Caring For An Ostomy Bag

If you are new to having an ostomy, caring for it may seem a little scary. If your child is new to having an ostomy, that may feel even scarier. Learning how to take care of an ostomy bag, or pouch, can help put your mind at ease.

Adult ostomy bag care

You will want to talk to your care team about choosing your ostomy bag, or pouching system. There are 2 main types of pouches:^1,2

• 1-piece systems that have the skin barrier and pouch together
• 2-piece systems where the skin barrier and pouch are separate

The skin barrier is important because the waste from an ostomy still contains digestive enzymes. These enzymes break food down in the digestive system. The enzymes can cause skin irritation. This is why you need a barrier between your skin and the pouch.^1,2

There are many types of pouches and skin barriers. Your care team can help you find the best and most affordable system for your needs.

Some skin barriers need to be cut to fit your stoma. Some are pre-sized and cut. There are many types of pouches. Some empty at the bottom, while others have to be removed to be emptied. There are pouches that block odors. Some are clear while others are opaque, or less see-through.^1,2

You will want to empty your pouch when it is about one-third to one-half full. This usually means you will empty it about 3 times a day. This will keep your pouch from getting too bulky and visible under your clothes. This will also keep pressure off the seals, which will help prevent leaks.^3,4

To empty your pouch:^3,4

• First, wash your hands. You may want to wear gloves if you have them available.
• If your pouch opens at the bottom, you will need to stand or sit near a toilet and hold the pouch near the bottom. You will unclamp the pouch and drain the pouch into the toilet.
• After the pouch is drained, you will wipe the bottom of the pouch or rinse it. This step will depend on the type of pouch you have.
• Take a moment to check the pouch to make sure there are no leaks or tears.
• If your pouch is in good shape, you can close and clamp it again.

To change your pouch:^3,4

• Know how often to change your pouch. This is usually every 3 to 7 days, depending on your pouch.
• Wash your hands and wear gloves.
• Gently remove the pouch and barrier. You may want to use water or adhesive remover to help with this process.
• Wash and dry the skin around the stoma. You will want to use a gentle cleanser that is free of dyes and perfumes.
• Using a faceplate or pouch with a correctly sized opening. It should be one-eighth of an inch larger than the stoma. If it is any larger or smaller it can allow waste to leak and cause skin irritation.
• Apply a skin barrier that is right for the pouch system you have.
• Firmly but gently press the pouch into the stoma and hold it there for about 30 seconds. This will help the pouch to seal to the skin.
• Dispose of the old pouch properly.
• Dispose your gloves and wash your hands.

Infant ostomy bag care

Caring for an infant ostomy bag is similar to taking care of an adult ostomy bag. Infants and preemies tend to have skin that is more sensitive than adult skin. Infant ostomy bags also tend to fill with gas as well as stool. You will need to consider this when deciding when to empty your infant’s ostomy bag.

Before your infant leaves the hospital, ask your nurse to show you how to empty and change the ostomy bag. This will help you know what to do when you get home.^5-7

To empty your infant’s pouch:⁶

• First, wash your hands. You may want to wear gloves if you have them available.
• If your infant’s pouch opens at the bottom, you will want to hold them near a toilet or a basin and hold the pouch near the bottom. You will unclamp the pouch and drain the pouch into the toilet or basin.
• After the pouch is drained, you will wipe the bottom of the pouch or rinse it. This step will depend on the type of pouch you have.
• Take a moment to check the pouch to make sure there are no leaks or tears.
• If your infant’s pouch is in good shape, you can close and clamp it again.

To change your infant’s pouch:^5,7

• Know how often to change your infant’s pouch. This is usually every 1 to 2 days depending on their pouch. You will want to do this when your infant’s stoma is less active. This is usually in the morning.
• Wash your hands and wear gloves.
• Gently remove the pouch and barrier. You will not use adhesive remover to help with this process. Adhesive remover can hurt a baby’s skin, especially if they are a preemie.
• Wash and dry the skin around the stoma. You will want to use a gentle cleanser that is free of dyes and perfumes.
• Using a faceplate or pouch with a correctly sized opening. It should be one-eighth of an inch larger than the stoma. If it is any larger or smaller it can allow waste to leak and cause skin irritation.
• Apply a skin barrier that is right for the pouch system you have.
• Firmly but gently press the pouch into the stoma and hold it there for about 30 seconds. This will help the pouch to seal to the skin.
• Dispose of the old pouch properly.
• Dispose your gloves and wash your hands.

Your healthcare team is your best resource if you have any questions or concerns. They can help you find the best pouch and barrier system for you or your infant. Do not be afraid to let them know if you have any questions or concerns. Let them know if you feel something may be wrong. If your team cannot answer your question, they should be able to direct you to specialists who can help.