Yes, no, maybe. There’s a song in there somewhere! In truth, and the one real truth of this article, is that everyone is different. I know, shocking, right? Just like with how your inflammatory bowel disease (IBD) or chronic illness affects you, the treatments that work for you, and the foods you can tolerate… It’s all about you. There are songs everywhere today!

It’s important to understand that lying on your stoma should not cause any pain. If it does, that may be worth investigating with your team. Not all stomas are created equal. Some are long, some are short, some are flat, and some even recess (go inwards). Some are wider than others, where the opening (where the output comes out) can differ, and the type, such as ileostomy, colostomy, or urostomy, and the placement of it, all play a part in how it feels and functions.

For many of us, the hurdle isn’t actually physical; it’s mental. When I was first recovering from the surgeries that led to my J-pouch, I remember the sheer terror of moving “wrong.” During those early stoma days, bags were awful, and leaks were a very real and regular occurrence!

Beyond the bedroom: massages, treatments, and relaxation

When we talk about lying on our front, we often default to sleep. But there are so many other reasons you might want or need to be in that position. Maybe you’re booked in for a much-needed massage, a cupping session, or acupuncture. Perhaps you just find that lying prone (on your belly) for ten minutes helps relieve your back pain or helps you feel grounded.

If you’ve spent years living with a condition like ulcerative colitis (UC) or Crohn’s disease, you’ve likely spent a lot of time protecting your abdomen. When you finally have a stoma, the idea of putting your full body weight onto it can feel counterintuitive. We worry about “squashing” the stoma, causing a leak, or stopping the output from flowing.

The mental barrier of “the squish”

If your nervous system is screaming that you are in danger because you’re putting pressure on your bag, you won’t be able to relax into that massage or find relief for your back. This state of high alert keeps your body in a “fight or flight” response, which we know makes it harder for your system to regulate its immunity and keep inflammation in check. Learning that it’s safe to lie on your front is as much about calming your mind as it is about the physical act itself. Your stoma is a sturdy muscle, and it’s remarkably resilient. It is designed to move and contract.

Practical hacks for lying prone

The Empty Bag Rule: Always empty your bag right before lying down. A flat bag has much more room to handle the pressure than one that is even partially full.

The “Hole” Technique: If you’re at a massage therapist or acupuncturist, let them know about your stoma. They can often use bolsters or towels to create a small “nest” or gap around your bag so it isn’t taking the direct pressure of your weight.

Ask about pregnancy supports: Most massage therapists and clinics have specialised pillows, props, or methods designed for pregnant people, which may be more suitable for ostomates.

Time it with your output: If you have an eating schedule or have had your stoma long enough to potentially predict when it’s less active, simply book your treatments for those quieter windows

The pillow bridge: If you’re at home, placing a pillow under your chest and another under your hips can create a natural “bridge” for your stoma to sit in without feeling compressed against the floor or mattress. You can also use a pregnancy pillow to stop you rolling completely flat on your abdomen.

Support Wear: Some people find that a snug support belt or ostomy wrap helps keep the bag in one place, preventing it from folding or shifting uncomfortably while you’re lying down.

Reclaiming your comfort

Revisiting how you move and position yourself is a huge part of recovery. It’s about taking back a sense of control when it feels like chronic illness has stolen it. If you try lying on your front and it feels pinchy or uncomfortable, listen to your body and shift. You don’t have to force anything.

But if the only thing stopping you is the fear of a leak, it might be worth a “test run” at home with a few pillows. Being able to relax fully is a biological necessity for healing, and if lying on your front is what helps you get there, it’s worth exploring.

The “no-hack” reality

While all these tips are helpful when you are first starting out, I want to reassure you that they might not even be necessary. Personally, I go for treatments all the time and I have never had an issue lying on my stomach just like a “normal” person!

Once you are healed and you have found a bag system that you trust, you’ll likely find that the stoma just does its thing. You don’t always need a fortress of pillows or special equipment to exist in a prone position. It is simply about getting over that initial mental “ugh” and realizing your body is tougher than you give it credit for.

Reclaiming your comfort is a huge part of the journey. Whether you’re on a massage table or just stretching out on the carpet to ease a sore back, you deserve to feel safe in your skin.

Have you ever been brave enough to lie on your front for a treatment? Or are you still in the “terrified of the squish” phase?