An ostomy is a surgically created opening, called a stoma, that allows for the elimination of waste from the body into a collection pouch worn externally on the abdomen. This pouching system securely collects output when the natural route for elimination is compromised. Determining how often to drain the appliance is highly individualized, depending on various physiological and lifestyle factors. These guidelines offer practical advice for managing your ostomy, but they do not replace personalized instruction from your Ostomy Nurse or healthcare provider.
The Primary Rule for Emptying the Pouch
The primary rule for managing a drainable ostomy pouch is based on volume, not a set time schedule. The pouch should be emptied when it reaches approximately one-third (1/3) to one-half (1/2) of its capacity. This range ensures the contents are managed before the pouch becomes too heavy or distended.
Allowing the pouch to become more than half full risks the security of the seal. The weight of the collected output places mechanical stress on the adhesive barrier, potentially leading to a premature leak or detachment. An overfilled pouch also presses heavily against the abdomen, causing discomfort.
The emptying process involves positioning yourself comfortably over the toilet. The tail or spout of the pouch is unrolled and opened, directing the contents into the toilet. After draining, the tail end must be wiped clean before securely closing the clip or Velcro closure.
Factors Influencing Output Volume and Frequency
The frequency of emptying varies considerably based on the type of ostomy and daily habits. The consistency of the output relates directly to the part of the intestine used to form the stoma.
Ostomy Type
An ileostomy, formed from the small intestine, bypasses the large intestine where most water absorption occurs. This results in liquid to semi-liquid output that requires frequent emptying throughout the day. In contrast, a colostomy, formed from the large intestine, often produces semi-solid or formed stool. Because some of the colon’s water-absorbing function remains, colostomy pouches typically need to be emptied less frequently, sometimes only once or twice daily.
Diet and Hydration
Dietary choices significantly influence the speed and volume of output. Consuming large meals or high-fiber foods can quickly increase the volume of effluent. High fluid intake is linked to a more liquid output, making hydration levels a determinant of emptying frequency, especially for those with an ileostomy. Certain medications, including diuretics or specific gastrointestinal agents, can also temporarily increase the volume or liquidity of waste.
Emptying Versus Changing the Entire System
It is important to understand the distinction between emptying the pouch and changing the entire system. Emptying is the frequent, multiple-times-a-day process of draining collected waste through the tail closure whenever the pouch reaches the designated fullness level. This maintains a secure seal and comfort.
Changing the entire system involves removing the whole appliance, including the collection pouch and the adhesive skin barrier (wafer). This less frequent task is aimed at maintaining the health of the skin around the stoma. The typical replacement schedule ranges from every two to seven days, depending on the product and the condition of the peristomal skin. Regular changes allow for skin inspection and cleaning, preventing irritation and ensuring the adhesive maintains its protective function.
When Output Indicates a Medical Concern
Fluctuations in output are normal, but certain changes or the complete absence of output signal a potential medical issue requiring professional attention.
A sudden, complete cessation of output for several hours, accompanied by severe abdominal cramping, stoma swelling, nausea, or vomiting, can indicate a bowel blockage or obstruction. This occurs when undigested food or a narrowing in the bowel prevents waste from passing through the stoma.
Conversely, excessively high volume and watery output, often exceeding 1500 milliliters per day, can lead to high output syndrome. Symptoms include extreme thirst, dry mouth, reduced urine output, and fatigue, which are signs of rapid dehydration and electrolyte loss. Any drastic change in the effluent’s appearance, such as a large increase in blood or mucus, should prompt immediate contact with your Ostomy Nurse or healthcare provider.