Ostomy Supplies: How to Choose

Finding the right ostomy supplies may seem overwhelming and confusing. There are a lot of choices and, quite honestly, at first glance, they all look pretty much the same.

Knowing what supplies to choose can be even harder when you’re new to having a colostomy, ileostomy, or urostomy. 

Not to worry — we’re here to help. We’ll cover the range of ostomy supplies, explain what they do, and help you understand how to pick the right products for you.

What supplies do I need?

Ostomy supplies can be broken down into two categories, must-haves, and accessories.

Necessary supplies

  • Ostomy barriers
    Also known as ostomy wafers or base plates, an ostomy barrier adheres to your skin. It surrounds the stoma and protects both the skin and the stoma.
  • Ostomy bag
    Also known as ostomy pouches, the ostomy bag attaches to the barrier and collects output.

Ostomy Accessories

  • Adhesive removers
    Available as sprays or wipes, adhesive removers help release the adhesive on the ostomy barrier from the skin, which helps protect the skin from tears.
  • Skin protectants
    Also available as a spray or wipe, skin protectants create a thin layer that helps protect skin from any output and can help the ostomy barrier adhere better.
  • Ostomy rings and strips
    Ostomy rings and strips, sometimes called barrier or stoma rings, surround the stoma and sit under the barrier. They fill in creases and gaps, creating a smoother surface for the barrier to adhere to.
  • Ostomy paste
    Ostomy pastes do the same job as ostomy rings but have the flexibility to act as a spot filler.
  • Barrier strips
    Barrier strips surround the edges of the ostomy barrier. They’re useful for keeping the edges of the barrier from rolling up and can help extend the life of the barrier.
  • Deodorants and odor eliminators
    Deodorants are available in as drops you can add directly to your pouch. Some deodorants also contain lubrication that helps output drain from the pouch more easily.

You can get ostomy care supplies from a medical health supply company like Better Health. Ostomy supplies, including pouches, barriers, and accessories are covered either fully or partially under your insurance. For example, if you have Medicare, it covers ostomy care supplies at 80 percent, leaving you to pay the remaining amount out-of-pocket or with secondary insurance. Read more about Medicare coverage for ostomy supplies.

All about ostomy pouching systems

First, a point of clarification. When you’re looking for products, you might see the terms “ostomy system” and “pouching system”. Both these terms refer to the same thing — the barrier and bag combination that collects output from your stoma.

The same goes for ostomy barriers, which are also called wafers, and ostomy bags, which are also called ostomy pouches. Terminology often varies by product manufacturer, hospital, and caregiver, so don’t worry if you hear different terms being used for the same item. 

You may also hear the names Coloplast, Convatec, Hollister, and Securi-T. These are some of the major companies that manufacture ostomy supplies. It’s helpful to know which company makes your supplies because it simplifies the reordering process.

One-piece and two-piece systems

Often, the first choice you’ll make about your ostomy system is whether to use a one-piece system or a two-piece system. What you use depends on your needs, personal preferences, and lifestyle.

A one-piece system means the barrier and bag are combined into one unit. Changing a one-piece system means you’ll replace both the barrier and bag at the same time.

You might make the choice between a one-piece and two-piece while you’re still in the hospital after ostomy surgery. However, you’re not locked into your choice forever; you have the right to change your mind if you discover you need something different. You can even choose to use a mix of one-piece and two-piece systems. It may take some trial and error to discover which system works best for you.

Which system is right for you?

One-piece systems

Benefits Disadvantages
Good for people who have limited dexterity and may have difficulty connecting barrier to bagLower body profile (it doesn’t stick out as much from the abdomen) than many two-piece systemsFewer supplies to manageCan be difficult to get the right fit around the stoma because the bag limits visibility around the stomaCannot swap out bag without changing the whole system

A two-piece system means the barrier and bag are separate and must be connected together. Two-piece systems are connected together via a coupling mechanism, such as a snap-together ring or adhesive.

Benefits Disadvantages
Can change the bag independently of the barrierFlexibility to switch to a bag that matches your activity, such as swimming or sleepingEasier to see how the stoma opening fits around the stoma to ensure it fits closely and there is minimal peristomal skin exposed to output.Mechanical couplings can be difficult to snap togetherNeed to order barrier and bag separately

Ostomy barriers

All ostomy barriers look similar to each other.  The important thing to know about ostomy barriers is the differences are in what the barriers do, not how they look

All barriers are designed to protect the stoma, the skin around the stoma (aka peristomal skin), and provide a way for the bag to connect to the body.

