How do convex bags prevent leaks? And closed bags?

[UnXmas]

When I'd had my first stoma for a few weeks, I began to get leaks quite frequently. I saw a stoma nurse, she switched me to convex bags, and the leaks stopped. Exactly the same happened with my second stoma. So when I began experiencing frequent leaks a few weeks after getting my third stoma, I didn't bother asking a nurse, I just switched to convex bags again, and again this stopped the leaks.

I'd never been able to work out how the convex bags worked, but the other day I happened to come across a website which gave an explanation: that they pull retracted stomas out away from the stomach. This makes sense as my first two stomas were very small and didn't stand out far from my stomach. But my third stoma, that I have now, is very big! It's basically prolapsed all the time. Except every now and then it retracts completely and disappears back inside my stomach, but that only lasts a couple of hours or so. The rest of the time it's very long and hangs downwards. So why do I need convex bags to prevent leaks?

Also, the reason I was browsing stoma supplies sites to begin with, can you use closed bags with an ileostomy rather than drainable ones? It seems people with colostomies that only produce a couple of bag-fulls of output a day use closed ones, and change the bag each time rather than emptying it. Since I only empty my ileostomy bag a few times a day, could I use closed bags, or is there another reason not to use them with ileostomies?

 

[DJW]

You are correct regarding convex appliances. It is used for stomas that don't protrude out much.

Is the closed pouch one piece or two?

Some with an ileostomy may use a closed pouch when swimming or something like that. It's smaller.
My thinking has always been the convenience of a drainage pouch. Ileostomies can be unpredictable.

 

[nogutsnoglory]

Convex can help if the stoma is not as tall as it need be and more flush or below skin level.

A closed bag is a personal preference I don't see why it would make a difference as for leaks or not except that you change it more often so the material is stronger.

 

[UnXmas]

You are correct regarding convex appliances. It is used for stomas that don't protrude out much.

Is the closed pouch one piece or two?

Some with an ileostomy may use a closed pouch when swimming or something like that. It's smaller.
My thinking has always been the convenience of a drainage pouch. Ileostomies can be unpredictable.

I was thinking of a closed one-piece bag. I empty my bag maybe four times a day, but that's usually with the bag only half full. So if I had a closed bag, especially if I used a bigger bag, and waited until it was full to change it, I'd probably use two a day. The reason I want to try this is because when I empty my drainable bag, I don't like leaving the stoma and the skin around it dirty, and I don't like leaving the bag dirty. My output is usually thick, which I know is how it's supposed to be, but a lot of it just sticks inside the bag. So at the moment I usually change my bag once a day, clean everything, put a clean bag on. If I did that twice a day,I probably wouldn't need to empty it at all - just wait until it's full, then change it for a clean one. Which is basically what closed bags are designed for (from what I've read), but it seems to be assumed that only people with colostomies would have a low enough volume of output to be able to do this.
I wouldn't mind having a bigger bag, and I'd be pleased if I didn't have to bother with trying to clean the outlet after emptying, which is difficult when the output is thick.

So do you think it is a coincidence that I stopped getting frequent leaks when I switched to convex bags with my current, very long(!), stoma? Are there disadvantages to using convex bags? I've seen some suppliers state that people should only order convex bags after consultation with a stoma nurse, which kind of implies they prefer people to stick with flat ones unless there's a reason not to.

 

[2thFairy]

If you use a one-piece closed bag and wait until it is full to change, you will have a very full bag of liquid waste that will be hard to manage without causing a mess while removing it and disposing it. That's the first thing that comes to mind.

 

[DJW]

It could be coincidence. How long have you had this stoma?

The first few months are always a challenge for me. The stoma is changing so I'll be fine for awhile then start having leaks again. I make some adjustments (usually a change in the base plate), then I'm good. After 3-4 months the unpredictability is gone and the leaks stop.

The only possible disadvantage I know of from convex appliances is they're a bit harder on your skin. It pushing in on the skin around the stoma.

