A stoma bag or stoma pouch is a small, soft, waterproof bag that is placed over a stoma (an opening of intestine on the abdomen). Waste from the body is collected in the bag before it is emptied or disposed of.
Surgery to form a stoma is carried out to divert faeces or urine from the body when people would struggle to pass it in the usual way (through the anus or urethra). This is used to treat a range of diseases and conditions. Find out more: What is a stoma?
In our ultimate guide to stoma bags, we’ll answer the question ‘What is a stoma bag?’ in full detail, explore different types of stoma bags and help you decide which is the best stoma bag for you.
Click below to skip directly to a section of the guide:
- What is a stoma bag used for?
- How does a stoma bag work?
- Do stoma bags smell?
- Different types of stoma bags
- Are stoma bags free on the NHS?
- Stoma bag help
What is a stoma bag used for?
A stoma is formed when a section of the digestive system is diverted to the outside of the body. This surgery is used to treat cancer, inflammatory bowel disease, abdominal trauma, and more. Find out more: Why would you need a stoma bag?
Depending on the type of stoma, it will either expel faeces or urine.
People with stomas do not go to the toilet in the ‘normal’ way and they cannot control when their stoma is active. So, a stoma bag is worn all the time to collect their waste in a safe and hygienic way. It can then either be emptied into a toilet or replaced with a new bag. How often a stoma bag needs to be emptied is highly variable, depending on the type of bag you have and how active your stoma is.
How does a stoma bag work?
A stoma pouch is placed over a stoma with an adhesive baseplate (also known as a flange) stuck to the skin around it, so it is attached to the abdomen. The stoma is positioned inside the hole so that it directs into the pouch and any waste is collected. The fit should be snug; if it is not, there is a risk of leakage which can damage the skin.
All stomas are different, so baseplates are cut to size to suit yours. You can either do this for yourself at home or ask your delivery company to do it for you.
Most stoma bags have a waterproof inside lining with a soft fabric outside. You can buy stoma covers with a range of patterns if you want to make your stoma bag more unique than the basic range of colours normally available (beige, grey or white). You may wear a clear bag post-surgery so that the nurses can monitor your stoma more easily while you are in hospital.
You can also get additional products to ensure your stoma bag works as it should, such as flange extenders to increase the adhesive area or stoma seals to hold the stoma in place and protect the skin surrounding it. For example, the Ostoform FLOWASSIST seal directs output into the pouch, making it particularly helpful for irregular or high-output stomas.
Do stoma bags smell?
It’s a common misunderstanding that stoma bags smell, causing ostomates to feel self-conscious. The truth is that stoma bags do not smell. They are designed so that any odour is concealed within the bag. Most also have a filter which allows gas to escape the bag to avoid ballooning while neutralising any smells. If you are worried about odour, you can buy scented drops, sachets and sprays.
Different types of stoma bags
There are many different types of stoma bags, so the question ‘What is the best stoma bag?’ has no definitive answer. Which is best for you will depend on the type of stoma you have, the size and shape of your stoma, and your lifestyle. Your stoma care nurse will help you choose the best one for your needs. Below, we detail the main different types of stoma bags and their uses.
Stoma bags are manufactured by a range of brands which all have unique selling points. Some come in different colours, some have a special filtering system, some fold up so they are smaller, some have a removable flushable lining, some claim that they don’t make noise…
Ultimately, they all serve the same purpose, so it’s up to personal preference. You can order free samples and test different ones to find your favourite. You may also find it helpful to hear what other ostomates think.
What is a closed stoma bag?
A closed stoma bag is used by people with a colostomy (an opening to divert part of the large intestine). Closed bags are rounded and don’t have an opening to drain output, so are single-use.
This is because the output from a colostomy tends to resemble a traditional stool (poo), which is solid and formed. Colostomies are generally active 1-3 times a day, after which the whole bag will be removed and replaced.
What is a drainable stoma bag?
On the other hand, people with an ileostomy (an opening to divert a section of the small intestine) use a drainable bag. This is because the output, having travelled through less of the digestive system, is looser and more frequent. This means that a drainable bag is more suitable for them because it gets full more often, so they use an opening at the bottom to empty the bag (about 3-6 times a day) without having to dispose of the whole bag every time.
