Deciding on an ostomy pouching system

Just as each person is unique and different, so is the fit of his or her ostomy pouching system.

An ostomy pouch is a heavy-duty plastic bag with an opening in it. This round opening goes over the stoma, which is a small part of a person’s large intestine (colostomy), small intestine (ileostomy) or urinary system (urostomy) that’s surgically placed outside of the body. Output such as urine or stool, depending on the type of ostomy, leaves the body through the stoma and is collected in the ostomy pouch. The person can then empty or change the ostomy pouch, as needed.

The kind of ostomy pouch that works best for you will depend on the type of ostomy surgery that you had along with your personal preferences and day-to-day activities. Some people find that it’s helpful to have different ostomy pouches on hand to meet their changing needs.


One-piece pouch

What it is: The ostomy pouch and skin barrier are all one piece. To apply the pouch, you peel the paper from the skin barrier and place the opening over the stoma. (You may need to cut the barrier portion to fit the size and shape of the stoma.)


  • Flexible for those with a bulge or hernia near the stoma
  • Easy to apply and remove (requires no assembly)
  • Supple, allows ease of movement
  • Integrated pouch and wafer with one connection point
  • Lower profile and lightweight


Two-piece pouch

What it is: The ostomy pouch and skin barrier are two separate pieces that attach together.


  • You can remove the ostomy pouch without removing the skin barrier
  • Easily change types of ostomy pouches without changing skin barrier
  • Potentially fewer skin barrier changes so it’s gentler on the skin
  • Some people find the two-piece systems easier to work and use


Drainable pouch

What it is: Available in both one- and two-piece ostomy systems; you empty the pouch and can potentially reuse it. Drainable pouches are used primarily by people with ileostomies, although they can be used by people with colostomies if the stool is semi-formed. Typically, people with colostomies use Closed-End Pouches.


  • Better for liquid or semi-solid output
  • Fewer changes than with a closed-end pouch
  • Easy to empty


Closed-end pouches

What it is: Available in both one- and two-piece ostomy systems; the pouches are not reusable. Once the pouch is full, it can be thrown away.


  • Replace new pouches and throw away old ones
  • Best for formed output
  • Some manufacturers make flushable pouch liners


Ostomy accessories

What they are: Several products are available to meet your individual pouching system needs. Talk to your WOC (Wound, Ostomy and Continence) nurse to determine which products might be right for you.




Related articles:
10 Ostomy diet tips
Attaching an ostomy pouch