This topic is about finding ways to boost self-esteem for someone living with an ileostomy, especially when feeling unattractive due to the appearance of the pouch. The person sharing their experience has been living with an ileostomy since 2008 and feels less attractive partly because of limited attention from their spouse and partly because of how the pouch looks when they are shirtless. They used to enjoy going shirtless in hot weather before surgery but now always wear a shirt to cover the appliance. After getting back in shape post-surgery, they miss the freedom of going shirt-free at the beach and are curious if others feel the same and how they cope with these feelings.

Here are some helpful insights and advice shared by others:

1. Clothing and everyday concealment:
- Use wraps, thin support belts, high-waisted undergarments, tight sleeveless undershirts, high-waisted beach shorts, tankinis, tank tops, or 1950s-style high-waisted bikinis to help flatten or hide the pouch.
- Pair a snug undershirt alone or under a loose outer shirt; if noticed, most people will assume it is just a bandage.
- A long-sleeved or short-sleeved surf/rash shirt over swim trunks can keep the pouch secure in the water.

2. Specialty ostomy wear:
- OstomySecrets.com offers wraps and undergarments, though they can be pricey.
- Stealthbelt provides ostomy belts in various colors and patterns, which are often reimbursable by insurance.
- Custom options include having a seamstress sew a “suspender-style” harness for men who want to go topless or using crotchless or elasticated support belts in bed.
- Austin Medical Products offers a small patch for BCIR patients to cover the stoma site.

3. Budget tips:
- Walmart offers low-cost shirts and undergarments, making it affordable to replace them in case of leaks.

4. Surgical alternative (BCIR – Barnett Continent Intestinal Reservoir):
- This is an internal continent ileostomy with no external pouch, only a small stoma that is catheterized 3–4 times daily.
- It provides "total freedom" to wear bikinis or any clothing, exercise, and avoid adhesive problems.
- The procedure is performed by Dr. Rehnke at Palms of Pasadena Hospital in St. Petersburg, FL, and at Lutheran Medical Center in St. Louis, MO.

5. Perspective and psychological strategies:
- Humor and playfulness with a partner can help maintain confidence, as partners usually focus on the person, not the pouch.
- Many people feel more attractive after weight loss and improved health post-surgery.
- Self-criticism is often harsher than how others perceive you; most people rarely notice the appliance.
- Focus on living life fully—clothing covers a lot, and modern appliances are smaller than ever.
- Meeting new people, such as through speed-dating, can help rebuild self-esteem; disclose the pouch later once rapport exists.
- Recognize that everyone ages; creativity in clothing and a positive attitude matter more than perfection.

6. Advocacy to manufacturers:
- Users suggest that companies like Coloplast, Hollister, and Convatec offer pouches in new colors, fabrics, or patterns, such as gradients or designer prints, to boost user confidence.