A colostomy bag, also known as an ostomy pouching system, is a medical device that collects waste after a surgical procedure creates a stoma, an opening on the abdomen. This system allows bodily waste to exit when normal digestive or excretory processes are altered. Adapting to life with a colostomy bag involves learning new routines for its application and care, becoming a manageable part of daily living.
Preparing for Application
Gather all necessary supplies before applying a new colostomy pouch system:
New pouch and skin barrier
Measuring guide
Scissors
Stoma powder (if recommended)
Barrier paste or rings
Clean wipes or soft cloths for skin cleansing
Disposal bag for the used system
Peristomal skin requires attention for proper adhesion and to prevent irritation. Clean with warm water and a soft cloth, avoiding harsh soaps or alcohol-based cleansers. Pat dry; moisture compromises the adhesive seal and leads to leakage.
Accurate stoma measurement ensures a secure barrier fit. Stomas change size and shape after surgery, so re-measurement is necessary. Use a measuring guide to determine dimensions, ensuring the barrier opening fits without touching the stoma. Improper fit can lead to skin issues or leakage.
Applying the Pouch System
After stoma measurement, prepare the skin barrier. For cut-to-fit barriers, cut the opening to the measured size using small, curved scissors. Cut the opening to match the stoma’s shape, leaving about 1/8 inch (3 mm) exposed. This margin protects the stoma from irritation and surrounding skin from effluent.
Apply the skin barrier smoothly and without wrinkles to prevent leaks. Remove the protective backing from the adhesive and center the opening over the stoma. Press the barrier onto the skin, starting from the stoma and working outwards, ensuring firm contact. Body heat activates the adhesive; hold your hand over the barrier for a minute or two to enhance the seal.
For two-piece systems, the pouch attaches to the flange or ring. Listen for a click or secure connection to confirm it is locked. One-piece systems integrate the pouch with the skin barrier, adhering directly to the skin, eliminating a separate attachment step. A wrinkle-free application and proper seal are important for comfortable wear and leak prevention.
Routine Pouch Care
Regular emptying ensures comfort and discretion. Empty the pouch when one-third to one-half full to prevent it from becoming too heavy or bulging. Waiting until too full strains the adhesive seal and increases leakage risk.
To empty the pouch, position over a toilet and unclamp or unroll the tail. Allow contents to drain, squeezing if needed. After emptying, clean the pouch tail thoroughly with toilet paper or a damp wipe. This prevents odor and keeps the pouch clean for re-sealing.
The entire pouching system, including the skin barrier, needs changing every three to seven days, depending on skin condition, stoma output, and system type. More frequent changes may be needed for leakage or irritation. When changing the system, gently peel the old barrier from the skin, starting from the top and working downwards. Dispose of the used pouch and barrier in a sealed disposal bag, then in regular trash.
Daily Life with a Colostomy Bag
Living with a colostomy bag involves adapting to new routines, but it does not restrict daily activities. Clothing choices remain flexible; many styles accommodate a colostomy pouch without detection. Loose-fitting clothing or higher waistline garments provide comfort and discretion. Some opt for specialized ostomy-wear undergarments or wraps for support and concealment.
Odor management is a concern, but modern colostomy pouches use odor-barrier materials and integrated filters to neutralize gas. Regular emptying and using ostomy deodorants or drops help control smells. Dietary adjustments, like avoiding gas-producing or strong-smelling foods, also contribute to odor management.
While modern pouching systems are designed for security, occasional leaks can occur due to improper seal, stoma size changes, or increased output. A small emergency kit with a spare pouching system, wipes, and disposal bags provides peace of mind for unexpected situations. If leaks become frequent or persistent, or skin irritation develops, consult an ostomy nurse or healthcare professional for troubleshooting and advice.
Many individuals with colostomies engage in activities like swimming and exercise by ensuring their pouching system is applied securely. Consistent care and practice make managing a colostomy bag routine, enabling an active and fulfilling lifestyle.