Finding the right stoma appliance usually takes a while, and hardly anybody nails it first time round. There’s a fair bit of trial and error along the way, which isn’t a sign that anything has gone wrong, because stoma care is just really personal. Your body shape, how sensitive your skin is, what your output’s like and how you spend your day all pull you in different directions, so a bag that’s brilliant for one person can be a right pain for somebody else.
If you’ve got a colostomy, the 1 piece closed stoma bag is one of the most popular choices out there, and there are good reasons for that. The bag and the baseplate (that’s the sticky wafer that sits on your skin) come as one single piece, so you don’t have a coupling ring to click together or a separate flange to fiddle about with. You just pop it on, wear it, take it off and bin it, and that really is all there is to it.
Why Plenty of People Go for a One-Piece
Lots of ostomates like how simple a one-piece is, especially if they’re fairly new to all this and found a two-piece system a bit much to get their head round at the start. You’ve got less stuff to cart about and nothing to put together, and it sits flatter under your clothes, which makes a big difference if you’d rather nobody could tell you’re wearing one.
A one-piece also sits that bit closer to your skin, and the adhesive tends to mould round the curves of your body more easily. That can really help if you’ve got skin folds, a softer tummy or a stoma that sits a little bit inwards. The stiffer ring on a two-piece can sometimes start lifting at the edges in those cases, whereas a one-piece is bendier and tends to move about with you.
Having said all that, a closed one-piece still won’t suit everybody, so it’s best to weigh it up against how your own body and routine work.
The Practical Side of Closed Bags
Closed bags are made to be taken off and thrown away rather than emptied and worn again through the day. Most people with a sigmoid or descending colostomy get by on two or three changes a day, and some only need one if their output is fairly regular. A closed bag hasn’t got an outlet at the bottom to drain it, and that’s the main thing that sets it apart from a drainable bag.
Most closed bags these days come with a filter built in, which lets wind out so the bag doesn’t puff up like a balloon. If that’s ever happened to you, you’ll know it’s uncomfortable and a bit of a shock the first time round. Filters help with smells too, although some brands are better at it than others, so it’s a good idea to ask a few different makers for samples before you pick one, since they don’t all behave the same way day to day.
Looking after the skin around your stoma is probably the biggest thing to get right, even more than which bag you choose. Leaks happen a lot more when the baseplate doesn’t fit properly, and if they keep happening you can end up with sore skin around the stoma, which then makes more leaks likely and turns into a really miserable cycle. That’s why it pays to get the size spot on. Most suppliers send out a sizing guide, and your stoma nurse can help if you’re not sure.
Ordering and Getting What You Actually Need
Here in the UK you can get stoma products on an NHS prescription and have them sent straight to your door by a dispensing appliance contractor. Companies like Salts Medilink do home delivery like this, and they can also give you advice on products if you’re comparing a few or thinking about changing from the bag you use now.
Changing to a different type of appliance isn’t a big palaver either, as it normally just means getting your prescription updated. If you’ve been on a two-piece and fancy trying a closed one-piece, or you’re not sure the bag you’ve got now really suits the way you live, have a chat with your stoma care team about it. Nothing’s set in stone, and you don’t have to stick with whatever you were sent home from hospital with.
