Which is the best pouch for me?

Choosing the best pouch for you is a bit like finding the best pair of shoes. Not every brand fits every foot, and the brand your friend or neighbour likes might not be the right one for you. Ostomy pouches are similar.

Many factors go into picking the right pouch.

Fit = wear time

The better your fit, the longer your seal lasts. It means you don’t have to worry about leaks and your skin will stay healthy.

Some people choose their pouch based on closure, or other factors. This may mean a trade-off with a flange is not an ideal fit. This means more frequent changes are necessary to keep skin healthy and prevent leakage. This is a personal choice.

Each pouching system is made up of the following parts. Each manufacturer has their own designs for each part. Finding the best one for you helps you pick the right pouch for you.

Also called a skin barrier, this is the part of the pouch that sticks to your abdomen.

  • Each company makes their own recipes for the components that make the seal
  • Some companies make flanges with tape, and the recipes for the adhesives for the tape varies by manufacturer.

This is usually part of the flange. It is a “bump” on the side of the flange that goes against the skin.

  • Different manufacturers make different depths of convexity
  • Convexity can have different shapes and angles
  • Convexity can be rigid or flexible
  • Some manufacturers make convexity that can be added, like a ring or an insert

This is how a two-piece pouch and flange stick together. Some are adhesive, some are like tupperware, and some use a locking system. Each company has their own style, and some companies make more than one kind of coupling.

Although most pouches are very similar, some have different features such as a viewing window or variation in size, or variation in covering fabric.

This is where the pouch empties.

  • Some pouches don’t have a closure (closed-end)
  • Some have a tap or spout for urine or liquid stool
  • Some have a closure that rolls up and closes with velcro or something similar; some have a clip

Here are several manufacturers’ websites so you can see how each one has their own variations on the different parts of the pouching system.

Start at the skin

Reliable wear time and healthy skin starts with selecting the best flange for you.

The first choice to make is whether you need a flat or convex flange.

Deciding whether you need convexity starts by looking at:

Take a look at: May or May Not Need Convexity Probably Needs Convexity
The height of your stoma Sticks up
  • Flat at skin level
  • Below skin level
The contours of your abdomen A bulge behind your stoma
  • Changes when you move around or stand up
  • Changes when your stoma is active
  •  There’s a “moat” around your stoma (an indentation)
Your abdomen Firm

Flat

 Soft

Has loose skin
Your stoma Is a loop stoma (the stoma has two openings)

  • Puts out urine
Pouch selection is based on the flange that fits you best. Each manufacturer makes pouches that are compatible with only their flanges.
You will choose between a one-piece system or two-piece system. Each has advantages, so it is really up to you which one you prefer.

Using accessories

“Accessories” like rings or belts can be essential to creating an effective seal and keeping skin healthy.

Rings:

  • Protect skin beside an oval stoma inside a round opening
  • Fill in space that convexity might not fill completely
  • Keep a seal when your skin pulls away from your flange
  • Help even out the contours around your stoma
  • Come in different thicknesses and recipes

Size

See how to measure and select the correct size for your stoma here.