Pouches are odor-proof, made of clear or beige plastic, and are held to the skin by an adhesive (sticky) wafer. They are lightweight and cannot be seen under clothing. Some pouches come with a filter that deodorizes gas as it passes through the pouch. The two main types of pouches are: one piece system and two-piece system.

One-Piece System is designed to be disposable (this does not mean that they can be flushed down the toilet - most toilets react very badly to having plastic bags flushed down them!). A one-piece system is just that - one-piece. It means that the wafer (the part that attaches the bag to your skin) and the bag itself, are all in one and cannot be pulled apart.

Two-piece Systems means that the wafer and the bag are separate and are joined together by what is commonly referred to as a "tupperware-type ring" on the wafer. The wafer is designed to stay put for a while and the only thing that you will need to change on most occasions is the bag itself - just attach the new bag to the wafer. Two piece bags can either be used as disposable or reusable. If the bags are reusable, the ostomate usually has about two or three bags which can be rotated in wear time. The used bag is cleaned, dried and aired then reattached later on when needed. This has the advantage in that if you pay for your ostomy appliances, it is a huge saving not having to buy new bags for every change, although eventually the bags do wear out and you will have to splurge occasionally.

There is no correct answer to this. Several types of pouches may be tried to find the best one for you. The patient has to decide by trial and error method to know which suits him the best, and which is very simple according to him. Simpler the device, more comfortable for user.

There is no straight answer to this question. But it is better to change the pouch after night sleep i.e. early morning before consuming coffee/tea. For urostomy there is no such ideal time.
• It may be helpful to change your pouch with new one in front of a mirror.
• You can change your pouch while sitting or standing.

In case of single piece system You should be able to wear the same pouch 3-7 days, as long as you have a good seal. If no irritation or leakage is there then it can be continued for another few days For 2-pc system normally wafer/flange can be changed every 5 – 15 days or if any leakage or irritation is there
• Anytime your pouch or wafer leaks – CHANGE IT. Patching or taping a leaking pouch traps stool and causes your skin to get irritated.
• Burning or stinging under your pouch may be a sign of skin irritation and the pouch needs to be changed.

This problem is mostly for male patients.Such patients need to wet the periosteal area with warm water or soap solution and remove the pouch very gently from top along the direction of hair growth. Remove your pouch using both hands and the push-pull technique that is; push your skin off the adhesive. Be gentle in removing adhesive. If paste is used after removing the pouch/ flange remove the residual layer by gently applying soap solution.

Use warm water/ mild soap/ Providence iodine solution with wet gauze to clean. After cleaning, dry it completely and ensure no solution is left over as this will affect the sticking of pouch to be used after this. Observe peristomal skin for any redness or irritation and call your ET Nurse if you are unsure of how to manage it.

• The pouch needs to be emptied when one third to one half full of gas or stool. A pouch full of stool or air could loosen the seal and cause a leak.
• Sit down on the toilet and empty the pouch between your legs. If you turn a cuff on the bottom of the pouch, you can empty it without any mess. Always clean the bottom of the pouch with toilet tissue or hand wipe. This will prevent odor.
• Make sure your clamp for pouch is clean.
• Sometimes, not every time, you may want to rinse out the pouch with cool or room temperature water after you empty it: Any squirt bottle can be used. Do not allow water to wash over the stoma. This may loosen the skin seal causing sore skin and leakage.
• If you stand to empty the pouch, put toilet tissue in the toilet bowl first to prevent splashing.

In some cases where the peristomal area is not uniform and has crests and troughs then paste may be necessary. Also in some ileostomy patients or patients with weeping skin the usage of paste may be needed. This is decided by the concerned surgeon and the Stoma Therapist.

For reduction of odour consume odour producing food stuffs in little quantity and put a piece of charcoal inside the pouch. Foods that can produce odour include asparagus; cabbage family vegetables: broccoli, Brussels sprouts, cabbage, cauliflower, onions; cheese; eggs; fish and some spices.

• Store your ostomy supplies in a cool, dry place.
• Do not leave your ostomy supplies in the car during the warm months.