One-Piece vs. Two-Piece Ostomy Systems: An In-Depth Look! 

I was 35 when I had my ileostomy, I am now 70. How things have changed, we are very lucky with appliances now. But I am still alive and kicking.

I have had an ileostomy bag for over 50 years. I started with awful washable black bags which needed glue to be attached to the skin and a belt to keep them on. As I have far from flat skin due to operation complications, stopping leaks was always a problem. Switching to thin disposable one piece bags was a major advance although for a while they were opaque which was not so easy and then they introduced hard plastic flanges which again caused leakage. I have now used plain, thin plastic bags almost without problem for the last 20 years or so, changing them twice a week (Wednesday and Saturday so I don't forget) although if my social or travel life doesn't fit in, I can adjust this quite easily. Don't be tempted to keep a bag on if you suspect a leak. Inflamed skin can be very difficult to heal so, if in doubt, change the bag. To allow the stoma to expand and shrink without a problem, I don't fit the bag too tightly but put a small amount of Karaya paste round the stoma to act as an extra seal and to protect the most vulnerable bit of skin. Wind remains a bit of a problem as the "valve" in the bags vary in effectiveness and sometimes I think I need the toilet urgently and it turns out to be just air. I have successfully travelled around the world (India, China, Egypt, West Indies, New Zealand and elswhere) so don't let a bag stop you getting out and about.

I started with the two piece system 9 months ago but recently purchased 10 one-piece systems to save money and try them out. While initially pleased with how slim and light they were, they seem to fail/ leak after two or three days, while my 2 piece will usually go 6 or 7 days. I thank you too, Eric for sharing. I don't feel so ' all alone ' in this now.

So I watched one ostomy video and now my recommended is filled with them and I'm shocked by the number of people who have this and they are also so young! I didn't even know it existed, it makes me so anxious I want to cry. You guys are so strong.

As a nursing student this was very helpful to see!! Thank you for your lovely channel :)

God bless our UK NHS System where everything to do with stoma supplies is free. Never have to think about cost when choosing what type of appliance to wear.

I just got my first colostomy 15 days ago, after living with Crohn’s for over 30 years. I’ve tried both, but I haven’t decided on 1 or 2 piece systems yet. You’re video brought up many points that I hadn’t even considered yet, so thank you so much! Looking forward to watching more of your videos.

I prefer two piece, I find it protects the stoma so much more than a one piece. Thanks for breaking it down! Also with a one piece your clothing is pressing right against the stoma.

Great video, I been having an ileostomy for over 10 years and gotta say that the 2 piece for me didn’t work and always had accidents. Now with the one piece, it’s a lot more easier with no accidents and I don’t mind changing them every 2-3 days.

Two piece are better to me. Being able to release gas from the two piece is handy bc it makes you not have to undo the bottom of the bag. I was sent home with the one piece but then got samples of the two piece sent to me to try out. But honestly it does come down to preference

I'm so blessed I only need this bag for 3 to 5 months! I feel for the people who need it for a lifetime. Or years

Hey Eric, I am a urostomate from 2 months ago and up till now have been doing a lot of trial and error. I have found your videos to be incredibly useful as you review different products and accessories. I was released from the hospital here in Tampa with a 2 piece Hollister New Image pouch with a mechanical seal. So far it has been the most successful for me. Thanks so much for the time and courage to prepare these videos!

7 years for me. I hate 2 piece systems, too fiddly. As you age you need to take into account arthritic hands which causes its own set of problems ie: snapping those 2 piece systems together. I prefer 1, shallow convex Mio. I also use Salts Aloe rings, much less harsh on the skin. I’m also very lucky I’m an Aussie and my supplies cost nothing.

Great video. I prefer a 1 piece and had used the Convatec moldable with a barrier ring from Hollister. I loved the feel of the 1 piece but had a leak at least once per week. I now wear the Hollister 2 piece with a moldable wafer and a barrier ring and a bag with no filter. I now only change my appliance on Wednesday and Saturday mornings and leaks are a thing of the past. I thought the only way to "burp" was at the bottom and now I will try opening the flange. I have fat fingers and Ankylosing spondylitis so the moldable products are the best for me. Keep up the great work.

