The Best Ostomy Pouching System

The Best Ostomy Pouching System

One of the most common questions I get asked in the clinic is: “What is the best ostomy pouch?” Most people are not satisfied with my answer: “The one that works for you.”

Most of us have a desire to have “the best” whether it is designer handbags or high end sporting equipment or ostomy pouches. In the world of ostomy pouching systems I wouldn’t say any one company’s product is better than any other company’s product – they are just different. Each company’s products have different characteristics such as pouch fabric and colour, barrier characteristics and shape, tape border, no tape border, pouch closure etc. etc.

The best way to determine the best pouching system for you is to work with a Nurse Specialized in Wound, Ostomy and Continence (NSWOC). Nightingale Medical offers free in-person or phone consultations with an experienced NSWOC at all of our store locations. The NSWOC will work with you to determine the best pouching system for you, your skin, your stoma and your lifestyle.

The NSWOC will ask you lots of questions – some mayseem irrelevant. They will also do an assessment of your stoma and skin before even looking at pouches. The NSWOC will use all of this information to determine what type of pouching system will likely work best for you.

Ostomy pouching systems include 3 components: 1) flange/barrier, 2) pouch and 3) accessories. Let me explain some of the different options and when they might be used.


The part of the ostomy pouching system that sticks to your skin is called a flange or barrier. Flanges/barriers vary from company to company and are made of a variety of products. Some have added ingredients which are intended to support skin health. Some flanges/barriers work better with liquid output than others. Some work better with damaged skin than others.

Flat vs Convexity: If your stoma sticks out, a flat flange/barrier will probably work for you. If your stoma is flat you will likely need convexity. The back of a convex flange/barrier protrudes. When applied to the abdomen that protrusion makes the stoma stick out more. This forces the stool/urine to empty into the pouch rather than underneath the flange/barrier. Not all convex products are the same. There are variations in the depth of convexity and flexibility of the flange/barrier.

Cut-to-fit vs Pre-sized: Many flanges/barriers are available pre-sized. If your stoma is round it is likely a pre-sized option will fit your stoma. A cut-to-fit flange/barrier is usually best if your stoma is oval or irregularly shaped.


The pouch is where the urine or stool is collected. Urostomy pouches have a top opening to drain urine. Stool is emptied from drainable pouches by opening and closing the bottom and are best suited for those with an ileostomy or colostomy. Closed pouches cannot be emptied and are discarded when half full and are most often used by those with colostomy who require emptying only once or twice a day. There are opaque (grey or beige) pouches, clear pouches, and pouches with a peek-a-boo window.

1-Piece vs 2-Piece: The flange/barrier are attached in a 1-piece pouching system and cannot be taken apart. The flange/barrier and pouch are separate with a 2-piece pouching system; the flange/barrier are attached using a Tupperware-like connection or an adhesive. It is usually a personal preference as to whether you use a 1 or 2-piece system. A 1-piece system tends to be a bit more flexible, which may work better for someone with a soft belly and creases, and is more discreet under clothing. For someone with lots of gas, a 2-piece system might work better as it is easier to let the gas out of the pouch. Some people find it easier to put on a 2-piece system – others find a 1-piece easier.

Ostomy Accessories

If all of the pouching options are not confusing enough there are also a number of accessory products (e.g. rings, paste, belts, and barrier extenders) that can be used to improve the wear-time of your pouching system. Most NSWOCs take a “less is best” approach to pouching and will only recommend accessory products when absolutely necessary.

Everyone, every body and every stoma are different. The best pouching system for you truly is the one that works. If you have any questions or concerns about your pouching system please make an appointment with an NSWOC(

Shop Ostomy products at Nightingale here:

– Laureen Sommerey, RN, BScN, MScN, WOCC(C)