You can enjoy a hot tub with a colostomy bag, provided you take a few simple precautions. The colostomy appliance, which consists of a pouch and a skin barrier or wafer, is designed to be water-resistant and withstand daily activities, including bathing and swimming. Modern ostomy systems are highly advanced, allowing for full water immersion without immediate failure. Planning is necessary to maintain the integrity of the appliance and protect the skin surrounding the stoma.
Appliance Security: Managing Adhesive and Heat
The main concern when using a hot tub is the combination of prolonged heat and moisture, which can compromise the adhesive bond. Ostomy skin barriers are typically made from hydrocolloid materials designed to absorb moisture and create a secure seal against the skin. Extended immersion in hot water, especially temperatures near or above 100°F (38°C), can cause the barrier’s edges to swell, soften, or lift prematurely. This softening accelerates the breakdown of the adhesive bond, increasing the risk of leakage or early appliance detachment.
To counteract this effect, bolster the security of the appliance before entering the hot tub. Applying specialized barrier strips or elastic tapes around the perimeter of the wafer, known as “picture-framing,” creates an additional waterproof seal. These barrier extenders are designed to flex with the skin and resist water intrusion, effectively locking the main hydrocolloid wafer in place. Wearing a snug-fitting ostomy support belt or a compression wrap helps keep the appliance flat against the body, offering mechanical security against the buoyancy of the water.
Practical Steps for Hot Tub Use
Planning your appliance change schedule is crucial for security. Change your skin barrier 12 to 24 hours before using the hot tub, allowing the adhesive sufficient time to fully cure and establish a maximum bond with the skin. Entering the water with a freshly applied wafer that has not fully set significantly increases the chance of early failure.
Before you step into the hot tub, ensure the colostomy pouch is completely emptied to minimize the volume and weight of the contents. This prevents the pouch from ballooning or creating unnecessary drag and pressure on the adhesive seal while submerged. For those with a predictable output schedule, selecting a time when the stoma is less active can also be beneficial. Some individuals who irrigate or have a very low output may opt to wear a small, closed-end mini-pouch or a stoma cap for discretion, though a standard appliance works well.
Once you exit the hot tub, immediately focus on drying the appliance. Gently towel-dry the exterior of the pouch and the skin barrier, paying close attention to the edges of the wafer where the adhesive meets the skin. If your appliance has a fabric cover, using a hair dryer on a cool or low-heat setting can help evaporate moisture quickly without damaging the adhesive. After drying, gently press down on the edges of the wafer and barrier strips to confirm the seal remains secure against your skin.
Stoma Hygiene and Infection Prevention
While the stoma lacks nerve endings, maintaining the hygiene of the peristomal skin is important when dealing with hot tub water. A properly sealed ostomy appliance provides a barrier, preventing water contact with the stoma or surrounding skin. However, poorly maintained hot tubs can harbor waterborne pathogens, such as Pseudomonas aeruginosa or Legionella, which pose a risk if the water breaches the seal.
The best defense is ensuring your appliance is fully sealed before immersion and choosing hot tubs that appear clean and have a balanced chemical odor, indicating proper sanitization. After leaving the water, the focus shifts to preventing skin irritation and fungal growth from trapped moisture. Thoroughly drying the skin around the stoma prevents the warm, damp environment from becoming a breeding ground for organisms.
If water has seeped under the edges of the wafer, change the appliance sooner than your usual schedule to prevent prolonged contact with chlorine or bacteria. Even if the seal appears intact, cleaning and drying the peristomal skin thoroughly after water immersion helps maintain its health and prevents moisture-related skin issues.