 

[UnXmas]

If you use a one-piece closed bag and wait until it is full to change, you will have a very full bag of liquid waste that will be hard to manage without causing a mess while removing it and disposing it. That's the first thing that comes to mind.

As soon as I read this I wondered how I've been stupid enough to forget that the other different between colostomies and ileostomies is consistency of output! Though most of the time my output is very thick, more solid than liquid. Is colostomy output usually completely solid?

 

[UnXmas]

It could be coincidence. How long have you had this stoma?

The first few months are always a challenge for me. The stoma is changing so I'll be fine for awhile then start having leaks again. I make some adjustments (usually a change in the base plate), then I'm good. After 3-4 months the unpredictability is gone and the leaks stop.

The only possible disadvantage I know of from convex appliances is they're a bit harder on your skin. It pushing in on the skin around the stoma.

I've had it since the start of September. I got out of hospital I think around the end of September... I'm actually really unsure about the dates now! I was in hospital practically the whole Summer, came home at one point then back for emergency surgery when I got this stoma sometime in September, but the whole thing's a blur in my mind. I might have to go back and check the dates on my the posts I made here about it!

But pretty much as soon as I left hospital, I started getting leaks. But I had convex bags left over from my previous stoma, so tried them after a few days and haven't had a problem with leaks since.

 

[DJW]

That's good. It could be you're getting a better seal with convex if you're using a belt.
I've been using convex for year. I like it and don't plan on changing.

Now that you mention it I never get convex out of the hospital. I let things heal around the stoma before going to convex.
I think I just had a lightbulb moment. Lol.

Try the one piece and see how you like it.

 

[UnXmas]

I don't use a belt. I do find convex bags much easier to cut to the right size and put on in the right position. Maybe the others leaked because I didn't get them to fit right?

I've ordered a sample of the one-piece (a convex version), I'll let you know if it's a disaster!

 

[Susan2]

My stoma tends to retract itself and so I've always used deep convexity bags (almost 15 years). I remember reading somewhere that it wasn't advisable to use convex bags but I can't remember what reasons were given. I don't use a belt and I use ones with pre-cut base plates.

 

[Absentminded]

I used to use convex bags and found them much less prone to leaks than flat baseplates. I always cut my own hole, as my Stoma seemed to change shape all the time! My Stoma nurse advised me to use a belt for about 30 minutes when I changed my bag to help it stick better; I didn't wear one any other time though.

 

[elakes]

I am using Hollister products - the stoma ring I just started using last Saturday has been fantastic - no leaks that I have expected for this time frame. very secure.

 

[DJW]

I am using Hollister products - the stoma ring I just started using last Saturday has been fantastic - no leaks that I have expected for this time frame. very secure.

Excellent.

That security is always a load off my mind.

 

[UnXmas]

Well I'm testing the closed bag. The only problem I've had so far is that there's no see-through part on the ones I've got, and I'm used to being able to check I've got the position right. Especially as at the moment my stoma is going from completely prolapsed to completely retracted and back again. But it is much larger than the bags I'd been using previously, and I think even if having a closed bag doesn't work out, I'll get larger drainable ones in future so I can get away with even less emptying.

 

[UnXmas]

Worked fine. I put it on yesterday mid-afternoon, took it off this morning. It wasn't even full, and no mess getting it off. I'm sure if I had a bad day with an unexpected watery output, it could get messy, but then so could a drainable bag. I definitely prefer this very big size. I'd always just stuck with the size my stoma nurses first order for me, and I think they assume you want a smaller - and therefore more discreet - bag, especially if you're a woman, but I definitely prefer being able to go the best part of a day and have it still only half full.

