A question I get asked often is, “How many times should I be emptying my ostomy bag?”.
Table of Contents
Introduction
Of course, just like with other questions about what’s normal when you have an ostomy, the answer may vary for each person.
In this post, I’ll go over various factors that can influence how often an ostomy bag may need to be emptied, as well as go over when to empty it.
If you are newly out of surgery, keep in mind that things will be a little crazy and your stoma may not be as consistent or predictable as it will eventually become with time.
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When Should You Empty Your Ostomy Bag?
Most ostomy nurses, supply manufacturers, and health websites will recommend that you empty your bag when it’s between 1/3 and 1/2 full.
I happen to agree, although I often get lazy and empty my bag when it’s more than 1/2 full. I don’t recommend waiting until your bag is too full because there are plenty of reasons why this could cause problems:
- It gets heavy. The weight of a full ostomy bag is unwieldy and uncomfortable.
- It gets bulky. Full ostomy bags are hard to keep concealed.
- Leaks are more likely to happen. Really full bags can cause leaks because of pressure and tugging.
- Emptying will be more difficult. I think most will agree that emptying 1/3 of a bag full is much easier than emptying 3/4 of a bag full!
- Pouch deodorants will fail to work. There’s only so much a few drops of liquid pouch deodorants will be able to do. If you’ve got a really full bag then expect more odor from it.
- Shit bombs aren’t fun! Ever have a two-pound bag of crap detach from your two-piece appliance and hit the floor? Let’s just say that it won’t be your proudest moment.
For me, the most difficult times to empty my bag are in the middle of the night because I can’t actively check my output while I’m asleep (no kidding, right?).
There are a few strategies to consider if you find yourself with a full bag at night or in the early morning.
- Don’t eat or drink too late at night. Some people swear by the, “don’t eat after 6 pm” rule, but the results will be different from person to person and it depends a lot on your “transit time” (the time for food to pass through your entire digestive system).
- Consider setting an alarm. Some ostomates will set an alarm to ring in the middle of the night so they can empty their bag before it gets too full. The disruption of your sleeping pattern may not be desirable.
- Wear a larger bag at night or use a night drainage bag.
- Consider medication to slow down your bowel movements. This should be discussed with your doctor, but you might be able to take something that will slow bowel movements for you at night.
Size Matters
Ostomy bags come in many different sizes, from teeny-tiny stoma caps (which really aren’t meant to hold any amount of output) to large, overnight drainage bags which are designed to hold several LITRES of output.
Obviously, the smaller the bag, the more often it’ll need to be emptied.
Many “large” bags (which are about 12″ in length) can hold about 650ml of liquid, but keep in mind that’s at maximum capacity. Smaller bags measuring 7″ may only hold 400 or 500ml of output at most, so at 1/3 full you’re looking at just over 130ml of output, which isn’t much.
I usually recommend wearing the largest size that’s comfortable to manage. That means if you’re only emptying your bag once or twice a day (i.e. you have a colostomy), there’s no reason to wear a large or XL-size bag. At the same time, if you find yourself constantly needing to empty your appliance, perhaps a small or medium bag is just not enough.
Type of Ostomy
Generally speaking, the higher up on your digestive tract your stoma is, the more output you should expect.
So someone with a jejunostomy would have more output than someone with an ileostomy. Likewise, someone with an ileostomy would have more output compared to someone who has a colostomy.
If you have a “short bowel” or have had a large part of your bowel resected, then your output frequency may be higher than normal.
Why does that happen? Well, mostly because fluids get absorbed further down (like the colon), so the more you’re missing the higher the volume of fluids will be passing through your stoma. This is why someone with an ileostomy or jejunostomy will usually have liquid output and a colostomate will often have a drier stool.
Some common expectations for various types of stomas follow below.
Colostomy
If you have a colostomy and irrigate your bowels, you might not need to empty your bag for a day or two! That’s pretty convenient! But if you aren’t irrigating your bowel then you may be emptying 1-3 times a day (or however often you would have been going to the bathroom before your surgery).
Ileostomy
Most ileostomates will empty their bag 4-10 times per day, but some may need to empty more often if they have liquid output. I find myself emptying around seven or more times per day, but I also let my bag fill up past the 1/3 mark.
