Ileostomy: Selecting Your Pouch

After an ileostomy, stool is collected in a pouch. This pouch attaches to your body around the hole (stoma). An adhesive skin barrier holds the pouch in place. It also stops stool from leaking onto the skin. Most pouches are made of lightweight, odor-proof plastic. They lie flat against the body, so they don’t show or make noise.

Types of pouches

There are many styles of pouches. Your healthcare provider will help you choose the one that’s best for you. The skin barrier has to fit around the stoma without touching it. And it must stick well. Then there won't be any leaking or odor from the pouch.

One-piece drainable

• The skin barrier and the pouch come as 1 piece. The skin barrier holds the pouch onto the skin.

• The bottom of the pouch has a tail with an opening. The tail is folded over and held closed with hook-and-loop closures or a clamp.

• To empty the pouch, open the hook-and-loop closures. Or remove the clamp.

Two-piece drainable

• The skin barrier and the pouch are separate pieces. The skin barrier is applied to the skin. The pouch snaps onto a flange on the skin barrier.

• The bottom of the pouch has a tail with an opening. The tail is folded over. It's held closed with hook-and-loop closures. Or with a clamp.

• To empty the pouch, open the hook-and-loop closures. Or remove the clamp.

Sizing the stoma opening

For the pouch to fit around the stoma, the skin barrier must have an opening. Some skin barriers have precut openings. But others you must size and cut yourself. To find the correct size opening for your stoma, use a measuring guide. Most pouches come with a guide in the box. Your healthcare provider may also give you one. Then follow these steps:

• Find the smallest hole on the guide that fits around the stoma without touching it. There should be about 1/8 inch between the stoma and the hole on the guide.

• To cut the opening yourself, center the guide hole on the back of the skin barrier. Trace the pattern. Then cut the opening using curved scissors.

• For precut openings, order pouches with the size opening that matches the size of the hole on the guide.

Use a guide to measure the stoma.

Pouch accessories

You can buy other stoma care items through special catalogs, at medical supply stores, and at some pharmacies:

• Powders and wipes. These add an extra layer of skin barrier. This helps protect the skin if stool leaks.

• Adhesive paste and skin barrier wafers. These fill in uneven places in the skin around the stoma. This helps the pouch stick better.

• Convex skin barriers. These help make a better seal when the skin around the stoma is uneven. Or when the stoma is level with or sinks below the skin. Some convex barriers come with a pouch attached. Others are inserts that can be added to any pouch.

• Pouch filters and deodorants. These help prevent odor.

• Ostomy belts. These help keep the pouch in place.

• Pouch covers. These help keep the skin under the pouch dry and comfortable.