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One-piece vs two-piece

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Posted 12/21/2014 10:08 PM (GMT 0)
I know that everyone has a personal preference of what they use, and these preferences are very individual, but I'm just wondering why people use one over the other?
I'm Day 11 post-colectomy and have only used the one-piece, as it's what I was given in hospital. But I'm just doing a bit of research before my stoma nurse calls on Tuesday to maybe discuss it with her also.
Thanks for any opinions! :)
Posted 12/21/2014 11:14 PM (GMT 0)
Hi! A two-piece has distinct advantages... One, you can "burp" out air by simply walking to a private location and letting some gas out. Two, you can pivot the bag. So when you are up and about, it's between your legs. When you're laying on your bag, you can turn it to hang down your right side. You always want to have the stuff moving away from the wafer area to prevent leaks. By the way, if you use a two-piece, it's good to lubricate the plastic ring a little - it won't make it pop open, but it will make burping and pivoting easier.

I mentioned earlier, attaching a bag when you are still tender right after surgery can be grueling/impossible, so at this point, I would recommend the one-pieces for you, or be sure to attach the bag before applying a two piece.
Just my thoughts. :-)
Posted 12/22/2014 12:33 AM (GMT 0)
Two piece has more advantages IE: If you encounter a defective bag you can just change the bag and not the wafer (Less expensive). You can flush it to clean the entire bag as frequently as you want to name a couple more in addition to burping or turning it to a desired position. Good luck ..WaterMaster
Posted 12/22/2014 12:42 AM (GMT 0)
^good points. :-)
Posted 12/22/2014 12:53 AM (GMT 0)
I never rotate the bag, or flush it out or anything, but I do use a 2 piece. I'm pretty sure that;s what I was sent home with, from the hospital. I like the fact that you can take the bag off & shower with just the wafer- it gets the stoma clean, & has zero impact on wear time. Then just snap on a dry bag. I also think it's easier to get a good seal with a 2 piece- when you do the wafer by itself, you can see how close it is to the stoma, if there's any gaps, etc. With a 1 piece, it's guesswork, & you only know if you screwed up by skin irritation or leaks. Gas is not much of a problem for me, so I never burp the bag. The Hollsiter stuff has what they call a "floating flange", so you don't need to apply much pressure to your abdomen to snap the bag on. It's hard to explain, but once you see it, you'll get it! Call the companies & ask for samples- try a bunch out, use whatever suits you best.
Posted 12/22/2014 1:41 AM (GMT 0)
Prefer 1-pieces. Less faffing about and would rather change everything at once; don't want to put a clean bag onto a grotty, stained wafer. Can be done and dusted with a change in 5 minutes.

None of the other 'advantages' are an advantage to me. If the bag fills with air, I take an extra 20 seconds out of my life to go to the bathroom to empty it, with zero risk of an accident and no stinking out my bedroom with a poo smell.

Literally cannot envision a situation where I would need to pivot the bag.

Luckily the NHS covers the cost of 1-piece bags - for now. I'm sure it'll follow America's lead sooner or later and severely restrict supplies. But until if/when that happens, I'm staying with the 1-piece bag.
Posted 12/22/2014 2:06 AM (GMT 0)
Lol! No, I definitely wouldn't just burp if I were home. That smell lingers way longer than good old fashioned farts! Yesterday, I was walking on the beach with friends and no bathroom in sight while a small balloon grew under my sweater. Grateful I could burp it!

I didn't really worry about pivoting either with my end ileo. This loop is much more liquid and if I'm sleeping on my back with the bag pointed towards my toes, it seems the liquid sits at the wafer and shortens wear time significantly for me. Glad if that's not something others need to fuss with.
Posted 12/22/2014 2:29 AM (GMT 0)
Outdoors, burping the bag makes more sense, admittedly. So far I've never actually needed to do it: have never been away from a public toilet for that long. But if I was on an all-day hike, I would have to do something about emptying the bag - probably just do it in a bush or something. Not great, but don't see what else I could really do.

Hmm. I have an end ileo and do sometimes get very liquidy output. I change the bag every 2-3 days and can't see that changing in the foreseeable future: the bag gets too grotty, the skin around my stoma gets worse, and the risk of a leak drastically increases. Even tried a 2-piece for a little while, but the 2-piece wafer didn't seem any longer-lasting than a 1-piece one.

