The act of “burping” a colostomy bag is releasing accumulated air or gas from the pouching system to prevent a condition known as “ballooning.” When gas builds up, the pouch can inflate, causing discomfort, visible bulging under clothing, and, in severe cases, the pressure can compromise the adhesive seal and lead to leakage. Learning this simple technique ensures comfort and helps maintain the integrity of the skin barrier, making this a common and manageable part of living with a colostomy.
Why Gas Accumulates in the Pouch
Gas accumulation in the pouch, or flatulence, is a normal and expected part of digestion, occurring for two primary physiological reasons. The first source is swallowed air, which enters the digestive tract through the mouth. Activities such as chewing gum, drinking carbonated beverages, smoking, or talking while eating can significantly increase the amount of air a person swallows.
The second major contributor is the metabolic process of gut bacteria fermenting undigested food particles in the colon. These bacteria naturally produce gases like hydrogen, carbon dioxide, and methane as they break down certain carbohydrates and fibers. Because the colostomy diverts the digestive stream through the stoma, this gas is collected directly in the pouch rather than being passed rectally.
Essential Techniques for Burping the Colostomy Bag
When the pouch inflates with gas, the manual release process must be done carefully to prevent accidental stool leakage. Always find a private location, such as a restroom, and have toilet paper or a paper towel ready for hygiene and noise reduction. The technique varies depending on whether you use a drainable or closed pouch system.
Drainable Pouches
For drainable pouches, which have an opening at the bottom secured by a clamp or tail closure, gently guide the pouch contents upward, away from the tail. With the contents clear, carefully unroll or unclasp the closure just enough to create a small opening. Apply light, upward pressure to the bottom of the pouch to encourage the trapped air to escape through the opening. After the gas is released, immediately and securely close the tail mechanism, ensuring the closure is completely sealed.
Two-Piece Systems
If you use a two-piece system, which consists of a separate pouch and skin barrier, an alternative method is to slightly detach the bag from the flange at the top. Press down lightly on the skin barrier with one hand to maintain the seal against the abdomen. With the other, carefully lift the edge of the pouch away from the flange just enough for the gas to escape. This method requires precision to avoid dislodging the entire system or allowing output to leak.
Closed-End Pouches
Closed-end pouches, which are disposed of after use, are typically not burped. They are often equipped with an integrated charcoal filter that is designed to release gas automatically. If ballooning still occurs, a specialized vent can be attached to the pouch, or the entire pouch should be changed.
Dietary and Lifestyle Adjustments to Minimize Gas
Mindful changes to eating habits and diet help minimize gas. Slowing down the pace of eating is one of the most effective ways to reduce the swallowing of air. Taking smaller bites and thoroughly chewing food helps decrease the amount of air consumed, which reduces the gas that ends up in the pouch.
It is helpful to be aware of common dietary triggers that increase the bacterial production of gas within the gut. Foods well-known for contributing to gas include:
- Beans
- Broccoli
- Cabbage
- Onions
- Asparagus
Carbonated beverages, such as sodas, beer, and sparkling water, also introduce a significant amount of gas directly into the digestive system. Avoiding the use of straws and refraining from chewing gum can prevent the unconscious swallowing of air. Keeping a food journal can help identify specific items that cause excessive gas, as individual tolerance varies widely. Drinking fluids separately from meals, rather than gulping them down, can also help minimize air intake.
Managing Odor and Noise During Gas Release
Concerns about odor and noise during gas release are common, but there are simple, effective strategies to manage them. For odor control, specialized internal pouch deodorants are available, often in the form of drops or gels, which can be placed inside the empty pouch before it is sealed. These products work by neutralizing the smell of the pouch contents.
Many modern pouches also come with built-in filters, typically containing activated charcoal, which work to slowly release gas while simultaneously absorbing and neutralizing odor. For external odor management, a small air freshener spray can be used in the private area where the burping is performed. To minimize the sound of escaping gas, the process should ideally be done in a restroom, muffling the opening of the pouch with a few layers of toilet paper or a paper towel during the release.