Changing your ostomy pouch can be simple and painless if you follow these four steps.

Perhaps the biggest adjustment after ostomy surgery is learning when and how to change your ostomy pouch. Before leaving the hospital, your ostomy nurse will provide pointers on removing and adhering a new pouch. You’ll likely need some time to adjust to your new normal, but this process can become a simple part of your weekly routine.

After intestinal surgery, it’s your pouch’s job to catch fecal matter. When the pouch is about a third full, you drain it and seal it up again. Though durable, ostomy pouching systems must be switched out periodically to ensure your skin stays healthy and your pouch is free of leaks. 

Ostomy pouches can be changed every three to seven days. Waiting longer than a week is not advised. A 2007 study found that the average wear time of a pouch was four days. A good rule of thumb is to put on a new wafer and pouch when the skin under the wafer begins to itch and burn. 

The best time to change the pouch is in the morning when the stoma is usually less active. However, that could change if you ate a large meal the night before. To make sure most of the fecal matter is out, walk around a bit before changing so you empty your intestines. Then it’s time to start changing your pouch.

Step One: Set Up Your Supplies

Before you begin, gather all the supplies you’ll need in one place so you can reach them easily as you change the pouch. Your supplies will include the new bag and skin wafer or one-piece pouch system, a stoma measuring tool, scissors or an x-acto knife to cut a new stoma opening, and stomadhesive paste. Some pouching systems come with a moldable skin barrier that molds to the stoma and doesn’t need to be cut. Either way, you may need to adjust the opening as your stoma size changes over time. To absorb any fecal waste that drains out while changing, wrap a paper towel or gauze pad around the stoma, or have a cup nearby to catch any output.

Step Two: Measure Your Stoma

Because your stoma size changes over time, especially in the weeks immediately following surgery, you’ll need to regularly measure the stoma. Some pouching systems come with a moldable skin barrier that molds to the stoma and doesn’t need to be cut. Whichever one you choose, a right-sized skin barrier will prevent leaks and skin irritation as the stoma shrinks or enlarges.

Step Three: Remove the Pouch and Wafer

Gently push the skin in around the stoma to make it easier to remove the wafer. This causes less skin irritation. You can also use specially-made adhesive remover wipes to help slip off the wafer. Then, clean the area with a gentle soap. Don’t be alarmed if there is slight bleeding — this is normal. Check for any skin irritation and discoloration as you thoroughly dry the skin. Discard the old pouch.

Step Four: Attach the New Wafer and Pouch

Apply the stomadhesive paste around the wafer opening to fill any gaps in the skin around the stoma. To ensure a smooth fit against the skin, lean backward slightly before you attach the new wafer, making sure the opening fits snugly over the stoma. If you use a two-part pouching system with a wafer and pouch, snap on the pouch. Lastly, close the pouch with a clip or velcro strips.

Although you may receive a set of supplies in the hospital, you can experiment and try different pouch systems. There are many to choose from, and with the help of an ostomy nurse, you can pick the one that works best for you. 

Schedule a consultation today to learn more about ostomy care and find out if an ileostomy or colostomy is right for you.