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Stoma placement

I'm going to be having a total proctocolectomy and end ileostomy procedure on 20th Feb and between now and then I need to meet with the stoma nurse. One of the main objectives is to decide on placement of the stoma.

I tried wearing a false stoma for a day or two and it was in a good position for my jeans but not for more formal trousers where the belt line is a little higher...

So I'd like to ask, where's yours in relation to your belt line? And how far left or right of centre?
 

Terriernut

Moderator
My suggestion is to place it where your 'normal' clothes won't interfere with it. If you wear formal attire alot though, I don't know what to advise you.

It's not just the placement of the stoma they need to get right either. You need to tell them to make SURE it sticks out, and has a spout. Believe me, it will make your life ALOT easier if they do that.

May I say welcome to our club. It's where the coolest people hang out!

:welcome:
 
Placement should also be best suited while sitting down so you can see where all of your normal sitting creases will be. This can interfere with bag adherence significantly.

I have a very short waist area and placement was limited. It is in a good location for creases, but clothing is a bit tricky. I end up buying jeans that are a bit loose and wearing my jeans more on my hips so it doesn't squish my stoma.

Like Misty said, stress to your surgeon that you want a stoma that hangs out a good bit--a spout--in order to avoid skin issues.
 
Make sure the bag is going to end up in a comfortable position, not too close to your belly button. This happened to me at first, I have since found smaller appliances. It is very unpleasant having the bag go into or across your belly button xxx
 

annawato

Moderator
Staff member
Mine is just below my waistline and well clear of my bellybutton. Most of the pants I wear end up with the waist across it or over the bag at least so I tend to wear a long singlet and loose tops and let the bag hang outside the pants covered by the singlet. (Also helps hide middle age spread :) )
The most important thing is to make sure its not in a crease, check when sitting in the way you normally do, and that it has a good spout i.e. sticks out lots. Whether the surgeon can do this may depend on how mobile your bowel is. ( or thats the excuse surgeons give when it hasn't got a good spout) I just had my second ileo and made a point of asking the surgeon for a good spout but again ended up without one. But its definitely worth mentioning!
Welcome to the stoma club - any questions don't hesitate, none of us are shy or easily embarrassed. :rosette1:
 
I have pictures of the before surgery X and after surgery with a bag in my profile info album if you want to see what I'm talking about. I use clear bags, so you can also see how it "spouts" out and down too.
 
Mine is about 2-3 inches above the waistline and about 4 inches to the right of my belly button. I wear my bag completely sideways and support it with a belly band (that pregnant woman use). That allows it to fill up quite a bit and the belly band still supports it.
 

annawato

Moderator
Staff member
2thfairy, I want a stoma like yours - maybe I should fly to texas next time and use your surgeon! All my problems would be solved. :)
 

Dukeis

Dynastic Overlord
Interesting thread. I'm going to be making the same decision soon and all this information is very helpful. Thanks to all of you for sharing.:thumleft:
 
Jealous of 2th fairy - my crappy stoma still doesnt stick out, and for the weight I'm losing, is still hiding itself more inside my body.

My stoma is a little lower than my belly button and pretty much in line with my right leg, which is better than where they suggested at first, which was lower I think and made the bag more visible in my trousers. Of course, positioning might look different if I had a flat stomach,
 

Dukeis

Dynastic Overlord
I have a question about stoma placement. I was given some wafers and was told I could try them in different places to help see where the best placement may be. Haven't meet with the stoma nurse yet, this was given to me at the surgeons office.

I have tried it in a few places now. I have heard below the waist line is best. Thing is though my lower abdomen seems very short. I placed the top of the wafer just below my belt line. That seemed Okay until I sat down. I don't have much of a belly standing, but when I sat down the wafer poked me in that fold and was uncomfortable. Where I wear my pants and belt doesn't leave much room to go further down with the wafer either.

The surgeon told me he likes when the stoma is higher because he said people can see it better to take care of it and seem to him to have less problems. He also told me he goes on where the stoma nurse and I would decide because that is my wishes and he wants to follow them when possible.