I sleep on my front so pancaking is probably less of an issue for me than for folks who sleep on their backs.
Posted 12/22/2014 2:54 AM (GMT 0)
I liked my 2-piece but it does stick out from your body a little further than a 1-piece.

Find a manufacturer and products that you like, everyone's experience is different. Call the manufactures and ask for free samples.
Posted 12/22/2014 3:11 AM (GMT 0)
I can't imagine putting up with a one piece, for the many reasons mentioned. Here's yet another advantage: two pieces allow you to swap out pouches in seconds in situations where emptying may not be as practical... Eg hiking or in a car or whatever. I have accumulated alot of extra pouches, so a few extras are handy to have on the go when hiking or whatever. A ziplock bag and a non ttransparent outer bag are all you then need to odorlessly dispose of the swapped out pouch. As for profile depth, I find that insignificant -- I use Hollister and that wafer flange is very thin, yet secure.
Posted 12/22/2014 3:34 AM (GMT 0)
Why would I want to carry a full bag of poop around with me all day long? Even carrying an empty wrapper or bottle drives me nuts.

Weird how competitive people get over this. m8s, it's a bag, it's not worth arguing about. I've tried both and I prefer 1-pieces, end of discussion for me. Nothing you say about the supposed virtues of a 2-piece will change my mind.
Posted 12/22/2014 3:42 AM (GMT 0)
Probiotic...what a great idea! I never thought about swapping out my bag. I'm going to have to start carrying a few extras in the car for emergencies instead of just a change.

For those of you mentioning the odor when burping....I use a deodorant that is excellent. No odor at all when I empty. Safe n Simple pouch deodorizer. The non-lubricating one. Call for a sample. It's incredible!!
Posted 12/22/2014 3:49 AM (GMT 0)
Or you could just empty the bag in a bush. Done in 10 seconds, no worrying about an active stoma leaking crap over you, or a full bag emanating unsociable smells from your rucksack or whatever oversized container it is you need to carry all this stuff around in the first place.

My idea of a good stoma is one that I never have to think about outside of bag changes. Literally have no interest in stoma supplies, equipment, etc. It bores me silly. 1-piece bags are about as simple as I can make it and if there was something simpler and easier than that, I'd go for it instead.
Posted 12/22/2014 2:39 PM (GMT 0)
I had read about all the advantages of a two-piece before surgery and swore that's what I was going to use. However, when I actually had to wear a two-piece I hated it. There was a big plastic ring that wasn't really flexible, so I had trouble bending. And when I did bend, it often would start pulling the wafer loose due to the ring. I tried several brands and had the same issues with all of them. So I use one-pieces and am pretty satisfied with them. Everyone is shaped differently though, so get samples, try everything, and find what works best. It took me a good three months to settle on a pouch, and six months to settle on everything else and have a constant routine. There are so many supplies out there, and your body will likely change in the months after surgery.
Posted 12/22/2014 6:12 PM (GMT 0)
Thanks everyone for giving your input, it's really helps me as I'm still very much learning!

I've no idea how it works in America with getting supplies, but I don't really have to worry about expenses here - for the moment anyway! I have a medical card (for the next 2.5 years) and ostomy supplies are covered under it, so I'm very lucky in that sense. I'll check with my stoma nurse if absolutely everything is covered, but that's what they told me in hospital. I was well stocked up before leaving hospital too.

The idea of being able to check my stoma without changing everything is very appealing part of a two piece. Especially as I've been having some irritation.
Although they do seem to be more bulky, which is putting me off... The colorectal nurse gave me one the night before my surgery, when she was showing me many supplies to play with, and it seemed a lot thicker... I know it was only one brand, others may be smaller. The one piece I have already seems to stick out a lot, though it's probably just my stoma still being swollen from surgery.

Hopefully I'll get some samples & I'll work out what works for me! :)
Posted 12/22/2014 8:33 PM (GMT 0)
@Ncot- swapping out a pouch doesnt mean carrying it all day- just dumping it in trash at first opportunity. that can mean instantly in some situations. obviously no chance to either empty pouch or dispose of one on side of a cliff if you are a mountAineer like blueheron. also handy if one ends up in a bathroom stall or a hosts home with a half broken toilet. anyway this isnt a competition but the OP was wondering why some of us prefer one or the other.

re odor if burping- M9 rocks. i use hydrogen peroxide if i am all put but i stock up on extra m9 cheap from amazon to supplement my free monthly supply from insurance, as a squirt totally prevents odor.

