This discussion revolves around the experiences of someone who recently had a colostomy and is exploring different colostomy pouches to find the best fit for their needs. They are dealing with a recessed stoma, which presents some unique challenges. Here are some insights and advice shared in the conversation:

- After trying various products, the Hollister 2-piece convex system with a smaller wafer helped reduce leaks, although it wasn't perfect.
- The Coloplast 1-piece drainable convex pouch was comfortable and easy to clean, but its capacity was insufficient. The pouch didn't expand well, requiring more frequent emptying.
- The issue isn't with the amount of output but rather the design of the pouch.
- The person is considering returning to the Hollister system despite occasional leaks because it requires less frequent emptying.
- Coloplast confirmed they don't offer a larger volume version of the pouch, suggesting more frequent emptying instead.
- An experiment showed that the Hollister pouch expanded with the same amount of liquid, while the Coloplast pouch remained flat.
- The stoma nurse now recommends changing the gear every 3–4 days and prefers the Hollister small-wafer system.
- Coloplast offers a high-output ileostomy pouch, but it seems too large for someone with low output and a smaller frame.
- The person is contemplating future stoma-revision surgery but is hesitant due to previous surgeries.

Advice and insights from the community include:

1. Consider different brands and products:
- Hollister two-piece systems are noted for their flexible tape edges and better gas management.
- Coloplast Sensura Mio Convex Flip variants might be worth trying.
- Coloplast High-Output pouch offers larger capacity and is used by some colostomates.
- SALTS Be Confidence is described as very reliable.
- Dansac Nova Easy-Fold Maxi and OakMed pouches are other options.
- Convatec two-piece convex with Eakin Seals has a low leak rate.

2. Obtain samples and talk to manufacturers:
- Contact Coloplast, Convatec, Hollister, Dansac, SALTS, and OakMed for free samples and provide feedback, as user comments can influence product development.

3. Gas management:
- Some users find Coloplast pouches balloon at night, while Hollister’s filters manage gas better.

4. Emptying and opening styles:
- Preferences vary between Hollister’s rigid tail opening and Coloplast’s Velcro “dots” for holding the outlet open.

5. Reinforcing the seal:
- Use 3M Tegaderm tape or Hypafix Non-Woven Retention Tape around wafer edges to prevent lifting and extend wear time.

6. Skin care and preparation:
- Modern wafers often adhere better without skin-prep wipes; use barrier film only if skin is irritated.
- Adhesive remover wipes/sprays should be washed off, and the skin dried thoroughly.
- Shave peristomal hair with each change to improve adhesion.

7. Leak reduction tips:
- Ensure the convexity and ring/seal match the recessed stoma profile.
- Shorter wear time (3–4 days) can help reduce leaks.

8. Irrigation option:
- For some, irrigation can eliminate the need for a pouch; discuss with a stoma nurse once healing stabilizes.

9. Stoma revision:
- A stoma revision could improve appliance fit and quality of life, especially if the stoma is well below skin level.