If your ulcerative colitis (UC) hasn’t responded well enough to treatment, your doctor may suggest surgery and an ostomy pouch. This might sound intimidating. But for people with certain birth defects, cancer, and bowel issues like UC, an ostomy bag can be life-changing.
An ostomy bag is a pouch on the outside of your body to hold waste (poop and pee). It’s often the last resort when other treatments haven’t brought relief from the pain and discomfort of UC.
Nearly 1 in 500 Americans lives with an ostomy bag. About 30% of people with UC will need one at some point, either temporarily or permanently.
What Is a Stoma?
A stoma is an opening created surgically on your body to divert the flow of waste. Stomas date back to the early 1700s. Napoleon Bonaparte was rumored to have one made of a goat’s bladder (which could be why portraits show him with his hand on his side). Former President Dwight Eisenhower and dancer Fred Astaire lived with stomas.
A few things to know about stomas:
- They’re made from the lining of your intestine or colon.
- They’re a reddish color like the inside of your mouth.
- The area around them can become dry or irritated and will need extra care.
- Your stoma is delicate, but it’s not painful.
- A stoma can stick out a bit or lie flat against your skin.
There are three main types of surgeries to make a stoma. An ileostomy (pronounced il-ee-os-tuh-mee) is the most common for people with UC. For an ileostomy, a surgeon makes an opening into your small intestine through your abdomen. In a colostomy, most often done in people with colon cancer, the doctor creates the opening into your colon. Often, this surgery is later reversed. A urostomy helps those with bladder issues.
What Are the Types of Ostomy Bags?
While your doctor will determine the best type of surgery for your UC, you can select an ostomy bag that fits your needs. Ostomy bags come in many different kinds.
Take some time to talk to your doctor and do your homework to select a pouch that fits your stoma size, activity level, skin condition, and budget.
Here are some pros and cons of the various types of bags:
Type of Ostomy Bag | Advantages | Disadvantages |
| *One-piece | Easy to use and secure Flexible Less bulky Good for uneven skin | You’ll need to change the whole unit including the skin barrier or wafer (the part that fits against your skin) |
| *Two-piece | Skin-friendly You can change the pouch without changing the skin barrier | May leak Opening can be hard to clean Rigid and bulky
|
| *Both one- and two-piece can be either drainable or closed | ||
| Open | Longer wear time Less changing needed Best for heavy liquids
| Hard to drain thicker liquids Harder to clean Attaching the bag can be uncomfortable |
| Closed | Disposable bags Suits an active lifestyle Good for swimming, exercise, intimacy | Bags need frequent changing Can't reuse bags Cost |
| Pre-cut | Easy to apply Best for round stomas | Fit can be challenging Not great for odd-sized stomas |
| Moldable | No scissors or cutting needed Fits different stoma sizes | Can be difficult to mold if you have limited movement in your hands |
| Cut-to-fit | Fit easily over different sized stomas – those that aren’t round or are still healing post-surgery | Difficult to cut if you have limited hand movement |
| Transparent | Helpful for caregivers and medical staff to check your stoma or contents of the pouch
| Stoma and pouch contents are visible, less discreet |
| Opaque | Discreet, some skin color options are available | Difficult to check stoma and contents |
Other types of ostomy bags include:
- Multi-chambered pouches that offer less sloshing and noise for those with active lifestyles
- Mini ostomy pouches, which are very discreet because they’re smaller, but hold less content.
- Pouches with filters (often made of charcoal) to neutralize gas odors. They also make it easier to bathe, swim, or exercise without the risk of leaks.
All these specialty pouches tend to be pricier.
Ostomy Belts and Other Supplies
You can opt for several accessories along with your ostomy bag.
Ostomy belt. This works to support the weight of your pouch. It helps hide your pouch and protects it from being knocked out of place if you bump into something. By keeping the pouch in place, it also guards against leaks. Some can come loose or pinch your skin, though.
Pouch covers. These provide soft protection for your skin. They can also hide your pouch for intimacy. Many pouches now come with a cover.
Tapes. Tape holds the opening of your bag in place and helps keep it waterproof. Adhesive remover can help when it’s time to change your unit.
Stoma cap. If you pass stool at regular times, you may be able to wear just a stoma cap, or cover, instead of a pouch. Talk to your doctor to see if this might work for you.
Ostomy pouches and supplies can cost $300-$500 a month, according to the United Ostomy Associations of America. Most insurance plans cover them to some extent, but coverage is variable.
