There are two types of ostomy pouches – open and closed. Open-ended pockets have a valve at the bottom for emptying, which is not seen by anyone else. Closed-end bags cover the entire stoma opening with no hole for drainage or gas release.
Closed-end ostomy pouches are typically used when patients need to protect their skin from leakage due to heavy output, ulceration, or trauma; they’re also used in situations where there’s an increased risk of leakage (e.g., during travel).
Some people might opt for a closed-end pouch to ensure that they’re protected from odor, and this can be effective if their output is malodorous and there’s no drainage control device (DDD) in place. The vast majority of ostomates use an open-ended pouch, as it gives them more flexibility and control.
Almost all ostomy pouches come with a filter for odor control, and most people use one at night and remove it during the day (to avoid discomfort and interference with clothes). The type of pouch that you choose is likely to depend on your clinical needs; however, we recommend that you at least trial an open-ended pocket before you commit to using a closed-end pouch for the rest of your life.
Choosing pouches can be confusing, especially because manufacturers talk in their jargon, and there’s not much evidence to guide us. There are no formal guidelines from ostomy associations or organizations on how long patients should use a particular type of pouch or when they should switch.
Your doctor might be able to recommend a type of pouch that they’ve seen work well for other patients with similar clinical profiles. If not, you can ask them to refer you to an experienced stoma care nurse in your area who can help in your decision-making. If this isn’t possible, it’s worth consulting the ostomy nurses at your local hospital or clinic; most provinces/territories have referral services.
If you’re unable to find the information you need after searching online, try asking around online communities for advice from people who are using the products you’re considering.
Closed-end pouches
There are a few closed-end pouches that we recommend due to their ease of use and effectiveness. These include:
Colostomy bags can be difficult to position as they stick out from the abdomen; however, some people find them more secure than other types of closed-end pouches. If you suffer from heavy leakage and your stoma is located low down in your abdomen (as with most colostomies), these pouches would probably work better than upper stomas, which tend to fit higher up on the stomach.
You might also want to consider using a larger pouch so that it fits over the entire stoma opening (similar to a colostomy bag). This works particularly well if you have leakage from the upper part of the stoma and the bottom, or your stoma is on its way out after surgery.
Some ostomates swear by using two pouches at once – one closed-end pouch for containment and another open-ended pouch with a DDD so that they can empty their bag without contaminating their surroundings.
If you’re traveling, it might be best not to use a closed-end pouch unless there’s no other option available. Try testing a few types of bags beforehand to know how secure your appliances are during transit. Dispose of any used pouches carefully before flying home!
Ostomy Specialist 