Introduction
Living with a stoma means learning new self-care skills. Changing your stoma bag is the most vital skill to master. This guide will help you if you’re new to having a stoma or if you care for someone who has one. We’ll walk you through each step of the process. With practice, you’ll gain confidence in this key part of stoma care.
What is a Stoma and Why Do People Have Them?
A stoma is an opening made by surgery. It connects an organ inside your body (often your bowel) to the outside through your belly. This opening lets waste leave your body when the normal path doesn’t work anymore.
People may need a stoma due to:
- Bowel diseases (like Crohn’s disease or ulcerative colitis)
- Colon or bladder cancer
- Blocked bowels
- Birth defects
- Belly injuries
- Problems from diverticulitis
“A stoma changes how waste leaves the body,” says Dr. Sarah Chen, a colon surgeon who works with ostomy patients. “But with good care, patients can lead full, active lives. Learning to change your stoma bag well is a key part of that care.”
Types of Stoma Bags and Systems
Before we talk about how to change your bag, let’s look at the types you might use:
One-Piece Systems
These join the sticky part (that attaches to your skin) and the pouch into one unit. They’re easy to put on but you must change the whole thing each time.
Two-Piece Systems
These have a base plate that sticks to your skin and a pouch that clicks onto it. You can change the pouch without removing the base plate. This can be better for your skin since you don’t need to remove the sticky part as often.
Closed vs. Drainable Bags
- Closed bags are sealed units you throw away after use. They work well for solid waste.
- Drainable bags have an opening at the bottom you can clean and close again. You can empty these many times before you need a new one.
“Finding the right system depends on where your stoma is, what comes out of it, how well you can use your hands, and what you like,” says Emma Roberts, a nurse who has helped ostomy patients for over 15 years. “Most people try a few types before they find what works best.”
What You Need to Change a Stoma Bag
Gather these items before you start:
- New stoma bag
- Adhesive remover (spray, wipes, or liquid)
- Skin barrier wipes or spray
- Warm water
- Soft cloths or paper towels
- Scissors (if you need to cut the bag to size)
- Disposal bag
- Measuring guide (for newer stomas that might change size)
- Mirror (to see better)
- Optional items: stoma powder, barrier rings, paste, or strips
“Good prep makes changing your bag much easier,” says Janet Miller, a certified ostomy nurse. “Have everything within reach. This keeps you from having to stop halfway through, which could lead to leaks or skin problems.”
Step-by-Step Guide to Changing a Stoma Bag
Getting Ready
- Gather all supplies and put them where you can reach them easily.
- Pick the right time – try to change when your stoma is less active. For colostomies, this is often a few hours after meals.
- Find a private, comfy spot – use a clean bathroom with a mirror and good light.
- Prep your new bag – if needed, measure your stoma and cut the opening to the right size (about 1/8 inch or 3mm larger than your stoma).
Taking Off the Old Bag
- Gently peel off the old bag – start at the top and slowly work down while supporting your skin with your other hand.
- Use adhesive remover if needed to help the bag come off without hurting your skin.
- Clean the stoma and skin around it with warm water and a soft cloth. Don’t use soaps with oils or scents as they can stop the new bag from sticking well.
- Pat the area dry fully – don’t rub, as this might hurt the skin or stoma.
“How you take off the old bag really matters for skin health,” says Dr. Michael Thompson, a gut doctor who works with IBD patients. “A common mistake is pulling the sticky part off too fast or roughly. This can harm your skin over time.”
Check Your Stoma and Skin
- Look at your stoma – it should be moist and pink to red, like the inside of your mouth. Note any changes in how it looks.
- Check your skin for any signs of redness, soreness, or damage.
- Let your stoma work if it’s active before you put on the new bag. This cuts down the risk of waste getting under the seal.
Putting On the New Bag
- Apply skin barrier if you need it – this helps protect your skin and makes the bag stick better.
- If using extras like barrier rings or paste, put them around the stoma before placing the new bag.
- Peel the backing off the sticky part of the new bag.
- Center the hole over your stoma and press gently from the middle outward to stick the bag down.
- Press lightly all around the base for 30-60 seconds to make sure it’s stuck well.
- If using a two-piece system, attach the pouch to the base, making sure it clicks or locks in place.
“Think of this step as making a custom seal around your unique stoma shape,” says Lisa Chen, an ostomy nurse. “Taking your time now means more comfort and fewer leaks later.”
Finishing Up
- Make sure the outlet on drainable bags is closed tight.
- Check for wrinkles in the sticky part and smooth them out, as they could cause leaks.
- Throw away the old bag properly based on your local trash rules.
