Ostomy belts are devices that wrap around the abdomen, protecting and supporting the weight of an ostomy appliance.
“An alternative way to keep your appliance in place during vigorous activity is to wear an ostomy belt. These are elastic belts that hook onto the small loops on your pouch or flange. Ostomy belts are also helpful in holding the flange snugly to the body, preserving the seal and helping prevent leakage.
You should begin walking in moderation after your surgery and do this regularly, every day after you get home. Walking stimulates the return of bowel function and will get you back on the road to regaining the muscle you lost while in hospital. Whatever sports you may have played in the past, you can enjoy them again with few exceptions. Common sense is required, of course and this mean NO heavy lifting during the weeks immediately following surgery.
Ostomates who regain previous fitness levels can and do return to a huge variety of sports and exercise like: running, biking, golf, hiking, hunting, yoga, riding, team sports, triathlon, you name it.
Ostomy belts are useful, as is taping the appliance around the edges. If you sweat a lot, you should check your flange periodically, you might need to change if a game is ongoing and you feel the appliance slipping.”1
Minimal research and literature are available about ostomy belts. A basic ostomy care routine requires a skin barrier or wafer over the stoma to protect the skin, and an ostomy pouch to collect waste from the stoma.
“Ostomates have always faced numerous difficulties with respect to their medical conditions. The numerous difficulties are presented in handling drainages that exit from the body through a stoma surgically provided to the ostomate, typically in the abdominal region. Attempts are continually being made to improve ostomy appliances and remedy the various difficulties faced by ostomates. A primary problem faced by ostomates is that of undesired leakage around the containment appliance attached to the stoma location. Typically, a pouch for containing and holding the bodily drainages (i.e., human excrement, such as fecal matter or urine) is adhesively attached to the skin surrounding the stoma. Any type of relative movement between the surrounding skin area and the adhesive material will create a channel or a track through which bodily drainages will leak. Such leakages are the source of humiliation and embarrassment for the ostomate, not to mention the other problems associated with smell and damage to clothing. Thus, although many ostomates desire to enjoy an active lifestyle, the problems associated with leakage have such a tremendous downside that most ostomates have traditionally been relegated to a sedentary lifestyle. Another problem faced by ostomates relates to irritation of the skin surrounding the stoma. A primary cause of skin irritation is the downward pulling force the pouch places on the skin surrounding the stoma as the pouch fills with human elimination. As discussed above, this pulling force may also cause leaks to occur between the adhesive material and the skin, which may cause skin irritation. Still another common problem faced by ostomates is the mounding up of the skin and tissue surrounding the stoma. Although perhaps some mounding is inevitable from the stoma itself, such mounding is exacerbated when the skin and tissue are required to support the weight of the pouch containing bodily elimination.”2
One-Piece and Two-Piece Systems
Any device aside from these two basic components are accessories that may or not be necessary for patient care.
Numerous accessories appropriate for ostomate care offer diverse uses and solutions for potential requirements.
However, adding accessories to your ostomy care arsenal also adds cost, complexity and time for patients to complete their routine ostomy change. However, consider that the majority of accessories are designed to protect the peristomal skin and the stoma itself from effluent and mechanical trauma from daily wear.
These principles are part of the ostomy care, both from a clinician and manufacturers’ standpoint. Therefore, other considerations such as preserving patient dignity are valuable, as an ostomy is a life-altering procedure often affecting their body image and general sense of well-being.
Promotion of simplicity ensures the patient can easily replicate self-ostomy care, as well as contain costs, since ostomy supplies can get quite expensive over time.
Ostomy belts play a part in support
The role of ostomy belts is to add support to the pouching system, especially in the case of ostomy hernias. Ostomy belts are elastic and most are about 1 inch in width and have a variety of lengths and sizes. The longest is around 154 inches, though they can be adjusted to shorter lengths.
At either end of the elastic, the hooks allow the ostomy belt attaches to the belt tabs on the barrier or pouch, depending on the type of ostomy system.
“In view of the foregoing, a significant need exists to provide an ostomy support belt that will minimize the risk of for holding the elimination and the areas of skin to which the pouch attaches, that will support the substantial weight of the pouch as it fills with bodily drainages to avoid skin irritation, herniation, and mounding of the skin and tissue surrounding the stoma, and to protect the stoma from irritation and trauma associated with external contact.”3
Users tend to confuse belts with binders, which are much larger. Multiple bands and binders are available for improved concealment and the prevention of hernias.
Advantages of Ostomy Belts
- “Supports, stabilizes and conceals ostomy pouch. Supports the substantial weight of the pouch attached to the skin area surrounding the stoma.
- Reduces noise from the pouch
- Capable of holding the pouch in a discreet and tightly secured manner close to the ostomate’s abdomen.”4
- “Reduces the tendency of the skin and tissue at the areas surrounding the stoma to mound.
- Reduces risk of additional herniation in the abdomen at areas surrounding the stoma.
- Provides additional lateral support to the skin and tissue surrounding the stoma.
- Aids adhesion of the pouch to the skin surrounding the Stoma.
- Helps Reduce or totally eliminate leakage of the contents of the pouch.
- Reduces skin irritation.
- Eliminates any pendulum effect that may otherwise be created by the pouch.”5
Ostomy belts provide support pouching systems in various ways. Using a belt can enhance convexity of flanges, so when using a belt, you pull that convexity into the abdomen, enhancing its effects. Also, supporting and securing the weight of the stools on the pouch, patients feel safer and comfortable.
