Wearing Your Ostomy Bag Horizontally: FAQ (w/ video)

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Ever since I originally reviewed the Stealth Belt several years back, I’ve been asked questions about how I could possibly wear my ostomy bag horizontally.

Because wearing your bag on its side raises so many questions, I felt it would be best to address these concerns in a single article – this article!


How the heck do you wear your bag like that??

With a support band designed to hold the pouch sideways. I’ve reviewed several of these accessories, the most well-known being the Stealth Belt, but there are many more available that do the same (including the recently reviewed ComfortBelt).

Don’t try to wear your bag sideways without the right support as it may cause unnecessary stress to your wafer, which may lead to leaks.

I also don’t recommend using regular ostomy wraps, which are great for supporting a vertical bag, but not a horizontal one.

ComfortBelt worn front view
The ComfortBelt is comfortable and easy to put wear.
Stealth Belt Front
The Stealth Belt is a popular support band.

What about emptying your bag?

Emptying your bag will require some practice, but I find it easy and just as convenient as keeping my bag vertical; I also notice very little difference when emptying a bag full of loose output vs thicker. Removing your bag from a typical support band is actually quite quick and easy to do, and you don’t have to fumble around or anything.

Depending on how you empty your bag, you may find it more or less difficult when your pouch is sideways. Because I tend to kneel when I empty my bag, I find emptying this way to be easier.

For those who also like to rinse their bag out after emptying it, I can confidently say that you won’t have any trouble doing this.

Does it cause shorter wear time?

One would think that keeping your appliance horizontally means you’ll get shorter wear time, but this isn’t something I’ve noticed in over 2 years of doing this off and on.

When you wear your appliance vertically, your stool collects at the bottom of the bag, away from your stoma opening. But when your bag is sideways, your output has nowhere to fall down, so it does spend more time around your stoma.

If your appliance has been fitted properly, then you should not experience leaks or shorter wear time. You may feel more comfortable emptying your bag more often than when you wear it vertically, but it’s mostly going to be a matter of preference.

What about my filter? Will it clog it faster?

Yes, pretty much guaranteed.

This is perhaps the biggest reason not to wear your bag sideways – the filters will clog much faster! Since your output will be in frequent contact with your filter (since it can’t drop to the bottom of the bag), expect your filter to clog much sooner than you would normally expect.

If you wear a bag with a filter that tends to leak (for me it’s ConvaTec), then I would suggest using the filterless version of that bag.

What about “pancaking”?

Pancaking is when your stool collects near the top of your bag and around your stoma. This can be a problem even with bags worn vertically, but it can be made worse when your bag is horizontal.

For the most part, sliding your stool towards the pouch outlet will help, but unless it’s causing leaks or other appliance failures, it’s more of an annoyance than a problem.

Will it restrict flow?


If your support band is really tight, or if you have really thick output, then it may restrict flow – just like any other accessory can, including stoma guards or ostomy wraps.

If your band is the right size, and you keep it comfortably tight, then it certainly won’t be as restricting.

Also, if your output is loose/liquid, then you shouldn’t have any problems with flow.

I find that I can feel whether my output is being restricted because things tend to get “tight” around my stoma. When that happens, I use my hand to gently swipe over my appliance to move any stool off to the side (which is now the bottom of the bag)

Will it limit my clothing options?

Quite the opposite!

With my bag in the horizontal position, I find that I’m able to wear my shirt tucked into my pants without the need to use a stoma guard.

I also find that without the bag dangling down, I never have to worry about it sticking out the bottom of my shirt or getting in the way of my belt.

For more clothings tips, click HERE for a men’s guide, and HERE for my lady’s guide.

Will it cause any problem when bending?

I find it makes bending much easier because my bag no longer gets squashed between my leg and stomach.

You may also find that physical activities are easier when your bag is horizontal and properly supported.

What about during sex?

I would always suggest wearing an ostomy wrap or support belt when having sex since they can help keep your bag supported and out of the way.

If I wear my bag vertically, I nearly always have to fold it in half so it stays clear of any private parts, but this isn’t a concern when wearing my bag horizontally.

I have an entire article about sex and intimacy HERE.

I love amusement park rides, so how will wearing my bag sideways impact me?

Glad you asked! I’m a huge fan of roller coasters and flat rides, and I’ve worn my bag sideways on many rides!

I actually find this to be more ideal than wearing a stoma guard because my bag is never being crushed by harnesses or seat belts.

Obviously, I would still recommend a stoma guard if your abdomen tends to hit the ride harness often (either due to your weight or ride inexperience), so this won’t be an alternative way to protect yourself, but it’s definitely something to try once you’ve gotten used to the rides!

ComfortBelt on Leviathan Canada's Wonderland
I’ve worn support bands with my bag horizontally on the largest, fastest coasters in Canada.
For more tips on enjoying amusement park rides with an ostomy, see THIS article.

Can I wear my bag sideways with a 1pc or 2pc appliance?

Both, and there are pros and cons to each.

A one-piece appliance will have a lower profile, and I’ve found it to be easier to empty. On the downside, you can’t simply rotate it to a vertical position if you want, and I find it offers less protection to my protruding stoma.

The two-piece adds a slight bit of bulk, but I find it more convenient to use, and I have the option to rotate it as I please.

If you already have a preference for one over the other, simply continue to use it – or use both depending on the situation.

For more info and comparisons between 1pc and 2pc appliances, check out THIS article.

I already wear an appliance that can fold, so what’s the point of wearing it sideways?

