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To Drain or Not to Drain Drainable vs. Disposable Pouches by BOA Member Frank Malanga

The purpose of this article is to help you make an informed decision on a pouching method sooner rather than later. You shouldn’t wait as long as I did.

After my colostomy I was introduced to the two-piece drainable pouch system in the hospital and continued using it until recently. If you use a drainable, you know how tedious the draining process can be.

I learned quickly that multiple pouch-emptying passes were needed to avoid clogging the toilet. I learned to float toilet tissue in the toilet to reduce the splashing. Sometimes that didn’t work.

I was not happy with this method, but unsure of what else to try. I had heard from others at BOA meetings that a disposable pouch was easy and convenient to use. They said: “Just pop off the old pouch, wipe the landing zone, and pop on a new pouch.” I assumed specific details were missing from the explanation. It couldn’t be that easy. I was afraid to try it since I had reluctantly gotten used to the drainable pouches and the 12- 15 minutes each session lasted.

What made me reconsider giving the disposable pouches a test was Hurricane Wilma. Several of my neighbors’ water service was interrupted when a pipe broke. If we got unlucky this year, how could I flush after each emptying pass to avoid clogging the toilet? I simply couldn’t stockpile enough water to flush so many times.
Casting about for an alternative I thought of the disposables where only one flush would be necessary. I requested samples of the disposables and anxiously tried them out. I was surprised at the results. Delighted, actually.

The disposables are easy to remove. They have a tab to grasp to peal them off without disturbing the underlying wafer attached to the abdomen. Any accumulated stool on and around the stoma is easily removed by grabbing with toilet tissue. Cleaning the landing pad is quick and easy. I start with a dry square of toilet paper to clean the landing zone, then, if necessary, moisten another toilet paper square with plain water to clean any stickier stool off of the landing zone. I’ve never had to use more than two or three toilet paper squares to wash the landing zone. Another single toilet tissue square to dry the landing zone and I’m done. This process is so clean that wearing gloves is not required. Hands don’t get soiled. It could actually be done without using the toilet at all, just a plastic bag or baggie for the debris.
Placing the fresh disposable pouch on the landing zone seems to be easier, less fussy, than positioning the drainable pouch had ever been. I’m not sure why.
Once the pouch is placed, a careful press on the pouch to seal the connection and I’m done. I’ve timed the process. The old drainable method took me up to 15 tiresome minutes, depending on how full the pouch was and how many separate squeezes and flushes I had to make. The new method takes me three minutes. I’ve timed it.

There are other benefits besides speed and convenience. The entire process is less unpleasant, much less smelly. I fold the used pouch over on itself which seals the stool inside so there is less time for the room air to get, uh, fragrant. If you are sharing a bathroom with someone else, this is a big benefit. I insert the used pouch into one of those plastic bags that the daily newspaper is delivered in, tie a knot, and dispose of it in the kitchen trash. There is no odor at all.

I am not afraid to leave the house in the morning (my stoma is generally active after breakfast) because I feel I am more in control and using a public or airplane restroom is less threatening and quicker than was ever possible with the drainables.
I have daily access to my stoma and can keep it cleaner and the skin around it healthier by not allowing a stool buildup in the days between drainable pouch changes.

I no longer get a skin rash under the bottom end of the pouch as I did with the drainables. They occasionally allowed seepage from the end of the tail, especially while sleeping. In addition, sleeping is easier without a tail to get twisted under your body. The gas release vent also works much better because the disposable isn’t worn long enough to clog the vents. I don’t have to “burp” my pouch to release trapped gas.

In summary, my change to disposables has made my life easier, less stressful, and reduced the ickyness factor by a hundred. I’m sorry I didn’t try them sooner. I realize that disposables aren’t for everyone. It depends on the action of your stoma and the frequency of its discharges. For very active stomas, drainables may be better as they can be emptied numerous times, if necessary.

Having said that, I do urge you to give disposables a try. The manufacturers will send you free samples. Medicare will pay or reimburse for 60 disposables per month. If you are using drainables, and your stoma flow allows it, you will probably eventually test disposables. Don’t wait like I did. Try them sooner. My guess is you will be glad you did.

Editor’s Note: We would like to thank Frank for sharing his important ostomy insights. He is a great friend of BOA and his articles are not only printed in the Beacon, but are also posted on our website for all to enjoy.
As Frank so carefully pointed out, disposables aren’t for everyone. They are unsuitable for all ileostomates and urostomates as their flow is almost constant. Colostomates whose surgery was “high” on their colon will have a more constant flow and also will have difficulty using disposables. For those who do have a liquid flow, emptying is very easy and only takes about a minute or less as the contents easily spill out. Just a clean wipe with tissue of the inside of the tail-piece and away you go!