Putting on an ostomy bag involves preparing your supplies, cleaning the skin around your stoma, cutting the wafer to fit, and pressing the pouch firmly into place. The whole process takes about 10 to 15 minutes once you get comfortable with it, and most people change their bag every three to seven days.
Whether you’re learning for the first time after surgery or helping a family member, the steps below walk through everything from gathering supplies to sealing the pouch securely.
Gather Your Supplies First
Having everything within arm’s reach before you start prevents you from scrambling mid-change with an exposed stoma. Here’s what you’ll need:
- A new pouch (either a one-piece system or a two-piece system with a separate wafer)
- Scissors for cutting the wafer opening
- A measuring card and pen to size the opening to your stoma
- Wet and dry paper towels or a clean towel
- Skin barrier ring or paste to fill in uneven skin and prevent leaks
- Skin wipes for cleaning
- Stoma powder if your skin is irritated
- A pouch clip or closure strips
- A disposal bag for the old pouch and debris
Measure and Cut the Wafer Opening
Getting the right fit is the single most important step for preventing leaks and protecting your skin. Use the measuring card that came with your pouching system to check your stoma’s diameter. Stomas can change size, especially in the first several weeks after surgery, so measure each time you change your bag rather than relying on memory.
Once you know the size, trace the matching circle onto the back of the wafer (the skin barrier) and cut along the line with scissors. The goal is an opening that fits right where the skin and stoma meet, with no exposed skin visible between the edge of the barrier and the base of the stoma. A gap leaves skin unprotected against output, while an opening that’s too tight can injure the stoma.
Prepare the New Pouch Before Removing the Old One
This is a detail that saves a lot of stress: get your new pouch completely ready to apply before you take off the old one. Cut the wafer, peel away the paper backing to reveal the adhesive side, and apply your barrier ring around the opening if you’re using one. With the new pouch staged and ready to go, you can remove the old pouch knowing you won’t be fumbling with scissors while your stoma is uncovered.
Using Barrier Rings and Paste
Barrier rings are flexible, moldable rings that sit around the wafer opening to fill in uneven skin surfaces and help prevent output from seeping under the adhesive. You can cut, stretch, or stack them to improve the fit. Apply the ring either to the adhesive side of the wafer or directly onto clean, dry skin around your stoma.
Ostomy paste works like caulk, filling small gaps, creases, or folds in the skin that a ring alone can’t address. If you have skin contours that create channels where output could travel, a thin bead of paste in those areas adds extra protection. Not everyone needs paste, but it’s a useful tool if you’re dealing with recurring leaks.
Remove the Old Pouch and Clean the Skin
Gently peel the old pouch away from your skin, starting from the top and supporting the skin with your other hand as you go. Place the used pouch in your disposal bag.
Use a dry paper towel first to wipe away any residue around the stoma. Then clean the surrounding skin with a wet paper towel or a plain, damp cloth. Avoid oil-based or moisturizing soaps, because the residue they leave behind can interfere with the adhesive and cause the wafer to lift prematurely. Plain water works well. If you do use soap, choose a mild, residue-free formula and rinse thoroughly.
After washing, pat the skin completely dry with a clean towel or paper towel. This step matters. Adhesive won’t stick reliably to damp skin, and even slight moisture can shorten how long your pouch stays sealed.
Apply the New Pouch
Center the prepared wafer opening directly over your stoma and press it against your skin. Start by pressing firmly along the edges closest to the stoma, then work outward toward the edges of the wafer. This sequence pushes out air bubbles and ensures the tightest seal where it matters most.
Once the wafer is in place, hold your flat palm over the entire pouch for about 30 to 60 seconds. The warmth from your hand softens the adhesive and helps it bond to your skin more quickly. Some people find it helpful to press for even longer, especially in cooler environments where the adhesive takes more time to activate.
One-Piece vs. Two-Piece Systems
With a one-piece system, the pouch and skin barrier are a single unit, so once you press the wafer down, you’re done with the main application step.
A two-piece system requires you to attach the pouch to the wafer after the wafer is on your skin. Snap the pouch onto the wafer by pressing it toward your body. You may hear a series of small clicks as the seal engages. To check that it’s secure, run your finger around the entire closure, feeling for any gaps. If you find a spot where the pouch and wafer aren’t fully connected, push the pouch inward at that point until the gap closes. Never tug the pouch downward to test the seal, as this can break the adhesive bond with your skin.
Close the Bottom of the Pouch
Most drainable pouches have an open bottom that you’ll need to seal after application. Fold the bottom of the pouch upward toward your body about three times, then secure the fold with the Velcro tabs or a pouch clip, depending on your system. A secure closure at the bottom is just as important as the seal at the top. Check that it feels snug before you get dressed.
What a Healthy Stoma Looks Like
Each time you change your pouch is a good opportunity to look at your stoma. A healthy stoma is pink or red, moist, and similar in appearance to the inside of your cheek. Some stomas lie flat against the skin while others protrude slightly. A small amount of bleeding when you clean around it is normal and not a cause for concern.
What isn’t normal: a stoma that turns dark purple or black, significant bleeding that doesn’t stop quickly, or persistent pain and swelling around the site. These can signal restricted blood flow and need prompt medical attention.
Preventing and Recognizing Leaks
Leaking is one of the most common frustrations with an ostomy pouch, and it ranges from obvious (output escaping onto your clothes) to subtle (skin irritation you only notice at your next bag change). A burning or itching sensation under the wafer, an unusual smell when the pouch is sealed, or irregular redness spreading outward from the base of the stoma are all signs that output is getting under the skin barrier.
If you notice any of these signs, change the pouch rather than waiting for your scheduled change day. Leaving a leaking pouch in place damages the surrounding skin, which makes future pouches adhere even less reliably and creates a frustrating cycle. Common causes of leaks include a wafer opening that’s too large, skin creases or folds that create channels under the barrier, and waiting too long between changes. Adjusting your wafer size, adding a barrier ring, or switching to a convex ring (which presses gently inward to improve contact on uneven skin) can often solve recurring problems.
Most people find their rhythm within a few weeks of consistent practice. The process that feels awkward and slow at first becomes second nature, and you’ll develop preferences for specific products and techniques that work best for your body.