Active individuals who contort or move from side to side fear their ostomy system will lose its grip, so belts provide that sense of security. It is difficult to find belt tabs on flat one-piece-pouching systems since there is no rigidity in the coupling mechanism as in a two-piece system.
As such, the ostomy belt might distort the entire flat one-piece pouch opening, making a round hole distort into an oval shape when pulling an ostomy belt with a belt tab. One-piece convex systems with belt tabs are rarely available.
Belt tabs are located on the barrier itself or on the ostomy pouch. It is easier to change pouches when belt tabs are on the barrier in a two-piece ostomy pouching system because the ostomy belt stays attached and supports the flange without removing the belt to take off the pouch.
What an Ostomy Belt Includes
“The belt includes a stretchable band for supporting the ostomy pouch, the stretchable band being positionable substantially in register with the waist of the intended user and substantially in register with the ostomy pouch. The stretchable band defining a band lower edge and a substantially opposed band upper edge. The stretchable band further defines a pressure exerting direction extending substantially perpendicularly from the band towards the intended user. A first band reinforcement is operatively coupled to at least one of the band lower or upper edges for opposing, at least in part, a substantially circumferential elongation of the stretchable band. The stretchable band is configured, sized and provided with a band elasticity such that: the stretchable band exerts substantially no force onto the ostomy pouch in the pressure exerting direction when the ostomy pouch is substantially empty, and the stretchable band exerts a band force onto the ostomy pouch in the pressure exerting direction when the ostomy pouch is substantially filled, the band force causing an alert pressure to be exerted onto the intended user by the ostomy pouch, the alert pressure being of a magnitude sufficient for alerting the intended user that the pouch is substantially filled.”6
Correct Ostomy Belt Positioning
Correct belt positioning offers comfort and support. Belt tabs are located on the sides of pouching systems that run parallel to the ground, creating a natural plane of support around the waste. Hence, belt tabs are positioned at 3 and 9 o’clock in order to ensure proper use.
Aside from positioning, the ostomy belt cannot be too tight or snug as it can distort the pouch and cause the pouch to pop off or leak from the sides where the belt tabs are.
“The proper belt tension is important to keep the pouch secure without excess pressure. With the belt attached, you should be able to easily slide two fingers between the belt and your skin.
- The belt should be snug but not too tight, as this can cause pressure areas
- With the belt attached, you should be able to comfortably slide two fingers between the belt and your skin
- If the belt “rides up” to your natural waistline, reposition as necessary.”7
Belt adjustment and tightness varies depending on the pouching system and the tension that the ostomy belt creates. The following are some recommendations:
- Manufacturers advise placing the other end of the ostomy belt near the other belt tab before stretching around the waist to avoid the hooked side from causing an off-center position.
- If the belt is loose or tight, adjustment the belt to have the right amount of tension. To make sure the tension is correct, you should be able to comfortably stick 2 or 3 fingers underneath the belt.
- If the belt is flapping around the waist then the patient is not getting any support from the it. Wearing the ostomy belt should be in line with the belt tab itself at 3 and 9 o’clock not off-position or off-center.
- The belt should not be higher or lower than the belt tabs or it can cause a ‘pouch drag’, damaging the peristomal area with ulcerations. Ostomy belts sometimes ride up on the natural waistline during daily movements and shifts. Ensure secure and proper placement.
- Excessive tension from the ostomy belt can also cause peristomal ulcerations due to the pressure from the belt tab connections, causing erosions into the surrounding skin.
- Excessive tension may cause the belt to irritate the skin folds towards the sides or back of the patient as well. Gauzes or other soft material may be required around the ostomy belt to prevent this frictional trauma.
- Belts typically last between 2-3 months. Avoid hot water to cleanse them because it will break down the elastic as will using a dryer.
“Using a belt can help strengthen the seal between the barrier and your skin. Advantages: A belt can give added security with hard-to manage situations: irregular contours in the abdomen, frequent leakage or a stoma that doesn’t protrude from the skin.”8
The basics of accessories is maintaining the process simple and with purpose, as specialists do not recommend adding complexity to ostomy care. Belts are common accessories and its use helps patients feel confident and secure about their ostomy and body.
(1) Ostomy Handbook. http://www.ostomytoronto.ca/pdf/handbook.pdf
(2, 3, 5) OSTOMY SUPPORT BELT. Millman. https://patentimages.storage.googleapis.com/0d/39/d9/1f35ea68592462/US5653701.pdf
(4) StomaSafe Classic. Ostomy Support Belt. https://tytex.de/Admin/Public/Download.aspx?file=Files%2FFiles%2FPDF%2FOstomy+and+hernia%2Fprint_corsinel_stomasafe-classic-belt_5000_en.pdf
(6) Ostomy belt. https://patents.google.com/patent/US20060047256A1/en
(7) Adapt an Ostomy Belt. https://www.hollister.com/~/media/files/pdfs%E2%80%93for%E2%80%93download/ostomy%E2%80%93care/hol_os_adapt%E2%80%93ostomy%E2%80%93belt%E2%80%93care%E2%80%93tips_na_923062-1117.pdf
(8) Ostomy Accessory Products https://www.coloplast.us/Global/US/Ostomy/Professional/Wellness%20Articles/Accessories.pdf