Barriers are available with a lot of different options, similar to the way cars can be modified with specific features.

“The important thing to know about ostomy barriers is the differences are in what the barriers do, not how they look.”

Pre-cut or cut-to-fit

When choosing a barrier, you’ll need to decide whether you want a pre-cut or a cut-to-fit barrier. A pre-cut barrier has the stoma opening cut to a predetermined size. Before ordering pre-cut barriers, you’ll need to measure your stoma first by using a specially designed card.

A cut-to-fit barrier allows you to cut a hole that fits around your stoma. The barrier has measuring guidelines printed around the stoma opening that help you cut the right size.

Should you choose a cut-to-fit or pre-cut barrier?

A cut-to-fit barrier is a good choice if:A pre-cut barrier is a great option if:
your stoma is still changing size after surgeryyour stoma has bumps or bulgesyou’re not sure what pre-cut size to order. your stoma stays a consistent sizeyou want extra convenience changing your barrieryou have limited dexterity and using scissors is difficult.

The majority of barriers are available as cut-to-fit and pre-cut. There is a third option, however, called a moldable barrier. Moldable barriers feature an opening that can be shaped, like clay or PlayDough, to create a custom fit around the stoma. This type of barrier is good for stomas with bumps and bulges or that sit in a crease.

Flat and convex barriers

You might also hear barriers described as flat or convex. These terms refer to how the barrier sits against the skin and supports the stoma.

Everyone has a unique body shape and that, along with surgery outcomes, affects the shape and placement of the stoma. The result is your stoma may be placed near or on a skin crease or bulge. The stoma itself could protrude or retract from the skin surface. This is normal. If you want to do a search for ostomy stomas, you will see that stomas come in all shapes and sizes.

If your stoma retracts below the skin surface, is flush with your skin surface, or sits in a crease, you may need a convex skin barrier. A convex skin barrier has a special cupped shape that helps lift stoma away from the skin surface.

There are several reasons why it’s important to ensure the stoma sits away from the skin:

  • It limits output from coming in contact with skin or pooling around the stoma. Output can cause skin breakdown and damage and create painful, red rashes
  • It helps output move away from the stoma and into the bag
  • It creates a supportive space around the stoma.

Convex barriers are available in both shallow (aka “light” convex) and deep convex. What you choose should depend on how much help you need lifting your stoma out.

If your stoma sits on top of your skin without retraction, you can choose a flat barrier.

Normal wear and extended wear

You might see these terms and think they mean how long a barrier is meant to stay on. However, “normal wear” and “extended wear” mean how well the materials in the barrier hold up against output. Since the tutput is acidic, the frequency and amount of output that passes through the barrier will determine how often the barrier needs to be replaced. High output stomas, such as urostomies and ileostomies, might need an extended wear barrier. 

Determining whether you need a normal-wear or extended-wear barrier could take experimentation. You might determine a preference right away or you might not notice a difference between the two types of barriers. What matters is how comfortable and confident you are with your barrier, so choose one that makes you happy.

Ostomy bags

Ostomy bags collect waste that passes through the stoma. Like barriers, ostomy bags are available with many different options.

Drainable bags or closed-end bags

The first choice you’re likely to make when choosing a bag is whether you want an open or closed bag. An open bag means the tail, or bottom, of the bag can be opened to drain the contents of the bag. To close the bag, the tail is rolled over several times and secured with a clamp or a hook-and-loop closure, similar to Velcro.

A closed ostomy pouch does not have an opening to drain its contents. The bag can be removed by disconnecting it from the barrier, as with a 2-piece ostomy system, or by removing the whole system, as with a 1-piece ostomy system.

If you have a high amount of output and need to empty it frequently, a closed bag may not be practical for you. Urostomy pouches always have an opening because they need frequent drainage.

You also have a choice in how your bag looks. Bags come with transparent, semi-transparent, and opaque covers that have a viewing window.

Transparent bags are useful in cases where it is necessary to see how much or what type of output is being produced because that can signal potential health issues. Alternatively, some people prefer opaque bags because they hide output and look more discrete.