Thank you so much for this information! I will be having my surgery on the 18th of this month. I'm honestly scared to death, cry daily and I can't get over the fact that this thing will be on my tummy, let alone I have to poo out of a hole there. I just am so depressed and scared, worried about insurance being it's basically the Obama care and insurance, and I still don't know if I will be approved for disability. If I get disability, I'm hoping that insurance will cover it. Seems everyone I've listened to on line, or met has had countless accidents where the bag bursting while sleeping, or they are out to eat and the bag leaks or fills and burst. Everyone is saying the nurse or nurses will make you think it's all easy, you all are not sugar coating this situation. I've been told it will burst, there will be accidents that's out of my control for a bit till I get to a bathroom. Anyway, I'm just beside myself...I pray I get thru this!! Again, thank you for all the information, and I will definitely be choosing the two peice. Or, like you have both. I hope the hospital gives me enough for when I go home and untill I order!

Thank-you so much for breaking all of this down in simple terms. I've had my ostomy for 4 years now and never understood why some people used one piece systems. On a slightly separate note, I just wanted to say thank-you for being an ostomate youtuber. I wish there had been resources like this for me when I had first gotten mine done and I am glad that there now is. :)

Thank you. He is an RN in a hospital MedSurg hi I’m constantly teaching new ostomy bag patients. One of my first suggestions as they’re getting used to everything, is to go on RU-vid and watch people who actually use these products. Let’s face it, you’ll learn more from someone who already has the experience in doing it. So thank you, I’ve added this video to one of several playlist for my future patients. Have a blessed day.

Hey Eric, thanks for making this video, I thought I was doing something wrong because the exact same thing is happening to me and I called hollister and they couldn't help me. I was using Convatec moldable before and they worked great but switched insurance and the only provided hollister, long story short I'm back to Convatec. Convatec I can keep up to 5 days without a problem.Thanks again Eric for making great informative videos.

One other thing to consider when deciding between the two is whether you have a colostomy or ileostomy. I have a colostomy and so I have less frequent, more solid output than someone with an ileostomy. So I use a one piece, closed end pouch from coloplast. Because I have output only once a day, I simply wait for that time and then remove the entire appliance. I find the adhesive with these one piece products are gentle enough for me to remove every day or every other day without damaging my skin. I’m very lucky in that regard. I’m a paraplegic, and I find it much easier to change my appliance while seated as opposed to being in bed - I get a better seal. I’ve also been lucky in that I’ve had very few issues with my colostomy at all.

I am a nursing student and this was extremely helpful information. We use a two piece in our classes but it was great to hear about the various options etc. I feel a lot more knowledgeable for when I become a nurse.

I am a new ostomy patient and found this video very informative. I like the slim appeal of the one piece, and will use it on occasion, but feel the two piece system is more secure for my lifestyle and stoma output.

I did one time had to Wear a Bag because in 2006.i had one 3'th d of my Colon remove then the. Before Mother's day . I went back to the hospital and got rebuilt.

I like one piece systems. I never could get comfortable with the thought of the bag just falling off with a 2 piece. Probably more in my head but the thought bothered me. Another reason I like one piece systems is they seem like the wafer and appliance are more flexible when I move.

The Coloplast two piece with the mechanical closure has been the best for me. I like being able to see that I'm lining everything up right with the 2 piece

Thanks for sharing this , as I'm a new user of ostomy bag, was confused whats better to use, after watching your video lot of questions are answered , thanks again. One more question how often do I need to change one piece bag ??

I'm a wheelchair user and wondering whether a 2 piece might be easier for me as I could take the bag off to empty it.

I have had my ileostomy for 58 years. You cannot believe what we had to do back then! I was 21 and am now 79. I use one piece Active Life pouches. I do ok till my stoma goes in some. Mine has had to be moved to the left side because it herniated twice. I can change the appliance in less than five minutes. I have used both the clear and the opaque.

Good information! I need a convex appliance. After giving it a shot to all the ones mentioned: Coloplast, Hollister, Convatech , and the only one that has worked for me, is Marlen brand. My body, particularly my waist not flat and trim , and my stoma is flat with the skin, needing a convex one to kind of pull up the stoma(?). I use the one piece and clean it with a hand held bidet connected to the toilet(very easy to connect and through Amazon was about $27) I have found my match finally😊 for about a month it was horrible! Angry stoma! And skin burned due to leaks. With this brand, all the problems ended! it is my anatomy

Awesome video! I have Crohn's disease and I'm going in for my ileum resection surgery on the 26th of April .. less than a week away! I don't think I'll be needing an ostomy bag, BUT who knows what the future will bring. Very informative video, thank you for sharing!

