An ostomy bag, or pouch, is an appliance worn externally to collect output from a stoma, a surgically created opening allowing waste to bypass a diseased or damaged part of the digestive or urinary system. A common issue is the buildup of gas inside the pouch, known as “ballooning.” “Burping” the bag is the procedure necessary to safely relieve the pressure and release the accumulated gas, maintaining comfort and appliance integrity.
Identifying Pouch Ballooning
Gas accumulates in the pouch from two primary sources: air swallowed during eating or drinking, and the natural production of gas by bacteria in the digestive tract. Swallowing air increases with actions like drinking carbonated beverages, chewing gum, or eating rapidly. Digestive gas production is influenced by foods such as beans, broccoli, cabbage, and certain high-fiber items. Pouch ballooning is visibly recognized by the pouch inflating like a small balloon, causing it to swell away from the body. If the gas is not released promptly, the increased internal pressure can compromise the seal, potentially leading to leakage and skin irritation.
Step-by-Step Guide for Releasing Gas
Before beginning, gather supplies like toilet paper and an odor neutralizer, and perform thorough hand hygiene. It is recommended to perform this procedure in a private, well-ventilated area, such as a bathroom, because the escaping gas will carry an odor. Never puncture the ostomy pouch with a pin or other object to release gas, as this will destroy the odor-proof and leak-proof seal.
Drainable Pouches
For drainable pouches, which have an opening at the bottom secured by a clamp or integrated closure, the process is straightforward. Hold the bottom of the pouch over a toilet and partially open the tail closure. Use your free hand to gently press the gas out by sliding your thumb and fingers from the top of the pouch down toward the opening. Once the gas has been expelled, wipe the end of the pouch clean with toilet paper and securely close the tail closure.
Two-Piece Systems
If you use a two-piece system, which consists of a separate pouch and skin barrier, the gas can be released without opening the bottom. Carefully separate the pouch from the flange by slightly lifting the top edge of the coupling. This small gap allows the gas to bubble out, and gentle pressure can be applied to the pouch to help push the air through the opening. Immediately after the gas is released, press the pouch firmly back onto the flange, ensuring the coupling is securely sealed to prevent leaks.
Preventing Excessive Gas Buildup
A proactive approach to managing gas involves mindful eating habits to reduce the volume of air swallowed. Eating slowly, chewing food completely, and avoiding talking while chewing can significantly decrease the amount of ingested air. Avoiding habits like drinking through a straw, smoking, or chewing gum also helps minimize air intake.
Dietary adjustments are an effective long-term strategy, focusing on limiting foods known to increase gas production. Common culprits include carbonated drinks, beer, beans, onions, cabbage, and broccoli. Keeping a food diary can help identify specific trigger foods.
Many ostomy pouches come with built-in charcoal filters designed to slowly vent gas while neutralizing the odor. However, these filters can become blocked by moisture or stoma output, which is the most common reason for ballooning. Using internal pouch deodorizers or taking over-the-counter anti-gas medications, such as simethicone, may also help reduce gas accumulation.