Concealing your Appliance

Question:

I am worried that people can see my ostomy appliance under my clothes. Is there any way that I can “hide” my pouch better?

Answer:

Concealment of an ostomy appliance under clothes is a common concern. There are several options that may help you to “hide” your pouch under your attire.

The style of pouch that you are currently using may be more noticeable under your clothes than other styles. The profile of a pouch, that is how far it ‘sticks out’ from your skin, varies dramatically between various pouching systems. In general, 2-piece pouching systems tend to have a higher profile (sticks out more) than a 1-piece because of the coupling mechanism used to join the pouch to the flange. The coupling mechanisms of Coloplast’s™ 2-piece Assura, Hollister’s™ Center Point Lock, or ConvaTec’s™ Autolok may all be considered to have high profiles. However, more recently, product companies have designed lower profile 2-piece systems, some actually mimicking the very low profile of a 1-piece system. Lower profile 2-piece systems include Coloplast’s™ Assura AC (Adhesive Coupling), Hollister’s™ New Image, and ConvaTec’s™ Esteem Synergy. While these newer products are available, some may not yet have a complete product line, and may not be suitable for people who require convexity, belt tabs or for those who have a urinary stoma. Check with your ET to see if any of the newer systems may be an option for you, or if switching from a 2-piece to a 1-piece system is appropriate.

Clothing choices may also help to conceal your appliance. People with ostomies often have concerns that clothing choices will be limited to pants and skirts with pleats, loose fitting dresses or tracksuits. Your choices, however, are far more extensive than that and may only be limited by your personal preferences for clothing. You may find that wearing clothes with patterns will make your pouch less visible. Wearing patterned tops/shirts loosely tucked into skirts or pants may help with concealment, as will wearing patterned skirts and pants. Your choice of whether tops or bottoms need to be patterned is dependent upon the placement of your stoma above or below the belt line. For those who have stomas above the belt line, patterned tops are best, while for those below the belt line, patterned bottoms may be helpful. Darker colors also tend to “hide” pouches better than lighter colors. Men may find that wearing pants with a higher/longer rise in the crotch will help to keep the pouch concealed below the belt line. Men may also find that suspenders, rather than tight belts, will help to make the pouch less noticeable. Women sometimes like to have the support of a light lycra pant to both support the pouch and keep it snug against the skin. Wearing multiple layers of clothes can also help to minimize the visibility of a pouch.

Swimming is often a concern, as those with ostomies feel that the pouch will be highly visible under snug bathing suits. Again, choosing a bathing suit with dark colors and/or a pattern will help to conceal the pouch. For men, wearing surfer type shorts, which tend to have a longer rise in the crotch as well as longer legs, will also help to make the pouch less visible. If you are using a drainable pouch, choosing a flatter style clip, or one of the newer style pouches with integrated clip closures (Coloplast’s™ Easi-close, Hollister’s™ Lock ‘n Roll, or ConvaTec’s™ InvisiClose) will also help to lessen visibility of your pouch. If you have a fecal stoma (ileostomy or colostomy)) and know the volume and frequency of your outputs, you may be able to use smaller pouches or stoma caps while swimming. Stoma caps have a very limited volume (1-2 ounces), so knowing the pattern of your stool function and volume will help you to decide if this is an option for you.

Those with ostomies may also desire concealment of a pouch during sexual activity. While concealment isn’t required for intercourse, some feel that covering the pouch enhances both a sense of security for the pouch, and a sense of sensuality. Crotchless underwear is a choice for both men and women, as are cummerbunds that just wrap around the waist, both options leaving genitals exposed. “Baby doll” pajama tops and camisoles for women, or tanks tops for either men or women may also help to make the pouch less visible.

Specialized clothing, swimsuits and intimacy wear is available through Weir Comfees. Catalogues and information can be obtained through their toll free number (1-866-856-5088) or through their web site at www.WeirComfees.com.

Lastly, regular emptying of your pouch is also a part of maintaining a low profile appliance. Pouches should be emptied when about 1/3rd full and gas released as soon as possible to help keep the pouch flat.


This series of ostomy care articles is authored by Jo Hoeflok, RN, BSN, MA, CETN(C), CGN(C), who is a Registered Nurse specializing in enterostomal therapy care. The information provided is not meant to replace care by or consultation with healthcare professionals.