Fixing Common Problems
Leaks
Leaks are a common worry for people with stomas. They can happen because of:
- Wrong size hole for the stoma
- Poor sticking due to oils, moisture, or rough skin
- Bag left on too long
- Waste getting under the seal
“If you have leaks often, keep track of when they happen, what you were doing, and what you ate,” suggests Dr. David Park, a colon surgeon. “This can help you spot patterns and fix the problem.”
Skin Problems
Healthy skin around your stoma is key for comfort and making the bag stick well. Common causes of skin issues include:
- Contact with waste
- Reaction to the adhesive
- Taking the sticky part off too often
- Fungal infections
- Pressure or rubbing
“Don’t ignore skin problems,” warns Emma Roberts. “Fixing them early can stop small issues from turning into big ones that might need medical help.”
Dealing with Odor
Managing smell is vital for many people with stomas:
- Empty your bag often
- Use special drops or tablets made for ostomy pouches
- Make sure the seal is tight
- Think about changing your diet if some foods cause strong smells
Special Tips
Bathing and Showering
You can shower with your stoma bag on or off:
- With the bag on: Normal showers won’t loosen a well-stuck bag
- With the bag off: This lets you clean the area well, but your stoma might work when you don’t expect it
Travel Tips
When traveling with a stoma:
- Pack twice as many supplies as you think you’ll need
- Keep key supplies in your carry-on if flying
- Cut your flanges to size before your trip
- Find out about ostomy support where you’re going
Staying Active
“A stoma shouldn’t stop you from being active,” says Dr. Chen. “With the right support and gear, people with stomas can do almost all types of exercise, even swimming.” Try these tips:
- Empty your bag before exercise
- Use support bands for high-impact activities
- Drink plenty of water, especially with an ileostomy
- Be careful with heavy lifting
Creating a Routine
Making a regular routine helps make stoma care easier:
- Set a schedule for changes (usually every 2-4 days for colostomies, 1-2 days for ileostomies)
- Keep track of how long your bags usually last
- Note any patterns in leaks or skin issues
- Keep an emergency kit with supplies for sudden changes
“Getting used to life with a stoma isn’t just about the physical skills,” notes Dr. Rebecca Wong, a psychologist who helps patients adjust to chronic health issues. “Having a solid routine gives you a sense of control and makes this care feel normal.”
When to Call for Help
Contact your doctor, ostomy nurse, or stoma care nurse if you have:
- Ongoing skin problems around your stoma
- Big changes in how your stoma looks (color, size, how far it sticks out)
- Constant leaks despite using good technique
- Pain around your stoma
- Trouble managing your stoma on your own
“Regular check-ups with stoma care experts are vital, especially in the first year,” advises Janet Miller. “Even people who’ve had stomas for years benefit from meeting with pros now and then to make sure they’re using the best products for their needs.”
Frequently Asked Questions
How often should I change my stoma bag?
It depends on your type of stoma and the bag you use:
- Colostomy bags: Every 2-4 days
- Ileostomy bags: Every 1-2 days
- Urostomy bags: Every 2-3 days Change it right away if you feel discomfort, notice leaks, or smell an odd odor.
Will changing my stoma bag hurt?
No, the stoma itself has no nerves, so you won’t feel pain there during a change. But the skin around it is sensitive, so be gentle.
Can I shower with my stoma bag off?
Yes, water won’t harm or enter your stoma. Some people like to shower with the bag off to clean the area better. Just know that your stoma might be active during this time.
What should I do if my skin gets irritated around the stoma?
Use skin barrier products and check that your bag’s opening is the right size. If the problem doesn’t get better, talk to your stoma care nurse or doctor. You might need special treatment or different products.
How do I throw away used stoma bags?
First, empty the contents into the toilet. Then wrap the bag in a disposal bag or newspaper and put it in your regular trash. Don’t flush any part of the stoma bag.
Can I go swimming with a stoma?
Yes! Modern stoma bags are waterproof and made to stay in place while swimming. Try using a smaller bag or stoma cap, and check the seal carefully before getting in the water.
What foods should I avoid to reduce gas and odor?
Each person reacts differently to foods, but common gas-producing foods include beans, cabbage, onions, fizzy drinks, and beer. Keep a food diary to find what affects you.
Conclusion
Changing a stoma bag is a skill that gets easier with practice. While it’s a big change at first, with good technique and the right products, stoma care can become a simple part of your daily routine. Remember that your stoma and needs may change over time, so stay in touch with your healthcare team and keep learning about new products.
“The most important thing to remember is that you are not defined by your stoma,” says Dr. Wong. “With good care, a stoma is just one part of your health routine, not something that limits your full and active life.”