This topic is about finding a comfortable and discreet way to wear a two-piece ileostomy pouch, especially when the stoma is positioned high and central on the body. The idea is to wear the pouch sideways for better concealment under clothing. Here are some insights and advice from others who have tried this approach:

1. **General Experience**
- Many people suggest giving the sideways pouch a try. Some have found it works well, while others have had issues with emptying or discomfort from the clip.
- Wearing the pouch sideways can help with issues caused by high stoma sites and waistbands pulling on a vertical pouch.

2. **Support Belts and Garments**
- The Phoenix Ostomy Belt is a popular choice, offering comfort and confidence with its padded fabric and silent snaps.
- The Better Life Ostomy Belt is another option, though some prefer the Phoenix.
- Various fabric ostomy belts, underwear, and support garments are available online, typically costing around $100.
- Some women use a snug camisole or bra top instead of a belt, which keeps the pouch discreetly under clothing.

3. **How to Position the Pouch**
- Many people position the outlet toward the side so the pouch lies along the hip, making it easier to manage when sitting or sleeping.
- One person alternates between horizontal during the day and vertical at night by rotating their appliance.

4. **Emptying Techniques**
- Keep the flange locked and fold the pouch diagonally to point the spout downward for draining.
- The Convatec Sur-Fit Natura system has a longer spout that makes this process easier.
- Be cautious to avoid spills by letting contents settle before opening.
- A plastic bag extension can help guide output downward, especially for those who are bed-bound.

5. **Liners**
- Some use disposable bag liners inside the pouch, which keeps the bag flat and simplifies draining.

6. **Other Tips**
- Tucking the tail into underwear or folding it can reduce the hanging length, especially with snug stretch panties.
- Horizontal wear might cause more effluent to sit near the flange, potentially clogging the filter sooner, but this is often no worse than vertical wear compressed by a waistband.
- Men who wear boxers might need a belt or support garment to keep the pouch secure.
- For temporary needs, like after surgery, a sideways pouch with an extension can be helpful, though it may be awkward when moving around.