Where to Position Your Stoma for Comfort and Convenience

Hi everybody. Due to having bowel cancer, I am soon to have all my large bowel and rectum removed and have a stoma and ileostomy bag. I'm practicing with a 'stoma' and bags now to get used to it, but can't decide whether it is better to have my stoma and bag above the beltline of my trousers, with the bag hanging over the top of my trousers, or to have the stoma and bag below my beltline, with the bag tucked in below. I would welcome any feedback or advice from anybody as to which option they think is best. Many thanks in advance, Ian.

My stoma is below my belly button at least 1 inch. It makes it easier to put in my underwear and empty. Just make sure they select the placement site while you are sitting down so it is not in a fold of your tummy, and before surgery. Take care.

I'd hate to have my stoma on or below my waistline; it would drive me nuts. No way I'd want my pants rubbing on my bag 24/7. Mine is even with my belly button and hangs over my waistline. Use a wrap or belt and have no movement restrictions. Works for me. 👍

G-Day Ian,

My ileostomy is 2.5 inches above my bellybutton, and that's how I asked for it to be. I wear my shirts on the outside of

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my jeans, but if I want to tuck my shirt in, I fold my bag up with the IGGIE Clip, and it works well for me. See photo of IGGIE Clip.

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Regards, IGGIE

Any flat spot to prevent leaks either up or down. I have placed it where you will not have leaks.

Avoiding Ostomy Bag Leaking | Managing Ostomy Leaks with LeeAnne Hayden

It's a personal choice, really, as you will see from comments. For myself, mine is the same height as my belly button used to be; it's the perfect height for me. The bottom of the bag is at waistband height, so there are no restrictions with the bag being cut in half by belts or the waistband. The stoma nurse should ask you to wear your normal trousers to discuss where to site the stoma.

You should get advice from a stoma nurse who will look at where you wear your pants, natural skin folds both standing and sitting, and whether your belly is round or flat.

My nurse recommended a very high placement for me due to multiple scars on my abdomen and a general round shape to my lower belly. It sits about 3 inches above my belly button and nestles inside my rib cage. I am very happy with this placement. But the best place for me may not be the best place for you.

Just make sure it is as flat as possible and far away from skin folds and other skin defects that may interfere.

I never had a choice or was asked. Why is that? A nurse came in. She said to stand up. Where do I place your belt?

She made a dot and circle and left.

No complaints about where it is.

3" to the right... inline with the button.

No issues or leaks. I got lucky, I guess.

Mine is just below the navel on the right. You will adapt to wherever it is, but yes, do your research. Most important of all is a larger flat area that will see no creases or folds in the base of the appliance when you bend or sit, as this will more than likely create leaks. The adhesive will also not stick to existing scars on the skin surface.

Hi Ian, welcome to the site. Lots of good advice for location. My first stoma was 3 in. to the right of my belly button, and since I had resection surgery, my new stoma is the same but to the left of my belly button. It is also very important to tell the surgeon that you want the stoma to stick out at least an inch, as a stoma at skin level causes a lot of problems. Good luck.

Welcome to the site. As you can see, you have different opinions as to the best placement. Good luck.

Hi Ian,

Lots of good advice given! I'd find out from the surgeon if they plan to remove any of your terminal ileum and/or your ileocecal valve. What you want to figure out is how often you'll need to empty your bag. If they don't touch those things, you'll be emptying much less frequently, so having your bag below your belt line might make sense. But if you're going to need to access your bag more than a couple of times a day, you might want to consider having your stoma placed above your belt line.

You said you're practicing with a stoma and bags..........so simply fill a bag with 4-6 oz of water, attach it to your barrier, and go do things you normally do. Try it with the bag hanging over your belt line and also below it. See what makes the most sense for you. As mentioned, pay special attention to where your skin is flat with no skin folds or scars, etc. There are pros and cons to every placement option, but only you can prioritize them for yourself. Just make sure you mention to the surgeon that you want your stoma to stick out at least a half inch from your abdominal wall.........and you don't want it flush or an "innie." You're lucky to have a choice, so choose wisely!!

;O)

I'm an outdoor enthusiast, so when I met with the stoma nurse, I brought the gear I wanted to be able to wear--whitewater sprayskirt, climbing harness, backpack belt--and we discussed where the stoma might be placed to accommodate that stuff (below the tightest constriction of the sprayskirt and above the belts of the harness and the backpack).