Ask the Ostomy Nurse

Linda Coulter has been a Certified Wound Ostomy & Continence Nurse for 10 years. In addition to working with hundreds of people with stomas, she has trained several WOC nursing students at the R.B. Turnbull Jr. School of WOC Nursing. Linda has presented nationally and internationally on ostomy related topics. From her home base at University Hospitals’ Ahuja Medical Center, Linda is active in raising Ostomy Awareness, and works to distribute ostomy supplies to people in need throughout the world.

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Pouch Rotation

My ostomy bag can rub me the wrong way. Namely, it hangs too low and gets in the way when I try to use the bathroom. I have heard that you can rotate a pouch to reposition it. Is this OK? Will it make the pouch leak? T.P.

Dear T.P.,

Thank you for this interesting question. Depending on the type of pouch you use, you may be able to rotate the pouch. For example, if you wear a two-piece pouch, where there is a wafer or baseplate that sticks to your skin and the pouch attaches to the wafer, you should be able to adjust how the pouch hangs by removing it from the wafer and attaching it at a different angle. You can do this temporarily, just when using the bathroom or you may choose to wear your pouch in this position all the time. This shouldn’t cause your pouch to leak.

The one issue you may have is if you need to wear a stoma belt to support the pouch. If the belt attaches to the baseplate, rotating the pouch won’t be a problem. However, with some brands the belt attaches to the pouch, and since it needs to be fairly level, you will only be able to rotate the pouch a small amount and still be able to use the belt. If you don’t wear the belt, the pouch will be less secure.

If you wear a one-piece pouch, where the baseplate and pouch cannot be separated from each other, the only way to reposition the pouch is when you first apply it. You can definitely place this pouch at an angle rather than straight up and down on your abdomen. Remember that it will stay in this position until the next time you change the pouch.

This change in position shouldn’t cause the pouch to leak. As with the two-piece pouch, for belts to fit properly, the pouch needs to be straight up and down. If you find you need to wear a belt to have a secure seal, then rotating the pouch will not be a possibility.

If you don’t feel that rotating the pouch is an option for you, you can try using a shorter pouch, which is less likely to get in your way. The drawback is that the shorter, mini pouches need to be emptied more frequently. Finally, I’ve had some patients who have solved this issue by folding the pouch and either taping or clipping it so it is shorter. It’s not perfect, but it works for them.

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