I'm wondering if it causes problems to have the stoma placed higher. I just want to get placed where I will have the fewest problems. Any suggestions I would appreciate.
 
I'm wondering if it causes problems to have the stoma placed higher. I just want to get placed where I will have the fewest problems. Any suggestions I would appreciate.
Mine is above the belt line. Having it on or below means your belt/pants will affect it when you sit. I wear my bag sideways (it essentially covers what's left of my belly button). I don't worry about it when I am sitting down because it is above the belt line. I wouldn't change it - I like it were it is.
 
You definitely want to have the stoma nurse place it while you are sitting down since the action of everything crunching together (bulges) can make a huge difference on potential leakage problems with the wafer dislodging.

...I also have a very short lower abdomen.
 

Terriernut

Moderator
And dont forget the spout! You REALLY need a spout, and a stoma that comes out a ways. It's not just placement.
 

annawato

Moderator
Staff member
Having a good spout like 2thfairys pictures is crucial.
Have it where you can clearly see for bag changes.
Make sure its not in any folds when you sit down.
Don't go too close to the belly button or the wafer will have to go over it.
Avoid any scars or skin creases as you will have to 'fill' them when you put the wafer on.
Make sure the stoma is above or below your normal pants waistline (or belt line)
Hmm? Does that summarise it all? Probably not, so more suggestions welcome. :)
 
Make sure the stoma is above or below your normal pants waistline (or belt line)
I would never go below the waistline. That would mean the bag is in your pants and sitting down when it has any waste could be a bad thing. Mine is above and I wear it sideways and support it with a belly band (that pregnant woman use). It keeps it in place and standing/sitting is a non-issue.
 
With a short abdomen, there isn't much choice. Mine is below the waistline. I have no problems. I think most people have theirs below the waistline. Maybe I'm wrong.


edit: I guess I should say mine is below the natural waistline. I wear my pants lower now to accommodate the stoma so it sits above my jeans.
 
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Yeah mine is also below the waistline. I'd say about where 2thfairy's is! Mine is also a nice spout and I don't have any problems. I just can't wear normal jeans anymore as I always had to wear a belt with jeans to stop them from falling down. Where jeans sit on me the belt would cut off my bag and the contents would get stuck at the top.

Pie-guy - how does the output go into the bottom of your bag if its placed sideways?
 

Dukeis

Dynastic Overlord
Does a persons age have a factor in where to place the stoma? I'm thinking I'm 49 and the folds on my stomach I would think are just going to keep heading south the older I get.
 
Mine was just above the pants/trouser waistband. I did have some work clothing with a higher waistband but I'd lost so much weight at the time they were baggy enough to go over the stoma and not cause any problems... I wore braces to keep them up! :D

You can just see where it was (reversed 16 months ago)
 

Attachments

Dukeis

Dynastic Overlord
My waistband would be about where your scar is compared to your navel and I don't have much room below there. I just don't have a lot of room between my navel area and my pubic area. Guess I'm built weird.
 
Dukeis, the stoma nurse looked at me and right off said "Oh, you don't have much room to work with. This is going to be tricky." But, she found a good spot and the surgeon liked it as well. It has really worked out for me. Don't fret just yet.
 

Dukeis

Dynastic Overlord
Dukeis, the stoma nurse looked at me and right off said "Oh, you don't have much room to work with. This is going to be tricky." But, she found a good spot and the surgeon liked it as well. It has really worked out for me. Don't fret just yet.
Thanks!! I think I am fretting a little to much about all this. My wife told me about the same thing you did last night. She said wait to you see the stoma nurse and they'll know what to do.
 

annawato

Moderator
Staff member
The stoma nurse will know what to do, and you're now armed with information to help the decision.
Not sure about folds travelling south- I know if I lost too much weight (which wouldn't be a bad thing) I'd have more folds and that would be a problem. Hey good excuse not to lose weight! Not. :(
 