Urostomy
A urostomy bag may need to be drained several times a day depending on the capacity. The volume of urine collected throughout the day should be closely matted with the volume of liquids you consume. A urostomate who drinks several liters of water should expect several liters of output in a 24h span.
Info: Visit my “What is an ostomy?” page for more information about types of ostomies.
What You Eat and How Often You Eat It
“What goes in must come out” is a nice adage that perfectly illustrates this point.
If you’re a coffee drinker, you may already notice that your stoma will be more active than when you aren’t drinking coffee. This may also true for people who drink red wine or fruit juice. Consider cutting back on foods and beverages that cause excess output if it’s something that worries you.
It also goes without saying that the greater the volume of food and beverage you consume the more output you will have. This is especially true if you’re eating fibrous, plant-based foods (like I do). If you find that eating plant-based foods cause your stoma to go wild, cut back on the amounts you’re eating in a single meal to help spread things out.
Some ileostomates and colostomates may change their diet a little to include more starch-based foods (i.e. potatoes, rice, etc.) to help slow down their bowel movements. This can be used as a long-term solution, provided you’re eating healthy foods and not only potato chips.
Info: For a list of foods that may increase your output, check out THIS article.
Other Factors
Several other factors could influence how often you’re emptying your appliance.
For example, if you are on antibiotics, you may notice that your bowel frequency is increased along with a change in the consistency of your output. This is considered a normal side-effect that often resolves itself after you’ve finished taking them.
I also tend to get a huge change in the frequency and consistency of my output when I have the flu or a cold.
Some, or all of these, may cause a change in your bowel habits:
- Stress.
- Cancer treatment.
- Antibiotic use.
- Food poisoning.
- Medication or supplement side effects.
- Active disease.
- Motility disorders.
Should You Worry?
There are a few instances where I would be concerned about the frequency of my output. Of course, always talk to your stoma nurse or doctor if you have any concerns.
Emptying Too Often
If you find yourself emptying your bag far more than have been in the past, check to see if your diet has changed recently. Even small changes in our diet can influence our bowel transit time – at least in the short-term.
If it hasn’t, I would generally wait to see if things settle down after a day or two. Sometimes, frequent stoma output tends to resolve itself without me even knowing the cause.
But if bowel movements have been increased over many days or weeks, I’d schedule a Dr’s appointment to investigate this further.
Not Emptying Enough
When I notice that I’m not emptying my bag as often as I should be in relation to the amount of food I’m consuming, the first thing I’ll do is make sure I’m getting enough fluids. Dehydration can slow things down considerably.
I’ll also try to note whether I have any pain or discomfort around my stoma, which often indicates a partial blockage.
Sudden Changes
Most short changes in bowel frequency aren’t usually a cause for concern, but if you notice any unusual or sudden changes that seem to be persistent then it’s important to monitor things more closely.
Always let your doctor or stoma nurse know of sudden changes to your bowel habits as it may indicate disease activity, which is something you’ll want to be addressed quickly.
Conclusion
As you can see, there are many factors that play a role in determining how often you’ll be emptying your ostomy bag.
While there are certain things that can make it more predictable, such as the volume of food you’re eating, expect to find your new normal after several months past surgery.
Question: What type of ostomy do you have and how often do you empty your ostomy bag?
I have been using a time tracking app and find that I spend between an hour and a half to two hours a day fiddling with the pouch and i would be ‘checking’ about 4 to 6 times a day. Feel like I have developed a new kind of OCD around dealing with pancaking.
I definitely felt like I was OCD at first. I don’t fiddle as much now, although I do still try to be aware if pancaking as a precaution.
The damn thing takes over your life.
I can’t even sleep any more. Going on any holiday or even any sort of significant “outing" is out of the question.
Couldn’t even get up to the surgeon’s office and he judged me as “not trying" to get help even tho I do have a long e-mail chain with, and numerous visits to, the local hospital in the quest thereof. So of course, I have not got any “help" and am confined to home min 22 hours a day because of this out-of-control monstrosity..
“Available resources" is a joke. And don’t tell me, AGAIN, that “it will settle". It’s been a TWO year battle and not even the gas has “settled".
