An ostomy pouch, or appliance, is worn externally to collect waste after a surgical procedure creates a stoma, an opening in the abdomen. While modern pouches are waterproof and designed to be worn during a shower, some individuals choose to remove the system temporarily. Showering without the pouch allows the peristomal skin—the skin surrounding the stoma—to breathe and facilitates a more thorough cleaning of this often-covered area. This practice requires careful timing and preparation to ensure a smooth and clean experience, but water will not enter the stoma.
Identifying Low Output Times
The most opportune time to shower without an ostomy pouch is when the stoma is least active, minimizing the risk of unexpected output. For most people, this period aligns with the digestive system’s natural downtime, typically first thing in the morning before any food or drink has been consumed. After a meal, digestive activity increases, and output will begin as the chyme moves through the intestine. Ileostomies, which have continuous, liquid output, are most predictable before breakfast. Colostomies, which typically have firmer, more formed output, offer greater predictability and longer quiet periods, often in the early morning or late evening. Tracking your personal digestive cycle is the most reliable method for determining the optimal window. Establishing a consistent schedule based on your unique output patterns will significantly improve the experience.
Essential Preparation Steps
Before removing the pouch, it is important to gather all necessary supplies and arrange the environment to allow for a quick and sanitary change afterward. The new pouching system, including the skin barrier and collection pouch, must be cut to size and placed within easy reach of the shower area. Having towels, wipes, and any skin prep products organized nearby prevents the need to search for items while the stoma is exposed. The existing pouch must be completely emptied just before removal to reduce the likelihood of immediate output during the shower. Some people find it helpful to limit fluid intake for about an hour immediately preceding the planned shower time. This brief restriction can help temporarily decrease the volume of potential liquid output. The bathroom should be comfortably warm, which prevents chilling.
The Shower Process and Stoma Care
Rinsing and Cleansing
When showering without the pouch, use lukewarm water, as extremely hot water can irritate the peristomal skin or cause the stoma tissue to swell. Allow the water to flow gently over the area; a strong stream is unnecessary. The stoma is made of mucosal tissue and is not sensitive to pain, so gentle contact is not a concern. Cleaning the stoma and the surrounding peristomal area requires a careful choice of cleanser. Use only mild, unscented, and residue-free soap, or simply use water alone. Avoid soaps containing moisturizers, oils, or strong perfumes, as these ingredients leave a film that interferes with the adhesive of the new skin barrier. Gently wash the stoma and skin using a soft cloth or your hand, taking care not to scrub the delicate skin.
Drying and Reapplication
The most critical step after the shower is ensuring the peristomal skin is completely dry before applying the new barrier. Residual moisture will compromise the adhesion of the pouching system, leading to a poor seal and potential skin irritation. Pat the area dry thoroughly with a soft, clean towel. To ensure all moisture is evaporated from the skin surface, use a hairdryer on a low, cool setting. This step is vital because even minor residual dampness can prevent the adhesive from bonding correctly. Once the skin is completely dry, the new skin barrier can be immediately applied to secure the system and protect the delicate area. This immediate application ensures the best possible seal and prevents early leakage.