier rings or paste, apply them to the back of the skin barrier or directly to your skin as instructed.
- Apply the barrier: Center the barrier over the stoma and press firmly. Hold your hand over the barrier for about 30 seconds; the warmth from your hand helps the adhesive activate and create a secure bond.
- Attach the pouch: If using a two-piece system, snap the pouch onto the barrier flange. Ensure it is securely locked in place.
How to Choose the Right Products
Choosing the right products often requires a bit of trial and error. Factors such as your body shape, the consistency of your output, and your daily activities will influence what works best for you. For example, a person who is very active or swims frequently may need a barrier with stronger adhesive or a waterproof tape border.
It is highly recommended to work with a Wound, Ostomy, and Continence (WOC) nurse. These specialists can evaluate your stoma and skin to recommend specific products tailored to your anatomy. Most manufacturers also offer free samples, allowing you to try different systems before committing to a large order.
Managing an ostomy is a significant life change, but with the right supplies, it does not have to limit your lifestyle. By understanding the function of each product and maintaining a consistent care routine, you can ensure your ostomy remains a manageable part of your daily life. For more tips on health and daily management, explore our other articles on wellness and self-care.