I battle loose output (which is actually the more manageable option) pancaking (with the GP made a whole lot worse on the assumption more fibre was the answer – followed by many stoma nurses who could not believe too much is possible and then they referred to a dietician – wash and repeat), ballooning big time (seemingly unrelated to diet), pouches not adhering, pouches smelling, pouches sticking into me, pouches interfering with all my clothing or the clothing interfering with them and making dressing a nightmare (yes I’m another shorty), pouches too large and unwieldy (by necessity to hopefully deal the massive volumes randomly produced) …. and more.
So to those posting hre – I’m with you. This is NOT the “picnic" they promise – not for a lot of us. I suspect a rather large and silenced/ignored proportion of ostomates are stuck with this or similar.
I agree you don’t need to be told it will settle and yes some resources do leave a lot to be desired. But don’t give up, on this site you will find answers and advice. Find out if you have a ostomy group near you and contact. Help is out there. Yes it’s very overwhelming but it’s possible to adjust.
nosiymina
I hear your pain. John is right this forum has been the most help to me. It helped me find for myself the bags and system that works best for me, not perfect but manageable. I sound like the Experts are stumped by yours? I guess by you saying (GP) that your in the UK and your supplies need to be approved by a stoma nurse. If that’s the case, for me I ended up tell the nurses what bags etc I wanted to try. a lot don’t work for me a lot of accessories don’t do the job but I ended up a solution thanks to Eric and the members here.
I still have bad days and episodes and a few scary moments but I’m still here.
Do you have a colostomy or ileostomy it helps to know?
Mina, I can hear the frustration in your post. Boy, do I ever identify with it! Sometimes, I have to actively restrain my right hand from smacking some medical professionals who seem to think there are easy answers! There aren’t! What I have found is that I need to discover my own answers. The best way to look for answers is to listen to other ostomates, because they have been on the same trial and error path that I am on. You are right – this isn’t the picnic that “they” seem to think it should be, but we have to find a way of making it work. What other choice is there? On a bad day, I give up, wave my white flag, and feel bad. On a good day, I say I am NOT letting that &*#£§* thing control me, and I try something new – anything. I have stumbled upon some things over the past 5 years, that mostly – not always – but mostly help. For example, I have found that I seem to be very sensitive to fibre, so I am careful about my fibre intake. But, (paradoxically) I have found that one teaspoon of Metamucil every day helps my stool to be more slippery, so it doesn’t stick to my pouch as much. I have found that using a stickie to cover up the pouch filter can help with pancaking somewhat (but not with gas). I have found that opening the pouch from the top (I wear a 2 piece) and emptying before my stool pancakes is what is the most helpful in preventing pancaking. When all else fails, I can irrigate, because I have a colostomy. None of these things were recommended by medical professionals – I either found out from other ostomates, or figured them out by trial and error. I still have lots to learn, Mina, which is why I belong to this site. I hope you will stay with us, and I hope you find some answers here. Hang in there!
Laurie
Mina,
I’m sorry you are having such a rough time. Especially if this was a choice you made to improve the quality of your life and you don’t feel like that is happening. I am almost 3 years in and still struggle with the little beast. For me, I have found that my attitude about it all makes a big difference. It took me quite a while to find what appliance works reasonably well for me. I still have problems with leaks, but they are fewer and further between.
When I can maintain my sense of humor about the whole thing, I tend to do better. I talk to Squeaky (my stoma) and believe it or not, that helps me too. His birthday is on the 18th so I will have a little party for him. I’ve actually been having a pretty hard time lately, so I’m hoping that will help a bit.
This might sound silly, but try to think of ways your life is better now than it was before. Hopefully there will be some ways. For me, I don’t really have any ways my life is better, but when they did my surgery, I would have died if I hadn’t had it, so I try to remember that and be thankful for it. It sounds like you are still grieving your loss, but when you can move forward to acceptance, things should get better. This is much easier to do when you find equipment that works well for you.
Hang in there and we are here for you if you need us!!
Very good post. Choose life with an Ostomy or death. What a blessing that medical history has found a way to deal with colon issues. There is so much good information out there. I don’t have a stoma but I help my brother with his. It is a totally life saving surgery. Doctor was surprised that the surgery was success. He called it a miracle. I am thankful everyday for the people who have survived their colon issues by this surgery. Please, try to be positive, positivity goes a long way. When your in a better mood things go much more smoothly. Try to smile and think of others in a much worse situation. You have been given a new life by doctors who chose this profession to help people like you. Blessing to all.
noiseymina…welcome to VO! You sound as frustrated as I was the 1st 3 years. Why not let us try and help you tackle your issues. Please give us a chance to guide you thru the difficulties your having. There are solutions, we just need to help you find the right ones.