But anyway, in case anyone else is interested, a closed bag can manage ileostomy output. It easily contained it all over night, and then I just took it off the usual way. I emptied it into the toilet, through the hole the stoma goes through, obviously, as that's the only hole... though I guess you could cut a slit in the bottom... hmm that's got me wondering now: if it had gotten so full you thought it might come through the stoma-hole when you took it off, I guess you could hold it over the toilet and cut a slit in the bottom, making it into a drainable bag before you took it off. I'm going to experiment a bit more, as I'm hoping to make myself a bit more environmentally friendly by not emptying and/or changing so much.

 

[UnXmas]

What do appliance suppliers mean by "clear" in the product descriptions? Some say "clear", some say "soft cover", some say "split soft cover". I was looking for bags that you can see through to get the positioning right. Some say they have an inspection window, so they're obvious, and what I have been using, but I can't find a large bag size with an inspection window (especially as I'm limited to convex bags). So I thought "clear" may be referring to the bag material, that the whole bag is transparent, as I've heard there are bags like that, generally for use in hospital when doctors and nurses need to see everything that's going on. But when I checked, the ones I ordered as samples are labelled "clear", and they're definitely not transparent, they're the usual peach colour (which has anyone else thought quite racist? I assume they're that colour because apparently we all should want our bags discreet above all else, so they make them flesh-coloured, or at least one kind of flesh-coloured that excludes an awful lot of people. Or have I missed something and there's another reason they're all that colour?). So clear, soft cover, split soft cover... anyone know what these things mean?!

Why are the websites so unclear? Can't they give explanations? When I first started ordering I had terrible confusion about whether I was ordering bags already cut or bags I had to cut myself, and couldn't make head or tail of it from the website, and ended up ringing them. The woman who answered seemed to find my questions quite amusing. Am I the only one who had this trouble, or is the website I use particularly lacking in explanations? They're always very good, get my order right, send it promptly, etc., the trouble comes when I want to order something new and need to work out what!

 

[2thFairy]

What brand did you order? Clear bags are see-through and opaque bags are not. They must have sent you the wrong ones.

 

[UnXmas]

I ordered Coloplast. When I ordered the sample I wasn't thinking of getting a transparent bag as I'm so used to having inspection windows it didn't occur to me that they wouldn't have one. So I went back to look for versions with windows or which were transparent, and found the one I'd already ordered as a sample says "clear". I checked just now on the confirmation e-mail they sent when I ordered the sample and it says it there too. So that's definitely what "clear" refers to? I couldn't think what else it could mean.

They don't use the word "opaque" at all - this is what I mean about them not making things easy to understand! The alternatives to "clear" appear to be "soft cover" or "split soft cover".

 

[UnXmas]

Here's the site: http://www.charterhealthcare.co.uk/

 

[2thFairy]

They definitely sent you the wrong ones or else their description needs to be changed.

 

[UnXmas]

I ordered Coloplast. When I ordered the sample I wasn't thinking of getting a transparent bag as I'm so used to having inspection windows it didn't occur to me that they wouldn't have one. So I went back to look for versions with windows or which were transparent, and found the one I'd already ordered as a sample says "clear". I checked just now on the confirmation e-mail they sent when I ordered the sample and it says it there too. So that's definitely what "clear" refers to? I couldn't think what else it could mean.

They don't use the word "opaque" at all - this is what I mean about them not making things easy to understand! The alternatives to "clear" appear to be "soft cover" or "split soft cover".

Having thought about it, I reckon split soft cover might refer to the ones with a window, that the split in the soft cover is where the window is. Then soft cover has no window, and clear is (should be) all transparent.

 

[UnXmas]

Still getting on fine with the closed bags. I put a new one on first thing yesterday morning. At bedtime I had a bit of a dilemma as the bag was only about a quarter full, so I didn't want to take it off and waste it, but wasn't sure whether it I left it on overnight it wouldn't end up overly full by the time I woke up in the morning. Usually most of my stoma output comes in the evening, but yesterday it apparently was delayed for some reason. But the point of getting the sample pack was to experiment so I kept the same closed bag on. I woke up this morning and it was very full, but no leaks, and no trouble whatsoever taking off a full bag and then emptying it into the toilet once it was off.