How you care for your colostomy stoma and ostomy bag can vary from person to person. For example, how often you change your bag depends on your output and the type of bag you’re using.
A colostomy is a surgical opening between a part of your large intestine and your abdominal wall. If, for some reason, your stool can’t pass naturally through your rectum, a colostomy allows your bowel movements to redirect into an external bag called a “stoma.”
This article will explore general stoma care tips, including how to change and care for your ostomy bag, complications to be aware of, and answers to frequently asked questions about living with a colostomy.
A stoma is a visible opening to your colostomy site. It’s made of a mucous membrane like the inside of your mouth, so a bright red color is natural. You shouldn’t feel sensations like pain at the stoma unless the skin around the stoma has become irritated.
Bleeding isn’t unexpected from the stoma site since blood vessels are very close to the surface of this kind of tissue. Light bleeding isn’t a cause for concern, and you shouldn’t be afraid to gently clean or touch the stoma site.
Since your stoma is almost always in contact with stool, it’s important to inspect and clean the stoma regularly. Cleaning doesn’t need any special supplies, just plain tap water and a soft cloth or gauze. Soaps, cleaners, and even baby wipes contain additional substances that could irritate the stoma.
Common complications to be aware of
Common
stoma prolapse - bleeding
- inadequate blood supply and tissue loss at the stoma site
- narrowing (stricture) of the stoma
- retraction of the stoma back into the abdomen
- hernias
- dehydration
- nutritional deficiencies
There are a few types of ostomy bags. If you have a closed bag that cannot be drained, you may need to change it several times a day, depending on how quickly it fills up.
Doctors recommend emptying your bag when it’s about 1/3–1/2 full. This is because the fuller the bag is, the more weight it exerts on your skin barrier.
You can leave drainable bags on for a few days at a time. How often you change your bag depends on how well it adheres to your skin or what specific model you use. Manufacturers generally recommend changing your drainable ostomy bag at least twice a week.
Steps for changing your ostomy bag
The steps for changing your ostomy bag will depend on your specific bag type, but the following steps are typical for most models.
- Wash your hands.
- Collect your supplies for changing your ostomy bag. Changing your bag in the bathroom near a sink and toilet is helpful. Tissues or an old towel are useful for catching any drainage that may come out while you change your bag.
- Empty your bag as you usually would. Do not rinse the bag.
- Remove the pouch seal carefully, peeling away any adhesive products you used on the last application. Adhesive removers are an option with this step but might not be required depending on how long your ostomy bag has been on since the last change.
- Wash your stoma gently with water and a washrag or by stepping into the shower and cleaning with plain water.
- It’s not unusual for your stoma to bleed a little while you are changing bags and cleaning the sites, but contact your stoma nurse if you notice changes in size, color, or shape.
- Once the stoma is clean and the skin around it is dry, measure your stoma with the guide that comes with your new bag.
- You will cut a hole in the new attachment device that matches the size of your stoma. You can use the products of your choice to stick the holder to your skin. Some people use self-adhering holders, but some pastes and adhesives are available based on your preference. Do not use any lotions or oils on your skin before placing the new holder.
- Once the holder is secure, attach a fresh bag to it. Some bags stick to the holders, while others may twist and click or snap into place.
Be patient with yourself. The first few times you change your ostomy bag, there will be some trial and error. If you have sensitive skin, you may have to try a few different adhesive products until you find the right one for you.
Talk with your colostomy team if you have ongoing problems with your bag staying in place, leakage, or irritation.
What should you avoid immediately after a colostomy?
It can take some time for your adhesive to make a final seal, so bathing or swimming immediately after changing your ostomy bag is not usually recommended. Submerging your ostomy bag just after attaching it could cause it to leak or fall off.
Are there certain foods you should avoid?
Gas-producing foods can be troublesome for people with colostomies. The gas produced in the digestive tract by foods like cabbage and beans can fill your bag quickly or cause it to pop off.
You may also want to note what you ate before experiencing irritation. Highly acidic foods could change the chemistry of your output and irritate your skin. These foods could also cause changes to the volume and type of stool you make.
My bag is leaking — how can I fix this?
Bags should not leak and should be fairly odor-free. If you are experiencing leaking, check to make sure your bag is sealed to your skin properly. You may need to change your bag or use different adhesive products.
If you have ongoing issues, talk with your colostomy team about trying a different model. You can try many types of ostomy bags, as some may work better for you than others.
The skin around my stoma is irritated — what should I do?
Your adhesive products can cause skin irritation, but leaking stool and other drainage is the most common cause.
Colostomy output can be very irritating to the sensitive skin around your stoma, especially if it’s a small leak that you might not notice right away. Keeping your colostomy site clean and dry is the best way to prevent irritation.
Can I go swimming or relax in a hot tub with a stoma?
Ostomy bags are designed to be waterproof. You should be able to swim or soak if your ostomy bag is well-fitted and applied securely.
Learning to change your ostomy bag can take some time. There will be a period of trial and error with different techniques and products. Give yourself some time to develop your own routine and strategy.
You will need to change your bag several times a day or a few times each week, depending on the type of ostomy bag you have.
If you’re having trouble attaching your ostomy bag securely, talk with your colostomy care team or nurse for specific tips, tricks, or product changes.
