Ostomy pouches can sometimes inflate with gas produced by the digestive system, a common issue known as “ballooning.” This happens when intestinal gas, which is normal, accumulates inside the pouch faster than it can escape or be managed. Ballooning creates discomfort and can cause the pouch to distend visibly under clothing. Increased internal pressure risks compromising the adhesive seal, which could lead to detachment or leakage. Effectively managing this pressure is a routine part of ostomy care.
Techniques for Drainable Ostomy Pouches
The most direct way to relieve pressure in a drainable pouch is by manually venting the air, often called “burping” the bag. This process requires a private space, such as a bathroom, because the escaping gas will carry an odor. To begin, unroll the drainable end of the pouch over the toilet bowl.
Securely hold the body of the pouch against your abdomen with one hand to maintain the seal. With the other hand, carefully open the clamp or closure at the bottom of the tail. Gently apply upward pressure on the pouch, starting from the top near the wafer, to encourage the trapped air to move down and out through the open tail. Once the gas has escaped, wipe any stool residue from the tail, and ensure the closure is securely fastened before leaving the private area.
Managing Air Release in Closed Pouches
Closed ostomy pouches, which are replaced rather than emptied, rely heavily on built-in technology to manage gas. Many of these pouches incorporate a carbon-activated filter, usually located near the top of the system. This filter allows gas to escape slowly and continuously while neutralizing the odor through the charcoal material. The function of these filters can become compromised if they get wet or clogged by thicker stoma output, which is a common cause of ballooning. When this occurs, the only effective solution is to replace the entire pouching system.
Using sharp objects like pins to puncture the pouch is strongly discouraged, as this destroys the odor-barrier film and creates an uncontrolled leak point, leading to infection and skin irritation. For individuals who use closed pouches without a filter or who experience frequent filter clogging, a dedicated venting device can be applied to the pouch. These small, attachable valves are manually opened to release trapped air instantly and then sealed again.
Preventative Steps to Minimize Gas Buildup
A proactive approach focused on diet and eating habits is the most effective way to reduce the frequency and severity of ballooning. Intestinal gas is primarily a byproduct of bacterial fermentation of undigested carbohydrates in the colon.
Dietary Adjustments
Common gas-producing foods include:
- Beans
- Lentils
- Onions
- Cruciferous vegetables like broccoli and cabbage
- Carbonated beverages
Eating Habits
Adjusting eating behaviors also significantly impacts the amount of air swallowed, which contributes directly to pouch gas. Swallowing air can be minimized by consciously avoiding actions such as chewing gum, drinking through straws, and talking while food is in the mouth. Chewing food thoroughly and eating meals at a slower, more deliberate pace also aids in digestion and reduces air intake.
Medical Management
Some over-the-counter products can help manage internal gas production. Medications containing simethicone work by breaking down gas bubbles in the digestive tract, which can help reduce the volume of gas reaching the pouch. Internal deodorizers, such as liquid drops added directly to the pouch or certain oral medications like chlorophyll or activated charcoal tablets, can help mitigate the odor of the gas that is produced.