Thank you for this. You answered a lot of my questions. I have been trying both 1 and 2 piece systems. My biggest issue hasn't been so much 1 vs 2 piece, but leaks due to pancaking and if I have 2 or more leaks in one day, I go through 1-piece bags which adds up in cost. Convex wafers have really helped with my leak issues. I'm 8 weeks post op and expect to be experimenting a while yet.

I am a two piece user. My stoma is flat some times and other times seems sunken in. There have been a few times when I have had to change a couple of times in one day. Silly me, I throw the bag away, not realizing that the bag is not the problem. I know better now. Most times I get at least five days out of a wafer. The times I don't are when I am sick and laying down a lot.

Great ! I would be lost if not for these videos. I like the sen sura mio convex flip. Thanks trying the new white plastic stoma rings.

WOW! thank you so much for explaining these things as I am new to this situation I now have, and I am using the two piece and as a bass guitarist and also 6 string electric guitarist having to keep the guitars from touching the stoma has been a real challenge and I like to stand when I play and not just sit on a stool, so the two piece as you described is the best protection for me. Great video thanx for posting it. You have a good teaching voice and speed that doesn't make me speed up the video.

Great video. I started with the one piece and had to change to the one with the belt due to stoma shape changes. It is extremely helpful to see the videos & listen to the facts. Thank you, God bless

great video as usual Eric , I'm using a two piece coloplast and find it great

Thanks for showing us the different options. I like using the Coloplast 2 piece with locking mechanism as it works well with the disposable liners I use.

I like Coloplast two piece closed end pouches. I use liners inside my pouches and throw them away instead of the pouch. It's super easy to place another liner in the same pouch and away I go.

My wife is has to wear an ostomy bag for 2 months, and was suggested the one-piece Hollister. One set of bags may had leakages from from defective adhesive. Two bags per day for two days had terrible consequences for her skin, which was raw. Hopefully, a home nurse corrected this situation. We were not given a choice of a two-bag system

I've heard that the bag on a 2 piece should be changed about twice as often as the wafer part but for me, I usually just change both at the same time. I've had a 2 piece last about a week but sometimes it will encounter issues much sooner like in 1 to 3 days. Since the insurance pays for most of the cost, I am not really concerned about any cost savings of 1 piece vs. 2 piece. One thing that is a little "tricky" is with the wafer in place, sometimes it is a little hard to snap the bag in place because the person I am installing it on has "rubber" for skin in her abdominal region so it just flexes when I apply pressure but I eventually get the bag on. It would be cool if the could make the wafer part clear or nearly clear (translucent) so that you could hold it up against the stoma and just trace the shape with a marker and then cut out that shape.

Hi Eric - I have an ileostomy and have suffered with leaks for the past year. Finally I found the soft convex pouch from Hollister that would give me 2-3 days without leaks. Due to a prolapsed stoma now my doctor only wants me to use a flat pouch. This has been unbearable with leaks twice a day and my skin is raw. We have tried every flat pouch available except Convatech one piece moldable. I am waiting for samples now from Convatech to see if this will be my solution. Do you have any recommendation. This has been so stressful. Thank you Eric Stephanie Weidman

Hi, may I ask what brand is reliable and durable, or what brand do you recommend? Thank you.

2 pcs.

Thank you for doing this video. My teen son will be getting a urostomy and we’re clueless and this info really was helpful. It’s was more educational and thorough than the meeting we had.

Thanks Eric. I am from hong kong. My 84~year~old has a temporary stoma since feb 7, 2020. I learnt a lot from your videos.

Thank you for your informative videos. I've had an ileostomy for 20 years and as I coloplast are discontinuing their easiflex 2 piece system I'm getting as much info as possible to pick a replacement. I'm actually excited about the Mio click system thanks to this video! Lol

I use the Coloplast 2 piece. Like you, I like the plastic as a bit of a stoma guard. My stoma sticks out a bit and the one piece just left the stoma "unprotected". I have 4 small grandchildren. So holding and playing with them I need that protection. Plus, the one piece was too difficult to put on. I've I only had an ileostomy since last June. It's a lot to learn then to navigate a one piece on top of it was too much.

