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How to Care for an Ostomy

Dr. Punam Amin, colorectal surgeon at Baylor Medicine, describes what it is like to live with an ostomy bag.

An ostomy is a surgically created opening on your abdomen to drain stool. It is the end of the intestine that can be seen on the skin of your belly.

There are two types of ostomies: ileostomy and colostomy.

Ileostomy. An ileostomy is an opening that connects the small bowel to the skin. The stool draining from an ileostomy will be liquid.

Colostomy. A colostomy is an opening that connects the large bowel, or colon, to the skin. The stool draining from a colostomy will be pasty.

Ostomy pouch. An ostomy pouch is the bag that collects the stool draining from your ostomy.

Skin barrier. The skin barrier is the part of the ostomy pouch that sticks to your skin and protects it.

Routine Care

  • Empty your pouch when it is one-half full to prevent leakage and bulges.
  • This should be about one to three times every day.
  • Change your pouch at least once every week.
Opening and emptying an ostomy pouch. Illustration by Scott Holmes
Opening and emptying an ostomy pouch. Illustration by Scott Holmes

Emptying and Cleaning an Ostomy Pouch

  • Sit on or stand next to the toilet.
  • Hold the tail of the pouch up and remove the clamp.
  • Unfold the tail and empty the stool into the toilet.
  • Wipe the outside and inside of the tail clean or rinse out the pouch.
  • Check and replace the pouch if there are any leaks or tears.
  • Re-clamp the pouch: Place the bar of the clamp on the tail of the pouch.
  • Check that the bar is across the entire width of the pouch, close the clamp, and press until it locks.
Closing an ostomy bag. Illustration by Scott Holmes
Closing an ostomy bag. Illustration by Scott Holmes

Changing an Ostomy Pouch

Change your ostomy pouch every seven days as follows:

  • Use water or adhesive remover to gently remove the old pouch.
  • Wash and dry the skin around the ostomy.
  • Fit the new pouch: Press the side of the skin barrier with the writing against your ostomy to make a wet pattern.
  • Using scissors, cut out the opening close to the wet pattern.
  • Place the opening over the ostomy to check fit. If it is too small, you can widen the opening with your fingers.

Attach the New Pouch

Ostomy bag placement. Illustration by Scott Holmes

1. Peel off the paper backing from the skin barrier.

2. Apply a thick ring of ostomy paste around the opening.

3. After waiting one or two minutes for the paste to set, apply the skin barrier on the skin around the ostomy.

4. Next, attach the pouch, if it was separate.

5. Clamp across the full width of the tail and press until it locks.

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