Post Edited (Probiotic) : 12/22/2014 1:38:08 PM (GMT-7)

Posted 12/22/2014 10:43 PM (GMT 0)
It's horses for courses. What works for one person, may not work for the next. All the supply companies do samples, which you can order via their website, or by phone if you prefer. Get one and two piece from each company, and see what you prefer. Some companies worth trying are: Holister; Coloplast; Dansac; Convatec; Pelican (Uk division of Eakin).
Sometimes people get a little precious here about their own setup, just find what works best for you, and the way to do that is trial and error.
Posted 12/23/2014 12:00 AM (GMT 0)
Whatever works. Tried both but my idea is keep it simple. Saw only really minimal advantage for a two piece. Didn’t like the higher profile went back to one piece.

Regarding hiking which I do a lot of I, as was suggested, just go into the bush and often tell my companions I have to that to pee. If it takes me 30 seconds to empty my pouch, that would be a lot. My Coloplast pouch takes a mere swipe or two of toilet paper (have used a leaf) and I am back in biz. I have a few times needed to empty and couldn’t find any immediate areas to bury and have emptied into plastic bags, which was not difficult. Much better to just bury. So the removal of a pouch and swapping out of pouches and transporting which still needs a plastic bag seems to be of little to no advantage. Burping not much of an issue for me except at night. You can burp a one piece while in a prone position but I rarely do it as I found the activity wakes me up just about as much as getting up.
Posted 12/23/2014 1:12 AM (GMT 0)
I prefer a 2 piece for many of the reasons already mentioned. I don't find it is much bigger or more noticeable than the 1 piece systems I have tried.

As for emptying a pouch while hiking, camping, in the woods... Before I had an ileostomy, I NEVER would have just pooped in a bush, on the ground, wherever...without first digging a proper hole to bury it in, unless it was such an emergency that I just didn't have time to dig a hole. The same rules apply for emptying a pouch. Unless for some reason, there is no other option, one really should dig a hole to bury waste.
Posted 12/23/2014 1:23 AM (GMT 0)

Probiotic said...
@Ncot- swapping out a pouch doesnt mean carrying it all day- just dumping it in trash at first opportunity. that can mean instantly in some situations. obviously no chance to either empty pouch or dispose of one on side of a cliff if you are a mountAineer like blueheron. also handy if one ends up in a bathroom stall or a hosts home with a half broken toilet. anyway this isnt a competition but the OP was wondering why some of us prefer one or the other.

If I'm in a place which has rubbish bins, then I'm also in a place which has public toilets somewhere - if they are there, I will find them.

If I'm on the side of a mountain, then the output is going underneath a rock or something. Where it's not going to go is inside my rucksack.

UCwhat? said...
As for emptying a pouch while hiking, camping, in the woods... Before I had an ileostomy, I NEVER would have just pooped in a bush, on the ground, wherever...without first digging a proper hole to bury it in, unless it was such an emergency that I just didn't have time to dig a hole. The same rules apply for emptying a pouch. Unless for some reason, there is no other option, one really should dig a hole to bury waste.

Nah m8, I'd find a bush or something, but no way I'm digging a hole. I'll reconsider it when people start keeling over and dying from all the dog sh1t that is left on the ground in parks and trails across the UK, but not before.

No way I'm swapping out a pouch outdoors either. What the hell do you do if the stoma is currently active? IB4 your perfect worlds where the stoma is never, ever active at an inconvenient time or place, so this isn't a problem for you and you don't even know what I'm talking about.

Post Edited (NiceCupOfTea) : 12/22/2014 6:27:26 PM (GMT-7)

Posted 12/23/2014 1:52 AM (GMT 0)
Well I'll put in my two cents here too. After surgery I preferred a one-piece, mostly due to the lower profile. But then a few years out I had some problems and needed to change pouching systems -- the one I settled on only came in clear bags in the one-piece, which was a deal-breaker, so I went with the two piece.

I now greatly prefer the two piece. First reason is being able to angle the bag. My stoma is oval, and it was just too tricky to cut the opening so that I could get the bag at the angle i preferred. Now I can put the pouch in my underwear, which is much better than having it straight down my leg with a pouch cover, as I used to (and being able to tuck in lowers the profile).

