Colostomy Care
Medically reviewed by Drugs.com. Last updated on Apr 6, 2025.
What is colostomy care?
Colostomy care includes how to change, empty, and clean your pouch system. Colostomy care also helps you prevent or manage problems with your stoma. You and your family will be taught colostomy care before you leave the hospital.
What do I need to know about colostomy care?
- Wash your hands before and after you do any colostomy care. Use soap and water. Dry your hands with a clean towel or paper towel. Use clean medical gloves each time you care for your colostomy.
- Check your stoma for problems each time you do colostomy care. Problems include leakage, changes in size or position, and intestine bulging into or around the stoma (hernia).
How do I prevent or manage stoma problems?
Most stoma problems happen during the first year after surgery. Your ostomy specialist may give you specific instructions. The following are common stoma problems and general management information:
- Prevent bowel movement leakage. The best way to do this is to empty the pouch often, and before it is too full. You can also thicken your bowel movements, such as with psyllium fiber. Make sure your skin is dry before you put on a new skin barrier. Lie flat on your back for a few minutes after you put the barrier on. You can also add a stoma powder and seal it in place with the barrier.
- Manage skin problems around the stoma. Problems include a rash or infection. Keep the skin around the stoma clean. Your specialist will teach you how to do this. Always apply a new skin barrier when you change the pouch. The barrier helps protect your skin to prevent irritation and other problems. You may also need to use a powder that helps prevent fungal infections.
- Manage a hernia as directed. Your specialist may recommend a hernia belt to keep the hernia from getting bigger. You may also need to change the type of pouch you use.
How do I empty my pouch?
- Wash your hands. Then put on clean medical gloves.
- Empty the pouch when it is ⅓ to ½ full and before you change the system. Do not wait until the pouch is completely full. This could put pressure on the seal and cause it to leak or spill.
- Hold the pouch up by the bottom end. If the pouch has a clamp system, remove the clamp. You may need to roll the end back to keep it from getting soiled.
- Drain the pouch. Place toilet paper into the toilet before you empty the pouch to reduce splash back. Drain the pouch by squeezing the contents into the toilet.
- Clean the end of the pouch. Use toilet paper or a moist paper towel. You may also rinse the pouch, but it is not necessary. Keep the end of the pouch clean.
- Close the end of the pouch. Unroll the end of the pouch. Replace the clamp or close the end of the pouch as directed.
- Take off your gloves. Put the gloves in the trash. Then wash your hands.
What do I need to know about changing my pouch system?
- How often you change your pouch system depends on the type you have. The type of system you use affects the amount of time it can be worn. Some pouch systems can stay in place for 3 to 7 days. Others can last 1 to 3 months, and the pouch is changed more often.
- Look at the skin around your stoma each time you change your pouch system. Your stoma should be pink or red and moist. You may have a small amount of bleeding when you clean your stoma. This is normal. Your stoma will get smaller and become its normal size in about 8 weeks.
How do I change my pouch system?
Your ostomy specialist will give you specific instructions on how to change your 1-piece or 2-piece system. The following is general information:
- Wash your hands. Then put on clean medical gloves.
- Remove the pouch. Also remove the faceplate if you use a 2-piece pouch system. Empty the pouch before you remove it. Gently remove the pouch or faceplate by pushing the skin down and away from the adhesive skin barrier with one hand. With the other hand, pull the pouch or faceplate up and away from the stoma.
- Gently clean the skin around your stoma. Use mild soap and water. Do not use soaps that have oil or perfumes. Pat your skin dry.
- Use a pouch or faceplate with the right size opening. Use a pouch or faceplate that has an opening that is ⅛ of an inch larger than your stoma. You may need to cut the opening to fit around your stoma. If the opening is too large, bowel movement can leak onto your skin and cause irritation.
- Use skin barrier products to help reduce irritation. These products can help protect your skin and keep it dry.
- Use slight pressure to place your pouch or faceplate. Center the pouch or the hole in the faceplate over the stoma. Press the pouch or faceplate firmly into place on clean, dry skin. It may be helpful to hold your hand over the new pouch or faceplate for 30 seconds. The warmth of your hand can help stick the adhesive skin barrier into place.
- Dispose of the used pouch correctly. If the pouch is disposable, place the old pouch in another plastic bag and throw it in the trash. If your pouch is reusable, talk to your healthcare provider about how to clean it.
- Take off your gloves. Put the gloves in the trash. Then wash your hands.
 |
Where can I find support and more information?
- United Ostomy Associations of America, Inc.
P.O. Box 512
Northfield , MN 55057-0512
Phone: 1- 800 - 826-0826
Web Address: http://www.ostomy.org
- Wound Ostomy and Continence Nurses Society
15000 Commerce Parkway
Mount Laurel , NJ 08054
Web Address: www.wocn.org
Call your local emergency number (911 in the US), or have someone call if:
- Your bowel movements are black or bloody.
- Your stoma is bleeding and you cannot stop the bleeding.
- You are too weak to stand up.
- You have severe abdominal pain.
When should I call my doctor or ostomy specialist?
- You have a fever.
- You have a foul odor coming from your colostomy bag or stoma that lasts longer than a week.
- Your skin around the stoma becomes red and irritated.
- You have nausea, vomiting, pain, cramping, or bloating.
- You do not have regular bowel movements through your stoma.
- The size of your stoma changes.
- You have questions or concerns about your condition or care.
Care Agreement
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.© Copyright Merative 2025 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.