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There are two main types of bags available for people who need to use ileostomy bags following bowel surgery: one-piece or two-piece. In general, ileostomy bags consist of a wafer that attaches to the skin around the ostomy, which then connects to a bag that collects the waste that exits the patient’s body from the stoma. In the one-piece ileostomy bag, the wafer and the bag are permanently connected to each other, while in the two-piece bag, the wafer and the bag are two separate pieces.
An ileostomy is a surgical procedure in which the small intestine is attached to the abdomen, producing an artificial opening called a stoma. The stoma is where the waste exits the body. An ileostomy can be permanent or temporary, depending on the patient’s degree of illness. Another factor in determining whether the ileostomy will be permanent is often the patient’s lifestyle and personal choice.
Surgery is typically performed to bypass the large intestine following bowel surgery where part or all of the intestine is removed. This can happen as a result of ulcerative colitis, Crohn’s disease, colon cancer or bowel obstructions. The permanent ileostomy can be formed into a K-pouch, where the small intestine is shaped into a pouch in the shape of the letter “K,” forming a temporary reservoir inside the body that can hold wasted until the patient chooses to release it through the stoma.
A temporary ileostomy typically requires a second surgery three to four months following the initial surgery. This second surgery often involves the construction of a J-pouch with the small intestine. The pouch is shaped like the letter “J” and attached to the patient’s anus so that he or she can have more typical bowel movements.
Regardless of whether the ileostomy is temporary or permanent, while it is in place, most patients have no control over when or where the body eliminates its waste. The exception is a patient with a K-pouch. For the most part, a stoma is almost always active, requiring the use of an ileostomy bag to catch the waste as its being expelled from the body.
One-piece ileostomy bags are designed to be entirely disposable. The wafer that attaches the bag to the skin and the bag itself are permanently connected. These bags often come with tape to help the wafer adhere to the skin, but many patients find the tape to be irritating to the skin, so the wafer is designed to adhere to the skin without it. One-piece systems are often easier to apply to the skin and typically appear less bulky under clothes than the two-piece systems. It is not as convenient to quickly change bags on the go with the one-piece system, however.
Two-piece ileostomy bags can be disposable as well, or they can be reusable. The bag that collects the waste itself is completely disposable and can be easily changed without needing to change the wafer that connects the bag to the skin. This can often lead to less skin irritation for patients; removing and reattaching the wafer is much of what makes the skin so sensitive around the stoma site. It also is easier to get rid of excess gas with a two-piece system, because it is fairly easy to disconnect the bag from the wafer so the gas can escape. This feature can also be a problem with the two-piece bag system, however, because the wafer and bag can sometimes disconnect when they should not.
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