First, do you have a good supportive system at home? Having even one person to help encourage you goes the mile on bad days. If not, this is why we are here and we are here for you!!
Do you have times where there is no gas or bulging bag? I found keeping a food journal helped me figure out what was causing my enormous amount of embarrassing gas & this helped also cut down on noise. For me it was bubbly Gingerale/ pop/ soda & yeast risen breads of all things & my favorite veggies broccoli & cauliflower. Giving up a few things but still having them here or there to satisfy worked well for me. I still eat them but I take Gas-X an hour before & 4 hours after then for a day or two until I know its passed thru me & there’s no more bloating. Usually within 8 hrs because my transit time is so fast. Also, I was able to replace yeast breads with crackers to avoid the gas. Have you seen the assortment of crackers out there? I enjoy trying the different kinds & testing different ones until I found the right ones for me as some did make me bloat like a hot air balloon ready for take off.
I also learned from Eric that attaching the Osto EZ Vents made letting the air out of my bag a dream compared to laying down, unrolling the end, release air, roll it up again, wash my hands & repeat which I felt was constantly! UGH!!! Buying the Vents meant I could have more free time and this meant I could leave the house comfortably releasing air where & when appropriate. I used to order them from my pharmacy but they charged 3 times what I pay now by going thru a medical supply company. A few of us have good ideas for attaching them to make it a quicker process then the company suggests. We’d love to share the process with you as it helps free up your time putting them on also . Depending on where you live, I can give you the website or phone number of the company I order my Vents from.
You mentioned that you feel having a pouch makes you stinky all the time. This could be a food you eat causing a stronger smelling output. Have you tried the M9 Liquid Deoderant drops to put in your pouch?? I use up to 22 drops or a few more until you feel your output is not as offensive to you. Hollister will send free samples of M9, different Pouches to try & they even have an Air Odour Nuetralizer in a spritz bottle for the smell after emptying a pouch. However I find the M9 Drops work great for giving only a very minimal order if any at all. Feeling like you stink is a common concern but with the M9 drops, I’m sure you’ll notice a big difference in odour. One 8 oz. bottle lasts me one month. After my surgery I found I was so much more sensitive to smell but realized too it was likely because the outout issues were now in front of me & to me, I felt they were basically in my face which made me more sensitive to smelling my output. Poop smelled before my ostomy so yes, it will stink now but there are things you can do to get around this matter when it’s in your pouch.
Clothing is a huge pain for most of us also!! I ended up giving away clothing I really enjoyed wearing & slowly adding pieces that worked better with my pouch. I learned I needed to wear pants that had an 18 inch rise from the center crotch to above my pouch by almost an inchso the waist band never moved my pouch around or rode down onto my stoma. I found some pretty tops to wear that never needed to be tucked in. These tops also helped disguise my pouch when it bulged until I could get to a place to loose the air. Some tops I found in the maternity department. It doesn’t matter where you find them just as long as you like them. I measured pants & top length & made sure they were long enough & if not I added some lace to them. I always carry a measuring tape in my purse now. If pants or a top don’t measure up I don’t even bother trying them on. Read labels & avoid materials known for shrinking like cotton & wools can.
There are all kinds of hacks & ideas we can help you with if your up to giving us a chance & tackling your issues. I also found naming my stoma helped me accept not just my situation better. Mine is named Rose but that was her 4th or 5th name. I gave her a few not so nice or polite names for a while! lol! Did you know you can ask the pouch companies to send you some samples to try untill you find a pouch that works for you the way you need it to?? There are several of us here willing to answer your questions & help you get through this hard time in your life.
I’m going to be bold here, but have you considered you may be dealing with depression? You have been through a life saving & life altering surgery & if you are depressed you need to address this also. There is no harm or embarrassment in admitting you may need a little help in this area. My hubby had pancreatic cancer & died a short 5 months after my ileostomy. He was my only true support. I eventually recognized I needed some help with depression & it was a good move on my part. Seeing your GP & getting some help in this area is not a shameful thing. If you feel your family doctor isn’t listening to you it may be time to find one who will. I appologoze for the length of this but sometimes it’s needed to guide folks ahead instead of being stopped or stalled. I hope your reading the replies here & will give us a chance to get you eventually mire confident & out of your home & onto living the new normal healthy life most of us are leading now.
