Choosing Between One-Piece and Two-Piece Ostomy Systems

I am a colostomate for 2 years. I have used a closed bottom 2-piece system from the beginning. I prefer to take the bag off, empty it, and rinse it out, then snap it back on. 6 months ago, I started using bag liners—it's even easier. When I am traveling or working (construction), I can change the bag liner, throw away the old one, and put in a new one. Much less handling.

Here is the problem. I had a peristomal hernia repair in January. Now my stoma is retracted, and no wafer is working. Flat bottom convex wafers don't reach the bottom of my "cone" stoma, and I am ALWAYS pancaked. Marlen seems to make a bowl-shaped flange on their one-piece system, but not a bowl shape in 2-piece. I feel closed-minded now to use a one-piece pouch, but perhaps I should reconsider. Please comment. Thank you.

G-Day BH,

With a two-piece drainable, all you have to do is open the end and dump the contents. Why the hell would you go through all that you do, taking off the bag and washing it out, then snapping it back on? While you have the bag off, does it keep pumping shit out while you're frantically trying to clean the bloody thing and get it back on before Old Faithful craps all over the place? No, thank you.

Regards, IGGIE

I have a colostomy, so I get the preference for closed-end bags. I don't empty mine, but emptying a closed-end bag seems easier than squeezing out thick waste from a drainable bag.

That said, you'll never know if you don't try. See how it goes for you. It has some advantages, so it might not be as bad as you think.

Circle back and let me know how the bowl-shaped wafer works for you. I have my own problem child stoma (urostomy, so switching to a 1-piece bag there would be easy).

Get the stoma fixed if it's truly retracted, and then pick whichever type of bag you want.

Squeezing out thick waste? Pour a little warm water in, swish it around, and it flows out without a squeeze. It seems easier than emptying a bag that wasn't intended to be emptied, less trash by throwing away so many bags, and a person doesn't have to walk around all day with crap in their bag waiting for it to fill up to a level to make it worth emptying or throwing away. 🤷‍♂️

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Mine generally fills all at once. So from my perspective, it's cleaner to just replace the bag. Also, in my case, my manual dexterity is limited by peripheral neuropathy, so it is much easier for me to replace bags than to empty them. I'd find it very difficult to add water to the bag and not end up wearing some of the contents. So it's really a matter of personal preference, and everyone is different.  

I don't question someone else's preferences.  

Me either. I was just stating some things that a person might not have thought about.

I like the 1-piece drainable pouch. It's called an Active Life pouch by Convatec. Works really well for my needs.

I have always had a retracted stoma, and I find that drinking more water helps me not pancake so much. I use a convex one-piece in order to get the opening of the bag as close as possible to my stoma. I have also added pieces of Brava sheets to my skin right around the opening to try to protect my skin. I would recommend calling various manufacturers and talking to their ostomy nurses for recommendations, as they will send you samples. I'm currently using Convatec Esteem Body one-piece drainable, but it comes in many different shapes and flexibilities, so you would need to talk to them about your situation. You may need to speak to your surgeon about a revision, as that is what I am considering.

I feel super lucky reading some of the comments on here about rinsing closed bags out.

I have a two-piece closed system and just take the bag off and throw it away. I even have a bin provided by the council for the waste.

I live in the UK where all my prescriptions are free; well, I have paid over 35 years in tax.

To be clear, I do not rinse out my closed-end bags. I take them off and toss them. The OP is rinsing them out, but I don't know why.

I have to empty my pouch 5-8 times per day. Who could afford that?

I'd go with a drainable pouch if it were that much. I'm averaging 2x per day, and my insurance covers that much.

But there's a lady on YouTube who empties closed-end pouches and reuses them, and she has an ileostomy. That's bound to be a lot of emptying. She says it's because of her very small stature; the closed-end bags being smaller fit her better.

Everyone is different. If it's worth the trouble to you, do it.

But I have encountered several British people who think we are required to rinse out bags, and I didn't want to leave a false impression. Britain and Europe, in general, have a bad enough opinion of the US without adding to it.

Save money. I remember someone on here was washing them out and then hanging them up like laundry to let them dry so they could reuse them.

In my humble opinion, life is too short to clean poop bags and reuse them. But to each his own.