What’s the Difference Between a Closed Ostomy Pouch and a Drainable Ostomy Pouch?

August 30,2023 |
Hiker with ostomy Bag

Although ostomy surgeries are life-saving procedures, they can come with a few challenges. During the surgery, an opening in the abdomen (stoma) is created so that waste or urine can be diverted out of the body more effectively. This means that ostomates will require an ostomy pouch to catch and hold the waste products. At first, this can be a difficult transition to overcome, but with time, changing your ostomy pouching system becomes second nature. In order to support your journey, however, it’s important to find the best ostomy pouch for your needs. To help you understand your options, we’ll discuss the difference between a closed ostomy pouch and a drainable ostomy pouch and which option is best for your lifestyle.

What to Know About Closed Ostomy Pouches

Closed-ostomy pouches are single-use ostomy bags that need to be removed and disposed of during each change. You cannot empty them and simply reattach them, as there’s no opening or outlet area to do so. Instead, once they’re full, you’ll go through the process of changing your ostomy pouch and throwing away the bag. The frequency in which you’ll change your ostomy pouch depends on your output and activity levels, but many ostomates find that, on average, they go through three pouch changes per day.

Since the only opening in a closed-system ostomy pouch is where it attaches to the stoma, these are a great option for sports, water activity, and intimate moments. The lack of an opening for drainage provides many ostomies with the added confidence that they won’t experience a leak or accidental drainage during these moments.

However, closed ostomy pouches need to be changed and disposed of regularly throughout the day, regardless of where you are. Therefore, it’s important to learn how to change your ostomy pouch in difficult situations (like public restrooms) and make sure that you carry enough supplies on you to make these changes throughout the day.

What to Know About Drainable Ostomy Pouches

A drainable ostomy pouch is a reusable ostomy bag with an open-ended side that can be released to drain the contents. Once cleared, drainable ostomy pouches can be reused throughout the day. This tends to be more convenient for ostomates, as they don’t need to carry around extra ostomy supplies or find a suitable place to dispose of their ostomy bags after changing them. While it can be tempting to wait to empty drainable pouches until they’re full, it’s recommended to release the contents when the pouch is about half-full to avoid putting excess strain on the bag and on your stoma. After emptying, you should take the time to carefully clean the pouch’s outlet area so that the seal remains strong when reattached.

Although some ostomates feel more confident with a closed ostomy pouch, drainable ostomy pouches are not made to release the contents easily. They’re designed to stay securely locked and in place, until you actively decide to open and drain them. If you’re concerned about this, don’t hesitate to talk to your ostomy nurse or doctor and ask questions as needed.

How to Choose Between a Closed Ostomy Pouch and a Drainable Ostomy Pouch

At first, choosing the best ostomy bag for your needs can be a little overwhelming. There are several different options to choose from, each with varying benefits and disadvantages. If you have a choice between a closed ostomy pouch and a drainable ostomy pouch, consider the following.

Closed ostomy pouches are best for individuals who experience more fully formed bowel movements or thicker output. However, they are also great for ostomates with thin or runny output who want to gain a bit more confidence during sports, while in the water, or when engaging in intimate acts. Although drainable ostomy pouches shouldn’t open on their own, the lack of this extra opening in closed systems tends to give individuals a bit more confidence.

Oftentimes, drainable ostomy bags are used by individuals who have a more consistent output schedule or those who experience heavier outputs. More often than not, individuals who have undergone an ileostomy surgery prefer drainable ostomy pouches to closed pouches. Similarly, individuals who have undergone a urostomy—where the output is strictly urine—benefit from using a drainable ostomy pouch. However, individuals with a urostomy may need specialized pouches to accommodate the release of urine. Drainable pouches may also be difficult for individuals with thicker outputs or more inconsistent bowel movements, as emptying the pouch itself can be time-consuming and may take more work.

Regardless of what type of ostomy surgery you’ve undergone, it’s best to work with your doctor and try a few options. This will give you the chance to experiment with different pouches and see which one works best for your needs and lifestyle. In addition to closed vs. drainable ostomy pouches, you’ll also want to explore one-piece and two-piece systems.

One-Piece Ostomy Bag

A one-piece ostomy bag can be either a closed ostomy pouch or a drainable ostomy pouch. The number of pieces does not refer to how the bag is emptied. Instead, it refers to the pouch itself and the skin barrier or wafer used to attach the pouch to your peristomal skin. The one-piece ostomy pouch has a conjoined bag and skin barrier. This will require a complete ostomy system change whenever you need to change the bag. Therefore, when you remove the ostomy bag, the skin barrier/wafer will also be removed, which means you’ll have to clean the adhesive from the peristomal skin between every bag change. For this reason, one-piece ostomy bags pair well with drainable ostomy pouches, but they’re also available in closed ostomy pouches.

Two-Piece Ostomy Bag

A two-piece ostomy bag tends to be the preferred option for many ostomates, as they make changing your ostomy pouch much easier. The skin barrier or wafer can be kept in place for about two to four days in this ostomy pouching system. Instead of removing the adhesive and undergoing the whole process, you simply detach the ostomy bag, empty it or throw it away, then reattach. This can help reduce the risk of peristomal skin irritation, as you’re not detaching and reattaching harsh adhesives to the skin multiple times per day. This makes two-piece ostomy bags a popular option for individuals with a closed ostomy pouch.

At the end of the day, the type of ostomy pouch you use is up to you. Your comfort levels, activities, and output may influence which type you use, but ultimately the choice is up to you. It can take some time to get used to, so don’t be afraid to be honest with your doctor about each type of ostomy bag.

Many individuals who undergo ostomy surgery have a difficult time with the transition. It results in major changes, but that doesn’t mean you need to give up living the life you love. Although there are several myths about living with an ostomy, once you adapt to the physical changes, you can do almost everything you did before the surgery. However, that doesn’t mean there won’t be some emotional turmoil in the process. The best way to adapt and overcome all of the challenges associated with ostomy surgery is to join an ostomy support group. To find an ostomy support meeting, look at the list of support groups affiliated with The United Ostomy Associations of America (UOAA). UOAA is a national, 501(c)(3) nonprofit organization that supports, empowers, and advocates for people who have had or will have ostomy or continent diversion surgery.

It's also important to ensure that you have all of the ostomy supplies necessary to support your lifestyle. At Byram Healthcare, we’re committed to helping improve the lives of people living with an ostomy and offer a wide range of high-quality, medical-grade ostomy supplies, pouches, and support systems. To get started, check out our ostomy product selection guide today.