If you like, feel free to start your own new forum & tell us your story & ask any questions or tell us how we can help you. This is what we are about here. We want to help you Mina, please let us try. We all have or had an ostomy or had one so we understand your frustration .
dear LK, I just had to say thank you for your honest words, I dont have a life threatening condition, I have IBS-D, it has controlled my life for over 30 years, I am waiting to speak to a doctor on the 2nd of August to see if he will refer me to a private consultant to discuss the option of ostomy surgery, this is drastic, but im not living, only existing. my husband had cancer of the bladder 5 years ago, he was extremely lucky, had his bladder removed and part of his bowel was made into a Neo bladder. ive not taken this decision lightly, my husband, daughters and parents back me 100%, I understand that its going to be hard,ive done tons of research, but its people that are willing to share their very personal experiences that make our journey slightly easier and less scary, so thank you. x
Nicky,
I support your decision 100% I, too, had IBS-D; it wasn’t life-threatening, it just didn’t allow me to have much of a life. My doctor tried several other treatments to try to help me because major surgery isn’t something you just jump in to. Like you, I did a lot of research and came to terms with the idea of even having a colostomy. I had my surgery on March 31st, which is a day I will now celebrate! I haven’t been sick AT ALL since the surgery. I thanked my doctor for improving the quality of my life. Best, best , best decision I’ve ever made regarding my health. And really, the doctor has got to know how bad you feel if you are actually asking for the surgery!
I wish you all the best, Alida and Sqiggy
They do take up a lot of time. I try to control my eating more so that I can control output more. Then there are skin issues.. In time it gets much easier, I guess; I’m supposed to get a reversal though it’s been 6 & a half months and I still haven’t.. Hope you’re doing okay!
I have an ileostomy and find it extremely difficult to stay hydrated and nourished. I literally have to empty my bag between 20 – 30 times a day. If I’m eating / drinking water, my ileostomy “burps" minutes later and can need two empties while watching a 30 minute TV show. Sometimes, I am heading back from the bathroom, and finding myself turning right back around and heading back. It is so frustrating: I feel like I spent nearly a tenth of my life going to / from toilets. and it makes work very difficult, especially in meetings that last an hour or more.
My output is always extremely liquid, probably because I drink about 16 glasses of water a day in an attempt to stay hydrated. I feel frequent thirst that never fully goes away.
I’m on my second ostomy now, as of a year and four months ago. My first one was 11 years ago but due to severe Crohn’s inflammation, it had to be relocated and now my small intestine is getting quite short.
Advice to slow this puppy down? Raw cheese seems to thicken it, as do potatoes, but those are the only two foods that help instead of make things worse.
Hi Vorpal,
Thank you for sharing your experiences. It certainly sounds like a challenge.
20-30 times a day is extremely frequent, even for an ileostomy.
Since you mentioned that have a short bowel, I suggest trying to connect with others with short bowel syndrome (SBS) to see if they have any tips on how to better manage the frequency you experience.
I also suggest speaking with your stoma nurse, surgeon, or GI doctor as medication may be a more appropriate option to slow things down.
I wish you all the best.
Not sure if this might help? as I have a colostomy.
Could it be that drinking a lot of water affect the ability of what’s left, of your intestines to absorbing the water and pass to the kidneys – what are the functionality of your bladder and kidneys?
I have always found that plain water over stimulates my system to urinate quicker than if I drink other drinks. I say that for me my drinks need some nutrients in the water, for example melon or juices do not have the same effect as water!
We have all discussed on here foods like chia seeds, linseeds supplements like mucil, slippery elm and pysillium. on this part I ask the other ileostomates to add their thoughts and experiences as its not my experience.
20 to 30 times a day is a nightmare lets see if addition to what Eric has given as good advice
you must be quite worn out by the many trips to the bathroom that does not help the kidneys function any.
@vorpal…Hi there. I have short bowel syndrome & have gone through what you are going thru. If your not diabetic, I think the reason your feeling so thirsty is that you are flushing your electrolytes right into the toilet. Cut back on drinking so much water. Sixteen cups of water a day is a bit excessive. You may be confusing your guts a little.