Stoma Caps

Stoma caps are an alternative for ostomy pouches in certain situations. A stoma cap is like a lid that attaches to the barrier. It is not meant to collect the output. Instead, it replaces the bag for activities like swimming, bathing, and intimacy.

Stoma caps work great for people with colostomies or who have formed output. Unfortunately, stoma caps are not meant for people who have high-volume liquid output such as with ileostomies and urostomies.

Bag Sizes

Bags come in limited sizes. Many, but not all, bags have a larger and a smaller option. And most bags are around 10-  to 12-inches long. People who are shorter or have smaller bodies can find this challenging. In this case, a Better Health product specialist can make a recommendation about smaller bags.

Additional ostomy supplies

Every ostomy is unique and you might discover problems caring for your ostomy that changing your barrier or bag won’t fix. Here’s a rundown of supplies that can help with those issues.

Skin Prep

Keeping the skin around your stoma healthy is paramount. Treat your skin gently. Peristomal skin is delicate and needs protection from output and adhesives. Read more about the importance of skincare and how to take care of it.

  • Barrier sprays

Barrier sprays or wipes create a thin, protective layer on your skin. You apply them during a barrier change after removing the old barrier and cleaning the skin. The protective layer guards against acidity from the output and makes it easier to remove the barrier at the end of its life.

  • Adhesive removers

Regular or frequent barrier changes can also be stressful on your skin. Adhesive removers, available as wipes and sprays, loosen skin adhesives and let you easily lift the barrier away from the skin. Adhesive removers are also great for removing the tacky areas that can build up around the edges of the barrier.

Be sure to wipe clean the areas where you applied remover. Cleaning off any leftover remover keeps it from affecting the adhesiveness of the new barrier.

  • Moisture control

Keeping your skin moist, but not too wet, is another important step in caring for your ostomy. Barriers adhere to skin and not to the stoma. Skin that is healthy and intact will create a better seal to the barrier which could lead to longer wear times between changes.

If you’ve noticed your skin looking red and weepy around your stoma, you can try stoma powder. Similar to how baby powder works to keep infants dry between diaper changes, stoma powder help absorb excess moisture.

Leakage control

If you have an ostomy, the sad fact is that you’ll probably experience a leak from either the barrier or the bag. It can be upsetting when that happens but you can take steps to reduce the chances of a leak.

  • Barrier rings, sheets, strips

The better the seal between your skin and the barrier, the less it’s likely to fail. Barrier rings, sheets, and strips (image) are made from moldable materials. They are placed between your skin and the barrier and surround the stoma. They create a smoother, more even surface by filling in creases or folds in the skin, which ensure

  • Barrier paste

Barrier paste performs the same role as barrier rings and sheets. The benefit is that it can be spot applied.

  • Barrier extender strips

In contrast to barrier rings and paste, extender strips are placed around the edges of the barrier. They function in a similar way to medical tape, by securing barrier edges to the skin and keeping them from rolling up. Extender strips are very flexible and can help extend barrier life by keeping it secure as your body stretches or twists.

Deodorants and Lubricants

Modern bags do an excellent job managing any odors from the output. However, deodorant drops add an extra layer of protection and do double duty with lubrication that allows output to slide out more easily.

Wearables

  • Ostomy Belts and Wraps

Ostomy belts and wraps are a means to make wearing your ostomy system more comfortable and discrete.  An ostomy belt clips into hooks on an ostomy barrier. The belt secures the barrier against the body, keeping it stable against your abdomen. 

If you’re interested in using an ostomy belt, remember to ensure that belt and barrier will work together. Belts are not usually interchangeable between product manufacturers and some product lines.

An ostomy wrap is a larger piece of fabric with a pocket for your pouch that goes around your middle. The pocket keeps the ostomy bag from shifting around and uses pressure to distribute the contents of the bag more evenly.

  • Ostomy Underwear

Ostomy underwear is similar to an ostomy wrap: they are sewn with a pocket to support the ostomy bag. Ostomy underwear is a good option if you prefer to avoid wearing too many layers (wraps, underwear, clothing) or find ostomy wraps uncomfortable.

Need help deciding?

Better Health can help! If you need more information about choosing an ostomy system or supplies, call us today at 415-475-8444.

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