Revision Above or Below the Belt Line

May 11, 2024 1:48 pm

Hi all! I am going to have my ostomy revision soon. It's too low, and when I stand up, it pulls in and below the surface. Kind of a pain to deal with. I plan on having it moved up and made an outie. My surgeon says that I can go above or below the belt line, as I don't want it on the belt line. I am wondering what experiences and opinions are out there so maybe I can have a better idea of placement. Thanks to everyone for sharing!

May 11, 2024 2:39 pm

It's a personal choice, but for myself, above the belt line is the best site for me. My stoma is high up, opposite where my belly button used to be many years ago! I can wear any trousers without the trouser waistband or belts restricting the bag. It's worked for me for well over 30 years.

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May 11, 2024 3:22 pm

I have my ileostomy about 2 inches above my belly button, and it works for me. Regards, Iggie

May 11, 2024 4:55 pm

Above the beltline, no problems.

May 11, 2024 5:08 pm

Hi Older,

Good question! Most of us didn't have an option... or at least weren't told we did, but now that you ask, I wonder what I would have picked? Many guys on here complain they can't tuck their shirts in with it above the belt line, which is true... there really aren't many ways to tuck a shirt in over a bag that needs to hang down over your belt line. But having it below the belt line would suck for me because whenever my pants slid down, which happens when I don't wear a belt, which is frequently, they'd snag on my barrier and probably pull the damn thing off. The other thing I'd be concerned with is a hernia. When normal folks get a hernia, it's usually in the area below the belly button line in the groin area, not above the line. So that would make me believe the groin area below the belly button line is more susceptible to a hernia forming. Punching another big hole right there and sticking a stoma through that one can't make the area any sounder... so I'd make it a point to discuss it with your surgeon or a hernia repair doc and see if it's smart to put a stoma below the line (I'm assuming your current stoma is also below your belt line). I've also heard that they cannot reuse a stoma site once it's been closed and the stoma has been relocated, and which side your stoma is put on depends on what type of ostomy you have... meaning the length of bowel determines which side it exits on. So if yours has to be on your right side and there's already a hole (and associated weak spot) there below your belt line... I would think that really the only other option would be to move it above. But there may be other surgical details I'm not considering.

I would think if your stoma simply pulls in when you stand up that there's not enough slack in your intestines below the skin surface. Could be from adhesions or a stricture or whatever, so they'll address that. But since they're going in anyway, have you considered having them just extend the stoma a bit so it sticks out further and leaving it in the same location... or is there another reason it has to be moved?

Very curious to hear what you decide... and why. We might all need that info in the future for a similar decision!!!


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May 12, 2024 9:57 am

Mine is about 3 inches below my navel on my right. It works for me; jeans, pants, and shorts always cover it. I prefer it there. Be aware that if they put it in the same location, it will be a larger diameter as they need to remove any and all surface scars because the appliance doesn't stick to scars for some reason. Make sure to keep it away from the fold in your abdomen when you bend over or any other crease for that matter, as it will probably cause leaks. Put some water in some of your bags and stick them on to experiment with locations.

ron in mich
May 12, 2024 12:30 pm

Hi, older. My first stoma was on the right of my belly button about 2 in. and my newest one after resection is on the left about 2 in. over and below the belt line.

May 12, 2024 1:25 pm

Hey there,

A lot of it also depends on your abdomen. They can only put it in so many spots, so if you have deep creases, mounds, rolls, or scars, it's harder to have it in that spot. They typically don't like to use them as it causes stoma and pouching problems. It should be on the flattest section of your abdomen where it's similar when you sit, stand, bend, etc. I have had mine in every spot they can put one, lol. I preferred mine higher, and for my abdomen, it was the best spot.