The closure on the bag depends on the manufacturer, and you can explore different options to find one that you find easiest to use. The opening may stick together with velcro or a more tactile material that you then have to roll up, or you may close it with a clip/clamp.
Some people with a colostomy may also wear a drainable bag, for example if they have high output or loose stools or at times when they have a stomach upset.
What is a urostomy bag?
A urostomy bag is specifically for those whose stoma outputs urine. It has a tap on the bottom which can be opened to drain urine into the toilet regularly. The closing mechanism can be a twist tap, a bung or both.
A urostomy is formed when a piece of small intestine is pulled through the abdomen and sewed down. Ureters are detached from the bladder and attached to the piece of the bowel to form a passageway for urine to pass through and exit the body via the stoma. This may be used in the treatment of bladder cancer, for example.
Two-piece vs one-piece stoma bag
All of these stoma bags are available as either one-piece or two-piece. While a one-piece has all the components of a stoma bag in one, a two-piece bag has a separate flange and bag which need to be connected. This means that the baseplate can remain attached to the skin while the bag is removed and replaced with an empty one.
The main benefit of a two-piece stoma bag is that it allows for quicker, more frequent bag changes because it reduces the number of times the flange is replaced. This can be a time-consuming process which can irritate skin, especially if medical adhesive remover and barrier films aren’t used.
However, two-piece stoma bags have more assembly steps, so they may not be suitable for people with limited dexterity. Plus, they have the added risk of the flange and bag disconnecting and causing leakage problems, an issue that one-piece users do not have to worry about. Two-piece systems also tend to be bulkier, which may not be suitable for people who prefer a more discreet stoma bag.
One-piece stoma bags tend to be more common in the UK.
What is a convex stoma bag?
A convex stoma bag is where the baseplate curves slightly outwards rather than laying flat. This is helpful for flat or retracted stomas because the curve applies gentle pressure which causes the stoma to stick out more into the bag. It is also useful for stomas under skin folds or creases because it can ‘iron out’ the skin and fill in dips. This improves the fit of the flange around the stoma and the security of the bag, reducing the chance of leakage.
You can get soft convex stoma pouches or deep convex pouches depending on your needs, with a firmer convex more suitable for very retracted stomas. Your stoma care nurse will advise you on whether a convex stoma pouch is right for you.
Much less common are concave flanges – the opposite of convex, curving outwards. They are designed to fit around stomas that are situated in a curved area of the body. This can be particularly helpful if you have a parastomal hernia.
What is a high-output stoma bag?
A high-output stoma bag is a larger-than-usual bag, designed for extra capacity, which can help to avoid leaks. This can be particularly helpful if you have a very active stoma or for periods where you don’t want to change your bag as often, such as overnight.
On the other hand, you can also get small stoma bags for times when you want it to be more discreet, such as during sexual activity.
Are stoma bags free on the NHS?
Stoma bags are free on the NHS for people who fit certain criteria. If you live in England, are under 60 years old and have a permanent stoma, you can apply for a prescription exemption certificate which you will need to renew every five years. This entitles you to free prescriptions which includes stoma bags and other essential stoma supplies.
If you have a temporary stoma and live in England, you will not be entitled to free prescriptions unless you have been diagnosed with cancer. It may be more cost-effective for you to get a prescription prepayment certificate, which is a yearly one-off payment to cover all of your prescription costs. Find out more here.
Prescriptions in Scotland, Wales and Northern Ireland are free.
Find out more information about obtaining stoma supplies on prescription from Colostomy UK
Stoma bag help
Whether you are due to have stoma surgery or have already had it, speak to your stoma care specialist about finding the best stoma bag for you. Having a stoma bag which you find comfortable and easy to use is vital, so don’t be afraid to try different ones or new combinations of products until you find what best suits you.
If you are confused or struggling with your stoma, there are lots of resources available to help, including:
- Colostomy UK
- Urostomy Association
- Ileostomy and Internal Pouch Association
- Bladder and Bowel Community
Further reading
Colostomy – NHS
Ileostomy – NHS
Urostomy – MacMillan Cancer Support
If you are a medical professional and are interested in finding out more about how StoCare products can help your patients or requesting a repeat sample order, please email info@rhodespharma.co.uk.
This information is for guidance and does not replace advice given by your healthcare professional.