The other reason, which I don't think anyone has mentioned, is that I've had to go to the ER several times this year, and in any kind of medical setting where people are going to want to look at your stoma, it's much much easier w/a two piece. With a one-piece, you have to take the whole thing off, and then change it (had to do this three times once at the ER... and when the blockage cleared, was a mess to change).... with a two piece you just take off the bag and put it back on .... goes for a scope too.
Posted 12/23/2014 2:25 AM (GMT 0)

blueglass said...
I now greatly prefer the two piece. First reason is being able to angle the bag. My stoma is oval, and it was just too tricky to cut the opening so that I could get the bag at the angle i preferred.

Mine is oval as well.

My stoma nurse cut out a template for me about a year ago and I've been using that same template ever since. I get my wafers pre-cut, so I don't even have to bother cutting the hole out.

blueglass said...
The other reason, which I don't think anyone has mentioned, is that I've had to go to the ER several times this year, and in any kind of medical setting where people are going to want to look at your stoma, it's much much easier w/a two piece. With a one-piece, you have to take the whole thing off, and then change it (had to do this three times once at the ER... and when the blockage cleared, was a mess to change).... with a two piece you just take off the bag and put it back on .... goes for a scope too.

My stoma nurses have looked at my stoma loads of times, especially in the first few months after surgery. Yes, they had to spend 5 seconds taking the bag off. Major, major hassle.

If I had a blockage and went to the ER, I'd actually insist on a total bag change even if I was wearing a 2-piece. There is no way I would accept having a clean bag put onto a dirty, stained, poop-ridden wafer.

And there in a nub is why I prefer the 1-piece. It's just cleaner. After a shower I wouldn't put on the same underwear; I'd put on new underwear. I wouldn't reuse toilet paper for the same reason either.

And yet UCWhat? insists on burying his waste in a remote and out-of-the-way place where the only living organism likely to tread in it is a wandering ant, or something.

Truly, I am baffled.

Post Edited (NiceCupOfTea) : 12/22/2014 7:32:55 PM (GMT-7)

Posted 12/23/2014 3:30 AM (GMT 0)
ncot-- purely answering your question as to how to change a pouch allone in a 2-piece system if the stoma is active at the time: the answer is, with practice, no issue at all. I have done it a number of times with zero leakage. I will grant that if ones outout haooens to be pure liquid (rare for me unless i eat/drink very liquid producing stuff) it could be trickier, but I have had no issues at all with the pouch swap procedure. It does take a bit of practice at home to do it in about 2-5 seconds. Maybe some ither systems are tricky ti snao on but the hollister one for me anyway snaps on real easy.

Re dog owners who dint pick up their dog's poop, yeah a pet peeve of mine. I love dogs-- and cats-- and all animals, but violaters of the dog poop rule should be forced to sit in a chair in a confined room with putrid dog poop for one day, and also have 3 pairs of their favorite shoes soles liberally caked with old dog poop.

Post Edited (Probiotic) : 12/22/2014 8:33:21 PM (GMT-7)

Posted 12/23/2014 3:43 AM (GMT 0)
Pro m8, I've spent 10 minutes before now grappling with snapping a 2-piece bag into place. Never tried Hollister bags, admittedly.

I've gotten much quicker at changing 1-piece bags, but I still don't like doing it when the stoma is active. For a start it interferes with the putting on of an eakin seal - that's the worst thing about rubber seals. Two drops of output distorts them into some deranged, deformed resemblance of a circle which loses all its adhesive powers.

EDIT: Just saw your addendum about dog poop and dog owners who don't pick it up. Couldn't agree more! There would be a lovely walk near us, if you didn't have to spend the entire time looking down at the path to avoid treading in something foul instead of looking at the views and the lovely old windmill. What is it with these people? If they don't want to pick it up, then they could at least drag their dogs off the path and onto the edges of the field - but no the ****wits can't/won't even do that little.

Post Edited (NiceCupOfTea) : 12/22/2014 8:47:37 PM (GMT-7)

Posted 12/23/2014 3:58 AM (GMT 0)
NCOT~ Exactly why are you trying to challenge any opinion that is not the same as yours? Everyone has their preferences for a wide variety of reasons...none of them are right or wrong. Nobody is saying you, or anyone else who prefers a 1 piece is wrong...we are all simply stating our own opinions and preferences. No need to be so defensive.

As for how to properly dispose of human waste in the wild, there are MANY reasons why it should not just be left any old place. Anyone who does a lot of hiking, backpacking, climbing etc...and cares about and respects the environment and other people who come along, know and understand that. There is plenty of info out there about this topic, if anyone is interested.
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