My first concern about your thirst is Diabetes. Have you talked to your doctor without telling him you think its your guts? I had at times drank as much as you & my output puts out just as much as I put in. When I am putting out so much fluids, is when I actually back off on drinking. Try cutting it in half. Give your system time to catch up & then also see how your thirst is.
One way to tell of your drinking to much is if your urine is yellow or on the clear side. It should be yellow. Your kidneys help wash your body & blood of toxins & into the bladder & into the toilet. Clearer meant to me that I was drinking too many fluids. Try cutting back. Your thirst may settle as well as the fluids are no longer being rushed out by more fluids.
I hope this makes sense. I tried answering earlier but had an eye issue & had to try again this A.M. When you feel thirsty like that add some V8 Juice or…& sprinkle salt in it. It helps you absorb the fluids not flush them out. Also, if your not Vegan, make a pot of tapioca pudding. It has helped slow things down for me & also helps provide a full feeling when I am putting out a lot of fluid even when I’m not drinking too much.
While your cutting back, if still thirsty try sucking a candy, tic tac, …sugar free if your diabetic.
I hope this helps. Keep in touch. Be Well!
Linda
When I get that thirsty is because my creatinine levels in my kidneys are up and I’m usually low on potassium and magnesium. I found simple truth has a bottled water is distilled with electrolytes added in as flavoring. It helps replace what I’m losing in high outputs. I’m a high output ostomate. I also drink advanced formula pedialyte.
I also was recommended by a dr to eat baked lays potato chips to help slow my ostomy and they really do work well.
Hi Vorpal
I have an Ostomy so not an expert but someone with an Illeostomy suggested isotonic (sports) drinks to me – to try and ‘retain’ more fluid. May be worth experimenting
Lil, I think you are gettiing a Loop ileostomy, I’ve read where they can be a little more trouble than a permanent ileostomy. luckily its temporary.
@dogtalkerer
Oh, you may have a point there! I will definitely ask my doctor about this. She did tell me the ileostomy is temporary until my colon is fully healed. So I remain optimistic! Thank you very much for the tip!Best,Lil Stomie
Hi Lil Stomie,
I think you will do great with an ileostomy. You have the advantage of having experienced life with an ostomy and that is the biggest part of the battle, right?
With an ileostomy, yes you will have to empty more often. You will also have to drink lots of water because it is easy to get dehydrated with an ileostomy. In my experience, I just empty my bag when I got to the bathroom to pee. I don’t have to empty my bag every time, but you can plan to do it at the same time and it won’t feel like an increased number of trips to the bathroom.
Eric and John are right. So much of it depends on what you eat and how often. You will start to get a feel for how long it takes food to go through you. Some foods, for me, go much faster than others. And different foods affect the consistency of the output in different ways.
Good luck Lil Stomie, and have a wonderful time on your girls weekend!
@squeakyandliza
Your tips are helpful–I will definitely keep in mind the tip about watching my diet and emptying the bag whenever I use the bathroom!And thank you for the well wishes! I’m keeping fingers crossed for a great weekend this year. My friends have all been pulling for me and keeping up with my progress, which helps a lot.Best,Lil Stomie
Generally speaking, the bag and wafer will be the same, however, you might find that “extended wear" wafers will handle the liquid output better and for a longer wear time. You can likely find one in the same wafer you already use without switching brands or a different product line.
As for emptying, many colostomates may empty their bag from twice a day to twice a week, while ileostomates can empty between 5-12 times a day – but…..
The amount of output will really depend on how much you drink, how much you eat, how often you eat, time past since your surgery, etc. Expect the first year to be an adjustment period, but you’ll adjust with experience.
@veganostomy
That is good to hear, that I don’t want to have to change to totally different products…I will keep that in mind about extended wear wafers, because since I switched to a two piece bag and started using a wafer as well, it has worked out great. No more leaks! I am gonna watch your diet videos on ileostomy and read the posts here! I was a vegetarian for 20 years, but in the past few years I have become a flexitarian. I sometimes go a few weeks without eating meat (I still LOVE veggie burgers and tofu), then have the odd beef burger or chicken curry.I am sure I will figure out the diet thing with the help of this site and my doctors! Fingers crossed…Thanks again!Best regards,Lil Stomie