I've tried all sorts but I agree with the person who pointed out that colostomies are different to ileostomies. I have an ileostomy and my output is normally pretty fluid. With a two piece and a shallow convex flange/wafer, I have pretty much eliminated leaks. I change every three days because my acidic and fluid output damages the flange. Fortunately, I live in the UK so my supplies are free - in that I feel very fortunate indeed. I wear cycle shorts with my Sensura flanges and noone has ever noticed. Good luck to all newbies - once you get used to this, your life will be so much better.

I prefer the 2 piece as it can be taken off and flushed clean of all output or easy replacement of bag only if needed ,whereas you always have leftover output in the 1 piece and can't get it totally cleaned out , also for burping the 2 piece works great and you don't need to handle the bottom of the bag getting your fingers soiled or smelly ,the 2 piece also has the belt attachment that provides a little more security against your skin ,the 2 piece also has a clip that locks across bottom of bag instead of having to roll the bottom down and squeeze output out of bottom and roll back up to attach Velcro tab .

One piece is more convenient for nurses, while two piece is more convenient for the patients. The patient’s preference is what I would go by❤

I wonder if people with an ostomy appliance can legally be banned in certain places such on amusement rides where if a bag failure could result in a biohazard such as on a "scrambler" type ride where the waste could get onto the person sitting next to you. How about a restaurant that is worried about gasses being vented?

Thank you for your quick response, I am usingColoplast SenSura Mio light convex and do get some odor leakage, any help would be appreciated. Thank you Bob.

They started me with a one piece at the hospital and I just stuck with it. Only had one problem in 10 months about springing a leak due to my own laziness. I changed it and I had a little brown water come out and instead of changing it again or emptying it I tried to go to bed. I was laying on my side and had reached my ankle to scratch. Well from the little liquid and the bending forced it out the side of the bag filling the area my supra pubic catheter has. Not a good mixture and thank God I didn't get a infection at the supra pubic catheter site.

In the UK, all supplies for the stoma are free so we don't worry about the price. So grateful.

You know i don't know if it was on this video of your but one of the best tips you gave me concerning the 2 peice Hollister system was to , on a new bag, open the bag end and pre crease the end 90 degrees, in othrrwireand open it all the way creating a new crease. That had been a great tip. Btw i have been wearing the bag for 2.5 yrs now and you and a young gal from Florida were vfery helpful in guiding this newbie, thanks

I tried a one piece Precut Convatec system and the hole was not clean through the Duramed such that the hole was actually too tight around my stoma. That resulted in a small amount of bleeding during wear. I ended up advising Convatec engineers and have changed back to a Two piece system I'm awaiting a response and hope fully they will get the hole fully to the mm size l need.

as someone who is 1 week post-op diverticulitis surgery/temp C-Bag 4 to 6 months then reverse - ...for me/it was mentally shocking / now EZ to stick to what I awoke with..and am already semi-adjusting too ( 2 pieces ) ..Ill be watching this numerous times for sure... appreciate the info .

Can you remove 2 piece convatec pouch and wash it out and reapply to the wafer, has anybody done this, new to all this thx any help would be appreciated.

Thanks Eric, but you didn't mention convex bags---- I wear a Dansac one piece convex, have tried many one piece brands, all of which have a window so you can see your stoma and also they all have belt tabs. i don't need belt tabs so they are an extra piece of plastic that gets in the way when i bend over. Also with the convex I feel that that shape gives an little but more security for my stoma. I have tried quite a few two piece bags but they have that extra bulk which i don't like. i tried the Coloplast two piece locking system but can't get it to lock - far too difficult for my hands.

I am not a guy, but I use a Hollister one piece throw away bag.

I’m a two piece Hollister 18184 because I change the bag instead of cleaning it. My output is such that it won’t drain and hard to clean so I feel cleaner changing the bag itself at least once a day or sometimes twice a day. Unfortunately Insurance only covers two boxes of ten each a month, so I have purchase with my own money. I’ve tried one piece but since I’d be changing it so much I think it would irritate my skin. I do get a lot of pancaking ugh.

