Best Stoma Placement for Permanent Ostomy?

Where is the best place to get a permanent ostomy?

I had an ostomy nurse mark the spots for ili or col before surgery. She looked for a spot where there were no folds or creases. For me, it was just above the belt line. You want a smooth spot so the flange can attach without any possible causes of leaks.

I agree with xnine. My soma nurse talked me through the options and marked the spot I preferred, before going for surgery. I suppose my decision was based on the sort of clothes I was wearing at the time, but as times and preferences change, so does the preferred spot. Sometimes I think I got it wrong but at least it was my decision and I therefore have to live with it without blaming anyone other than myself.

In other words, I feel there is no right or wrong answer to this question. 

Best wishes

Bill

The nurse suggested placing the stoma far enough from the incision to allow it to heal easily without being covered by the ostomy skin barrier. (Surgeons don't like taking suggestions from nurses!) But, if the skin barrier does cover part of the incision, as mine did, it will heal fine.

I would also suggest placing the stoma on the flattest part of your abdomen. If you have folds and valleys, use moldable rings to even the skin surface prior to placing on the skin barrier. Mine is to the right of the belly button below the waist; I need to use rings under a convex skin barrier and it is working great.

I would not suggest a stoma above the waist or belt line. You want the stool to collect in the bottom part of the bag, not be divided and lump over the top of the waist.

You may need to adjust some of your clothing choices a bit regardless of the placement.

So I guess that's the question. Does it work better above the belt or below? My natural belt line rides right in the middle of my ostomy now and my underwear band rides just under the flange behind the bag. I'm thinking I should see if my surgeon can lower my stoma an inch when I go under the knife for hopefully the second last time and I'll hike up my pants so they just cover the top of the flange.

My nurse marked the perfect spot before surgery and then the doc placed it about an inch higher. The problem now is that it's right on my waistline where all of my pants snap or button shut! I'm still in yoga pants right now (1 month post-op), so I'm going to have to figure out what to do when I start wearing street clothes again!

Yeah, that's kinda where I am, wearing PJs all the time because it's hard to get comfy with this ostomy!

The best place to get a permanent ostomy is in the hospital. These back-street ostomy surgeons just don't work out well.

I've had a colostomy since 2013, and I was done 2 inches to the left of my navel. Unfortunately, I developed a parastomal hernia, and as of now, my stoma has become my new navel since it pushed it to the far right; go figure. I am literally a "front crapper," hahahaha.

It works fine for me because I irrigate and sit right in front of the toilet. I'm not sure if I want it moved when I go for hernia surgery.

Definitely under the belt line! I just don't understand why it would be any other place! That way, the natural waistline of your pants is on the top side of the pouch/flange, which hides the pouch because it's a natural line! Mine is about 3 inches under my "pants waistline" which puts the top of the pouch just slightly grazing above my underwear. Many folks are totally surprised that I have a pouch because it is so unnoticeable! Definitely have the ostomy nurse mark the spot!

Good luck

If you have a chance to consult with a wound care nurse prior to surgery, you and the nurse can discuss the placement and test the placement prior to surgery. I used a pouch and wore it for a day or so to see how things felt. If the surgery is an emergency one, the surgeon on call decides and it could be great or not so great. The wound care nurse in my support group shared that many times, problems occur because of the placement of the stoma. If the placement was better and stoma stuck out 1", issues would be more manageable. LH

Where is the best place to get a permanent ostomy? I would say "the armpit" - easy to hide, not near your belt line, easy to see in the mirror, some people already shave there.... I tried for that, but didn't go over very well!

I have an urostomy right in my belt line and thinking of getting it moved. Where do you think I should move it to?

My thought is right above the belt line if this makes sense.

I have had my ileostomy for over 50 years, and I don't know if it was by chance or great planning that the doctor placed it about two inches right of the scar and about two inches below my waist. The flange is almost in line with my misshapen belly button. I was only 15 at the time, but I was blown up with about 50 lbs of fluid retention from all the steroids I was on. I also was wearing a back brace, which had to be altered to let the pouch through. But when I was finished with the back brace (about a year later) I was very pleased with the placement. I believe that sometimes colostomy stomas are higher, near the waistline, because that's where the larger intestine naturally falls. I don't think they like to "pull" or rearrange the placement to find the "perfect" place for optimal management. Back in the "olden days," we didn't have ostomy nurses to consult with patients and doctors. I was fine until my first and second pregnancies, when my abdomen stretched out some and then didn't go back. I also gained some weight through the years, and the texture and firmness of my abdomen changed, which affected the type of flange I wore. No longer did I have the flat firm belly of a 15-year-old. But the convex, moldable flange (Convatec) has been working relatively well. I've asked surgeons about moving the stoma, but in my case, there is no undamaged skin/area left. He recommended that I just cope with it until it gets unmanageable. It's not so easy to "just move" it, and it often results in a hernia or difficulty healing. That was about 10 years ago, and I'm still coping. Best of luck to the rest of you...

I hope this helps... Marsha

I too agree that if it is at all possible below the belt line. I've heard some folks having small issues with the safety belt when in the car, but there can be "home made" fixes for that.

The main thing is how much colon you have left to attach to where your stomach wall is strongest, as well as being sure all will work correctly.

LOL Clearly from Idaho :). Me too and still expecting to wake up in 2016!

Thanks for all the comments. The nurse picked the best place for optimal performance and lasting ability for the flange. It turned out to be an inch lower than before and on the opposite side. So I guess I'm happy with that. Just gotta get these wounds healed up and it's back to work!