The first day of your ostomy life is akin to the first day of your new job! A lot of things running to and fro in your head – how are the colleagues, whom to interact more with, what is the main task, what’s the project all about, how to get deeper into the business, and pick up the unknown facts and so on...

Beginning life with an ostomy pouch is somewhat similar. Your health advisor provides you with a lot of information – you need to remember them, apply them and most of all adapt to them! All your nurse talks about is your daily ‘to-dos’ and the proper use of the accessories that you require. An ostomy pouch is one of them.

Ostomy Pouch

Pouching systems are prosthetic devices that are needed post an ostomy. So, what’s an ostomy? Ostomy is a surgical procedure – a life-saving one in which the body effluent is made to pass through an artificially created opening in the abdomen called the ‘stoma’. Now, where does this waste drain into? Here comes the need for a prosthetic – a pouch that collects the body’s waste material.

Why would a patient need an ostomy at all?

Ostomy is indeed a life-saving procedure. The normal pathway for the passage of urine and stool needs to be diverted because of anomalies or improper functioning of the excretory system. The conditions that give rise to the need for ostomies are many – birth defects, cancer, acute incontinence, inflammatory bowel disease, accidental trauma, etc.

All about pouching systems

Ostomy pouching systems are broadly categorized into two – the one-piece pouching system and the two-piece system. A look into their basic differences and why would you choose one of them are the two topics that this article will walk you through...

The one-piece system is one in which the pouch and the portion that attaches the bag to your stoma (the base plate) are a single entity. The adhesive base plate is known by various names – don’t get confused – ‘skin-barrier’, ‘wafer’, ‘flange’ or ‘base plate’ – they are all the same! In short, the bag and the wafer are incorporated into a single system when we are discussing the one-piece system.

1-piece vs 2-piece ostomy bag

What are the advantages of the one-piece system?

A few reasons for which one-piece systems are chosen over the two-piece ones have been assorted below:

• It requires less expertise of the candidate as it’s more user-friendly
• Pouches can be changed quickly
• Being a single unit there’s a zero chance of the bag and the flange coming apart
• Lies flatter beneath your attire helping your ostomy to bear a lower profile (inside your clothes)

One-piece ostomy pouch

Lying flat below the clothes is the primary benefit and the most useful one. A lower profile and lesser visibility beneath one's dress keeps one from remaining cautious round the clock! Finally, being the simpler ones, they are less expensive than their two-piece counterparts!

Why do then ostomates often go for the two-piece system?

To emphasize the cons of the one-piece system, it goes without saying that changing these bags, again and again, harms your tender skin. This is because the adhesive barrier that clings to your skin needs to be pulled off. Moreover, each time, one has to go through the entire process of adhesive removers, pastes, tapes, etc.

To avert all of these, ostomates choose the two-piece system. This system (as its name itself suggests) keeps the ostomy bag and the wafer separate. Therefore, the pouch can be changed without having to remove the wafer or skin barrier. This is a huge factor that counts for ostomy candidates, who need to live with it for the rest of their lives!

Despite its pros, the two-piece is not many ostomates’ choice, the primary cause being – ‘costlier’! Two-piece pouches are more expensive than their one-piece counterparts. Besides, they are bulkier too! This makes them a little more visible under the clothing. Most ostomates don’t want this and hence choose the other variant!

[Read more: What is ostomy]

Definite factors in determining ostomy pouching

There are a few obvious factors that come in while considering which pouching system to go for. These are –

• The shape of your abdomen
• The type of stoma that you have (its shape and size will decrease gradually post-surgery)
• Your lifestyle

How often should an ostomy bag be emptied?

You might have to empty the pouch at least 6 to 8 times a day! That's because you cannot let the pouch be more than half full. Ideally, you should empty it once it's 1/3 full. That keeps a check on the weight of your ostomy bag and does not exert unnecessary pressure on the wafer!

So the pouching system that one wears in the hospital may not be the one with which he or she would want to continue back home! A lot of factors come into play. With the passage of time and change in the level of activity, pouching needs change. So, a comparative study between the types would at best help you to decide which works best for you!