I am a two-piece gal. I have had my current stoma since 2006, but prior to that I had my Colectomy in 2001, and an internal appliance fitted following a reversal operation in 2004. This actually never worked, and the internal appliance burst inside me in December 2006. I have never known pain like it, and I was in hospital over Christmas 2006/January 2007. This was no fun, especially as my daughter was only 7 years old at the time, and didn’t really understand why her mummy was poorly. I advise anyone who is thinking of going for a reversal op to think very carefully about it beforehand. I wish I had never had the reversal op - I could have died. Thank God for my husband Ken, my rock, and my dad who took early retirement and took on the job of taking my daughter to school, keeping her on weeknights, and giving me the chance to have fun times with her on weekends, when she would stay with us. At the moment I am trying to master computerised repeat prescription requests through my surgery; it’s been horrendous, but I am going to persevere with this as it is the future. I will just make sure I have a good supply of stoma baseplates and stoma bags, both one-piece and two-piece to tide me over if the system doesn’t generate the prescription for Coloplast Charter Scotland. Happy days! Just one more thing - why is it that the bag only seems to break/leak in the middle of the night? I’ve lost count of the number of times I’ve had to change my bag in the dead of night, or early in the morning; waking up with a bag of your own faecal matter having burst is no laughing matter. You have to change the bedsheets and/or pillowcases where they are soiled. Hey, ho, got to remember if I had been born in another century I would be dead now. And thank God for Mr Graham Sunderland - give the man a knighthood I say.

GM. Am new ostomer.Do you feel nauseated at times & What do u take naturally to relive the blah feeling & What foods r good during these episodes? Thank u. :(

My husband has had ulcerative colitis for 6 years and he has finally opted for the surgery to get the bag so he won't be married to the toilet anymore. I am watching as many instructional videos as I can.His belly hangs so it's going to be interesting for him to get use to it.

I'm a 2piece user..(Hollister) but I'm thinking of trying Coloplast 2 piece.....Thanks for the video..Always great information.

I us a 2 piece

Could you talk about Urostomy bags and problems.

Most one piece systems have belt tabs. Certainly Coloplast, Wellend and Hollister do. Also, you should NEVER wear a one piece for more than 3 days.

Thank you so much for this video! I am 3 months out from my ostomy surgery, and have only used a 1 piece system. I was really curious about the 2 piece! Now I know that's what I want!

Im a 2 piece but looking A ring that goes on. I guess that's called a barrier ring. But trying 2 find the right 12 fit.

Thank you for encourgement I have my 2 time colostomy bag I have wear it the rest of my life I thank God for takeing care me and I thank him for my family

Thank You! Just getting started

I'm a two piece user. I've used both Coloplast and Hollister, but like the latter more, as I can get my fingers around the rim of the connection and make sure it's firmly on there. One thing to note that you didn't mention: If you have a colostomy and irrigate, two piece products with non-adhesive couples are really the only thing that works. That way you can remove your bag, irrigate using a compatible irrigation sleeve, and then pop your bag back on.

Hey, I cannot thank you enough. your video contains most useful information and practical. I am an NP and looking for some clues with my patient who suffers with frequent leaking/burst out his colostomy bag. He's tried multiple different bags then found one piece pre-cut bag without drainable opening (closed bag) that he likes. the issue is with frequent leaking but he dislikes other types of two piece ostomy or anyother kinds. I was thinking to try with coloplast brand as it is more flexible. Do you have any recommendation for this poor guy? TIA!

25yrs iv had illiostamoy stoma i ues the one piece with velcro closure no probs at i go on holiday swimming

Thank you that was very helpful. I’m fairly new to this world and have only been using the two piece but curious about the one piece. I think I will ask convatec for a sample. I had my surgery 5 months ago. Barb

If you like the one peice, I would suggest installing a Vent, to let the out, as it fills oten.

The day I had my reversal was the best day of my life. I had the hardest time applying the bag and scared to death when I went out in public. One day I almost freaked out when I went thru three bags and none stuck.

I.wanna.thank.u.wacthing.u.help.me.in.every.way.God.bless.u.and.good.health.🙏

I am caring for my partner who just had surgery. I find connecting the 2 piece quite tricky sometimes. I generally have the outer ring with the safety catch all connected to place over the bottom section but as you say, I can’t see if the stoma is in place with the measurement of the whole.I like the 2 piece except for the bag being opaque and not transparent. Any suggestions. Thanks.

