Living with a colostomy involves a surgical procedure that creates an opening, or stoma, from the large intestine to the abdominal wall, diverting waste into an external pouch. Because this pouch collects fecal matter, which naturally contains odor-causing compounds like skatole and indole, managing scent is a primary concern for users. Successfully eliminating odor is entirely possible and requires a multi-pronged approach combining specialized products, consistent maintenance routines, and dietary awareness. The goal is to ensure discretion and restore confidence in all aspects of daily life.
Immediate Odor Control Products
A variety of commercial products are specifically formulated to neutralize or contain odor molecules immediately upon waste entering the pouch. These solutions offer a first line of defense.
Internal pouch deodorants, often available as drops, gels, or tablets, are added directly into the empty pouch after each change or emptying. These products work by chemically neutralizing odor molecules or masking the scent. Some liquid versions also contain a lubricant that coats the inside of the pouch, helping contents slide out more easily during emptying.
Many ostomy pouches incorporate an odor-reducing filter, typically a patch containing activated charcoal. This charcoal material traps and neutralizes gas molecules as they are vented from the pouch, preventing the appliance from “ballooning” with air. If a pouch lacks a built-in filter, adhesive charcoal filters can be placed directly over a small puncture made on the outside of the bag.
External spray deodorizers are designed for use in the surrounding air when the pouch is being emptied or changed. Unlike standard air fresheners, medical-grade sprays are formulated to break down or neutralize airborne odor molecules. Odor-proof disposal bags are also available; these are opaque, thick plastic sacks that securely contain a used appliance or waste for discreet disposal in a regular trash receptacle.
Procedural Management Techniques
Consistent, careful management of the pouching system during routine maintenance prevents odor buildup. Waiting too long to empty the appliance allows concentrated gases and waste to accumulate, increasing the potential for strong odors.
It is recommended to empty a colostomy pouch when it is approximately one-third to one-half full. Emptying the pouch at this frequency prevents the weight of the contents from pulling on the skin barrier. A planned schedule, such as emptying before going to bed and immediately upon waking, helps maintain a manageable volume in the appliance.
During the emptying process, thoroughly clean the drainage spout, or tail, of the drainable pouch before resealing it. After draining the contents, the inside flaps and outside edge of the tailpiece should be gently wiped clean using toilet paper or a soft, dry wipe. For thicker output, squirting a small amount of water from a peri bottle into the pouch can rinse the residue toward the opening, ensuring a cleaner seal.
Used supplies, such as the entire pouching system during a change, should always be secured in an odor-proof manner before being discarded. Specialized disposal bags offer the best containment, but double-bagging the waste in sturdy, opaque plastic bags also works well. The sealed bag should be placed in the regular domestic trash; it should never be flushed down the toilet.
Dietary and Lifestyle Adjustments
The composition of colostomy output, and thus its odor, is directly influenced by the foods and beverages consumed. Certain inputs can produce volatile sulfur compounds that contribute to a more pungent smell.
Foods notoriously linked to increasing ostomy odor include:
- Sulfur-rich vegetables like onions, garlic, asparagus, broccoli, and cabbage.
- Eggs, fish, and certain spices.
Patients should monitor their diet to identify personal triggers, as sensitivity to these foods varies widely.
Conversely, some foods and supplements can help neutralize or reduce the strength of the odor. Natural internal deodorizers include parsley and spinach. Consuming buttermilk, yogurt with live active cultures, or cranberry juice may also help modify the intestinal environment. For an oral option, over-the-counter internal deodorants containing bismuth subgallate are sometimes recommended to neutralize odor-causing components within the digestive tract.
Lifestyle habits also play a role in managing gas and odor. Chewing food thoroughly and eating slowly minimizes the amount of air swallowed, reducing gas buildup in the pouch. Maintaining good hydration by drinking plenty of water helps to dilute the output, making it less concentrated and less likely to adhere to the inside of the pouch.
Addressing Leakage and Pouch Integrity
A persistent, unexplained odor often signals a compromise in the pouching system’s integrity, requiring immediate attention. A faulty seal allows minute amounts of effluent or gas to escape, creating odor and potentially irritating the skin.
The peristomal skin barrier, or wafer, must be checked regularly for signs of lifting, erosion, or wear, particularly around the edge closest to the stoma. If the seal is compromised, output may seep onto the skin. Ensuring the opening in the wafer is the correct size and shape for the stoma is crucial, as an improper fit is a leading cause of leakage.
Routine changing of the entire pouching system, even if the seal appears secure, prevents material breakdown that can lead to odor. The materials are designed to last for a specific period, typically three to seven days, before they degrade from exposure to moisture and digestive enzymes. Changing the appliance on a predictable schedule ensures the materials remain intact and the seal is robust.
Skin irritation around the stoma, known as peristomal dermatitis, should be addressed promptly, as damaged skin can be a source of odor. Using barrier rings, protective seals, and stoma powder on irritated skin can restore a smooth surface for the wafer to adhere to, ensuring a tight, odor-free seal. Any leakage or persistent odor problem should prompt a consultation with a Wound, Ostomy, and Continence (WOC) nurse to re-evaluate the appliance fit and technique.