An ostomy is a surgical opening connecting an internal organ, such as the intestine, to the surface of the abdomen. The visible part is called a stoma, and an appliance or pouching system is worn over it to collect waste. For those new to managing this change, bathing is a common concern, often driven by the fear that water might cause the appliance to fail. It is important to know that you can take a bath with an ostomy bag securely in place. Modern ostomy technology is designed to fully accommodate immersion in water, allowing individuals to maintain their hygiene routines without complication.
The Simple Answer: Water and Your Ostomy Appliance
The safety of bathing relies on the specialized design and materials of the ostomy appliance. The skin barrier, also known as the wafer, is the adhesive portion that sticks directly to the skin around the stoma. This barrier is constructed from a water-resistant, hydrocolloid material engineered to maintain a secure seal even when exposed to water.
Ostomy adhesives are designed to absorb small amounts of moisture, which helps them swell slightly and create a tighter, protective seal against the skin. This construction ensures that short-term immersion, such as during a bath, will not cause the appliance to fail. The stoma itself is mucosal tissue, similar to the lining inside the mouth, and normal bath water cannot harm it. The pouch material is water-repellent and designed to dry quickly, ensuring the system’s integrity remains intact during and after the bath.
Before You Get In: Preparing the Ostomy System
While bathing is safe, a few preparatory steps ensure the system remains secure and comfortable.
Before submerging, the pouch must be completely emptied of output. This precaution prevents the bag from ballooning or creating internal pressure that could stress the adhesive seal when water pressure is applied. A full or partially full pouch is more likely to cause issues when immersed.
It is also crucial to inspect the entire perimeter of the skin barrier before getting into the tub. Gently running a finger around the edges of the wafer confirms that the adhesive is lying flat against the skin. This quick inspection ensures there are no wrinkles or lifted areas that could allow water to seep underneath, confirming the leak-proof seal is fully engaged.
A decision must be made whether to bathe with the entire system on or to remove the pouch entirely. Bathing without the appliance allows for a more thorough cleaning of the peristomal skin, the area immediately surrounding the stoma. If the system is removed, the stoma can safely be exposed to the bath water, but a new, dry appliance must be ready for immediate application upon exiting the tub. For those using a two-piece system, the pouch can be detached from the wafer, allowing the wafer to remain adhered to the skin.
Safe Bathing Procedures and Hygiene
The primary threat to the longevity of the ostomy appliance during a bath is heat, not water. It is advised to avoid extremely hot bath water, as excessive heat can prematurely weaken the hydrocolloid adhesive. While the polymers in the wafer soften slightly with body heat to conform to the skin, high temperatures can cause the adhesive to loosen more quickly, compromising the seal. A comfortably warm bath is the safest choice for maintaining the appliance’s adhesion.
The type of cleansing product used is a significant factor in maintaining the adhesive barrier’s performance. Soaps, body washes, and shampoos that contain heavy moisturizers, oils, or strong perfumes should be avoided. These ingredients can leave a thin, oily residue on the skin or the appliance that is detrimental to the adhesive. This residue interferes with the wafer’s ability to stick securely, potentially leading to shortened wear time and leakage.
It is best to use a mild, unscented, and non-oil-based bar soap, such as a basic white or clear variety, to wash the body. If the appliance is removed, the peristomal skin and the stoma should be gently cleansed with this mild soap and thoroughly rinsed. Products like bubble bath solutions or bath oils should be excluded from the bathwater, as their residue is a major cause of adhesive failure.
Post-Bath Routine: Ensuring Adhesion
The steps taken immediately after bathing are important for ensuring continued security. Complete and thorough drying is the single most important step, as any residual moisture on the skin or the wafer will prevent the adhesive from bonding properly.
If the appliance was worn during the bath, the pouch material and the entire barrier surface should be patted completely dry with a soft towel. The skin surrounding the appliance must also be checked for dampness. To enhance drying and improve the adhesive bond, a hairdryer on a low heat setting can be directed over the wafer for a few moments, as gentle heat helps the hydrocolloid conform more tightly to the skin.
After drying, the seal must be rechecked to confirm its security. Gently press down around the edges of the wafer for a minute or two, focusing on any areas that feel slightly lifted. If the system was removed, the skin must be entirely dry before applying the new barrier. Any skin preparation products used must also be allowed to fully dry before the new wafer is placed, ensuring a secure and long-lasting seal.