Hey Eric how have you been please let’s hear an update many people enjoy your videos

Help please! How to get through a one piece bag change without him pooing? I tried changing in the mornings, evenings, marshmallows nothing is working! help please

My husband had surgery a month ago and is now having to use a colonostomy bag. We have been using the one piece and have had to change daily. He has developed skin irritation and we are putting the powder and using the adhesive to put on the bag. I noticed you don't say anything about using that. Every day his bag is leaking. Everyone has tried to keep the bag to stay on but to no avail. We are at our wits end on what to do to be able to make the bags last 😢. He is on hospice and doesn't need the added unnecessary burden

Watcha, I had my ileostomy in 2010 and successfully used a 2 piece adhesive drainable system. With a particularly high stoma on my abdomen my selected pouch was perfect until without any market research the product was withdrawn with no suitable alternative changing my lifestyle for the worst. Why do manufacturers do this is it only for the benefit of the balance sheet at the detriment of the patient?

I was hoping you’d cover the cutting of the bags to fit the stoma. I have an inverted stoma that was a wound initially . I have only used Coloplast 2 piece that has a thick wax like wafer and a stainable bag because that’s all I know. I would like to try the one price but how would you cut it to fit your stoma?

Which one hurt the skin more?

Hello I was 35 when I had my first stoma bag and I've always used a one piece that is what I had on in hospital I have had cases where with colour blast iPad still one piece and that has just dropped off as soon as the weights coming to the bag I've also been with fitter Earth anthem one pieces of brilliant but I do not always know when the stoma is in the bag so I use the mirror to look at as well but they have told me to go over to a two piece but I'm not too sure about a two-piece cos I've never done it I've not got anyone to show me how to do it so I don't know I don't trust what I don't know I trust what I do now but thank you that was very interesting

Hi! Thanks for the video! My mother is 53 and she uses a colostomy bag located very closed to her belly button. She has to use it due to a fistula that it is not closing anymore. The problem is that we cannot find the way to keep the bag stuck on the skin more than few hours or a day as maximum. That is because the liquid filters through the body folds that she has around the belly button. We have tried everything and we are quite stressed because changing the bags is a very painful process for my mum. Could you give me some advice related to doble-piece colostomy bag please? Thank you very much. Lucrecia

I am wearing one peace will this work for me or not i am happy I found your progrqm

Конватек система лучшая я с 2010 г пользуюсь конватеком это о лучшее на сегодня всем здоровья ,

Two piece.

Hi Ive been teaching student nurses about stomas today so was revising myself and this has been very informative. Thank you 😊

Very well done video, thanks! 2 piece here!

Thanks for this wonderful information, Eric! Just got my ostomy on 8/6/24 and am at home and learning. This was very useful information, even years after it was recorded. God bless!!! ❤

i have a one peice system you say you can keep it on for 4 days bloody helli would not like to risk that i have to change mine every day i told my stoma nurse i was sore around the stoma told her i changed the bag after 3 days she said oh dear dont do that thats your problem the bag as to be changed every day so i have been changing it every morning but still sore every day even though i place a small amount of water to inside the bag i spend ages cleaning and drying my skin and use prescribed powder but still sore

Hello everyone out there, is there electric a shaver that is suited for shaving around the stoma area? Cost ? Model? Thanks a million!

Hi. I started with a one piece but am trying a two piece, today. I put a one piece on yesterday and I'm not sure I put it on right because it started leaking today. So, I'm putting on a two piece.

Intank God for you sir keep up the good work encoureing people's

Halo how are you ? Can I ask where I can get astomy bag ? My uncle always get eretasion on stomach

My brother wears a two piece put the problem is he thought away the clips that goes on the end of the bag I need to find a hollister bag that already made with it which hollister bag would you recommend

So I have had an illiostomy for about ten months now and have not experimented yet as my coloplast supplies are being supplied still the government only gives you less than $2000 a year for supples, I have a a few very messy leaks away from home which is a real learning curve and so I think if you had a one pc to carry in an emergency kit it would b the easiest to carry to save you in an emergency leak scenario away from home. I have had many leaking issues and most of them from nurses including stoma nurses in the end my husband took the job over and he has a far better outcome gotta appreciate a farm boy