Pie-guy - how does the output go into the bottom of your bag if its placed sideways?
Well, the side becomes the bottom in my case. Gravity always takes it downward of course. Even when I wore it down, waste was always around the stoma when you sit down or sleep. So the bag fills up sideways and is supported by the band so I empty it less often (it doesn't feel like it's getting heavy when I stand up now thanks to the belly band). I just started doing this a few months ago and regret not trying it sooner.
I am planning to do up a thread with all my tips and tricks for changing/wearing a pooch. (Pooch - poo-pouch - I gave it that name in the Hospital after my operation and the nurse liked it so that made it official).:ybiggrin:
 

annawato

Moderator
Staff member
ha I like that name, very clever!
Good idea for a thread too - I keep meaning to start some information threads but haven't got around to it. make the heading such that its easy to find when doing a search. I always have trouble searching for something but maybe thats just me.
 
I have a couple of appointments lined up with the stoma nurse before my hospital admission on 19th Feb.

Thanks for all the tips on placement, "spouty-ness" etc.

Any further advice?
 

Terriernut

Moderator
I deleted it didn't I. Here I thought no one wanted to play in the sandbox with me! Whaaaaaaaaaaaaa!!!!!!

I will start another one now...but you gotta promise to write in it!!!!!!!
 
I am planning to do up a thread with all my tips and tricks for changing/wearing a pooch. (Pooch - poo-pouch - I gave it that name in the Hospital after my operation and the nurse liked it so that made it official).:ybiggrin:
There has now been a thread started...go for it!
 

annawato

Moderator
Staff member
Anna, I started a thread...no one put tips or tricks on it!
Misty I must have missed it! I'll have a look and reactivate it and hopefully we can get it going. I've actually been sick since friday with a 102-103 deg fever so missed a few days on here. When did you post it?.
Ok just read the rest of the posts here and saw you deleted and now redone. You are a clever girl making it a sticky!
 
Well, the side becomes the bottom in my case. Gravity always takes it downward of course. Even when I wore it down, waste was always around the stoma when you sit down or sleep. So the bag fills up sideways and is supported by the band so I empty it less often (it doesn't feel like it's getting heavy when I stand up now thanks to the belly band). I just started doing this a few months ago and regret not trying it sooner.
I am planning to do up a thread with all my tips and tricks for changing/wearing a pooch. (Pooch - poo-pouch - I gave it that name in the Hospital after my operation and the nurse liked it so that made it official).:ybiggrin:
Pie-guy,

Are you using a 'stealth-belt' (see http://www.stealthbelt.com/ )I was thinking of ordering one after surgery to try out. I also saw a good video review here: http://www.youtube.com/watch?v=ynrcmxmX9OM

If not what type of belt is it?
 

Nyx

Moderator
I bought the stealth belt when I first got my stoma, but I hated it!! I don't like my bag hanging sideways. I think that's because my output is very thick and would always get stuck around my stoma and not move to the bottom of the bag. Might be better for those with ileostomies and more liquidy output. The belt itself was very well made, but a bit of a pain to put on (you have to squish your bag through the small opening (also a pain for emptying....there's a zipper at the bottom of the belt, but you have to bend your bag to get the opening out the bottom). It's very secure though. I also found that it wasn't very slimming and could be seen under my clothes.
 
Pie-guy,

Are you using a 'stealth-belt' (see http://www.stealthbelt.com/ )I was thinking of ordering one after surgery to try out. I also saw a good video review here: http://www.youtube.com/watch?v=ynrcmxmX9OM

If not what type of belt is it?
Nope. I refuse to pay $90.00 for something that costs $20.00 to make. Just go to e-bay and search for "belly band". You can get them for 10 bucks each + shipping. (They are also referred to as maternity bands and they are used by pregnant woman). I got 3 white ones. It doesn't have a pocket for the bag but I don't need it. The band keeps everything in place and emptying is as simple as pulling it up/down.

Robb
 
Guys have a look at ostomysecrets.com. I use their bands everyday and feel secure and tucked away. I wear pouch hanging down and it fits fine. It's another option to have a look at.

bTW good luck with your surgery. Hope it all goes well.
 
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