Some appliances, like the Coloplast Sensura Mio, can be folded in half so it’s more compact. Doing so will allow you to tuck your shirt into your pants, and it will also make your bag less noticeable.

However, I find that folding my bag falls short in the following areas, which horizontal support bands excel in:

  • It limits the capacity of my pouch when it’s in half.
  • Isn’t well supported doing activities.
  • Tends to bulge out more.
  • I find that puts too much pressure on my stoma (the fastener to keep the bag folded is right over my stoma)

Of course, using a product like the 2pc Sensura Mio will mean that you can easily rotate your bag from the vertical to horizontal position and back, so you get the best of both worlds.

I’ve got two stomas – what now?

Interestingly, the company Stealth Belt does offer a belt for ostomates with two stomas!

You can find out more on their custom belt page HERE.

double bag belt
You can get belts for double stomas from Stealth Belt.

Stealth Belt or ComfortBelt? Which is better?

I get this question so often that I published an in-depth comparison!

Check it out HERE.

Can you wear your ostomy bag across the front or only towards the side?

This is a great question that I received from a follower on my YouTube channel.

You actually CAN wear it across the front of your abdomen (I have with the ComfortBelt) however, it has a few weaknesses compared to wearing it pointing towards the side.

  • Not as easy to conceal. With the bad going across your front, you may find that it sticks out far more than when it’s pointing to the side, especially as it fills.
  • Gives you no abdominal room to use as leverage.  When I’m lifting something heavy, I tend to use my abdomen to prop whatever it is that I’m holding. This is something I can easily do when my bag is pointing towards the side, but quite risky if it’s across the front (because of the potential to “pop” the bag).
  • More likely to hit your bag on something. With your bag going across the front, I find that it’s easier for it to get smooshed unexpectedly.
  • Most support bands aren’t made for it.  While you have the option of going with a left or right-sided support belt, most are designed for to have your bag point towards your side. You could order the “wrong” belt (i.e. get a belt made for a colostomy when you have an ileostomy) and wear it across your front that way, but it won’t be as comfortable as wearing it as intended.
  • It may interfere with abdominal wounds. If you’ve had ostomy surgery recently, then you may have incision wounds down the center of your abdomen. Wearing your bag across the front may cause irritation.
  • May interfere with your range of motion. I find that bending at the stomach feels more restricted when my bag is across my stomach compared to when it’s out-of-the-way and pointing towards the side.

On a plus side, some may find it easier to empty their bag when it’s across the front, so if you have the option then give it a try!

I’m a side sleeper. Can I still wear my bag sideways and sleep on the same side?

I’m a side sleeper as well, and I don’t find it to ever be a problem – at most, the very bottom part of my outlet is being slept on, and that never causes a problem (for me).

Now, this could also depend on the length of your bag, your weight, where your stoma is placed (closer to or further from your belly button), etc. If you don’t already have a belt, you can position your bag sideways and lay on your side to see how much of it is under your body.

Have any other questions? Let me know in the comment section below, or CONTACT ME.
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1 month ago

I stumbled on this a while back but I was too chicken to try. A couple days ago I happened to put some baby oil in the top of my pouch (Hollister 2-piece) for the pancaking issues I’ve been having. A little while later I was checking to make sure everything was snapped together and I felt the sliding! I must have gotten some oil on the ring. It works so well. I wore it that way to work today. No problems moving it back and forth to empty and felt that everything stayed snapped together. And it actually helps my pancaking since my stoma started pushing out the top as well.

I’m a believer!

11 months ago

I have a temporary ileostomy and am one month in. Experiencing leaks almost daily. Sometimes going through 5 pouches in a day because the skin is broken around the stoma and the adhesive won’t stick.

Out of the all WOC nurses at the hospital and home health nurses, you have been the most helpful person through this challenging journey. Thank you so much for providing such good advice and answering all the important questions that newbies like me don’t know to ask.

Be well and keep doing what you’re doing 🙂

Last edited 11 months ago by Sue
2 months ago
Reply to  Sue

Hi I have been wearing my stoma bag vertically since my op but now I have a Stoma belt and unsure to wear bag horizontally. Trial and error m, hopefully get to you all with positive outcomes. Stay safe all and thanks everyone that shares 👍

1 year ago

Hey man! New ostomate here- 6 weeks in. I’ve been pretty gung-ho, just doing stuff and working it out with support from my stoma nurse. Recently got a stealth belt and horizontal pouch rules – sooooo much more comfortable and “natural feeling”, just feels like the spare tyre I used to have before my surgery and al the weight loss!! Haha
Thanks for your tips – I came here for tips on emptying, and what you said was awesome – I was worried about the filter, but doesn’t seem to matter that much. It’s a fraction harder to empty, but I might put the bag on at a slight downward angle.
I’m gonna try the kneeling squat technique, will be easier with a horizontal bag.
No more tucking into the the belt, no more accidentally tucking into the undies and scratching up the junk…. I’m a convert to horizontal (with stealthbelt).
Thanks for your website – my wife is vegan, I’m freegan (vegan at home but if someone else is cooking….), so I’m gonna poke around the website for diet tips… thanks for all your sharing!!

Tyler Gendron
2 years ago

Hello, I’m new to a colostomy, its temporary and hopefully will be reversed within the year. What belts do you recommend for someone who does tuck in their shirt every day and don’t want to spend a fortune on belts. Thanks!

Joe Sordi
Joe Sordi
2 years ago

I’m wondering if one could wear bag vertically. Simply do not zip the belt and allow bottom part to hang outside the belt. This gives some support for low volume exercise like golf.