Changing Your Ostomy Pouch

At first, changing your ostomy pouch might make you feel nervous.  This is completely normal.  With practice, you will be able to change your ostomy pouch easily and confidently.

Step One:  Gather Supplies

Make sure you have everything ready before you start.

• 2 plastic trash bags
• Warm water
• Paper towels or wash cloths
• Stoma measuring guide (usually in the skin wafer box)
• Pencil
• New appliance
• Ostomy scissors gloves (optional)
• Adhesive remover wipe (if needed)
• Ostomy powder (if needed)
• Ostomy paste (if needed)
• Makeup mirror

Place all supplies on a bathroom counter or table within easy reach.

Step Two: Remove Appliance

1. Wash your hands.
2. Empty the pouch before removing it.
3. Starting from the top, gently remove the appliance by pressing the skin away from the tape/barrier (don’t pull the tape from the skin). You may use an adhesive remover wipe if needed.
4. Place the used appliance in one trash bag, tie it shut, then put that bag in the second trash bag, and tie it shut. Throw it in the regular trash.

Step Three: Skin Care & Cleaning

1. Gently wash the stoma and the skin around it with warm water and paper towels or a washcloth. Do not use soap, as it can leave a residue that prevents the skin barrier from sticking.
2. It’s normal if the stoma bleeds a little. If the bleeding is heavy or doesn’t stop, call your doctor.
3. Pat your skin dry, or let it air dry. Cover the stoma with a moist paper towel or washcloth to keep stool or urine from touching the clean skin.
4. Check the stoma. It should be red, moist, and "perky." If it looks purple, dark, or black, or if it is dry or limp, call your doctor.
5. Look at the skin around the stoma. If there is any irritation, use ostomy powder, tap it gently with a damp finger, and let it dry. This is called “crusting.” You can repeat crusting up to 3 times if needed.

Step Four:  Measure Stoma

After surgery, your stoma will shrink for about 6-8 weeks. Measure the stoma each time you change your appliance until it reaches its final size. 

1. Using the stoma measuring guide, size the hole in the skin barrier 1/8 to 1/4 inch larger than the stoma. The skin barrier should leave a little space around the stoma when in place.
2. Cut the skin barrier to match the size and shape of your stoma. Be careful not to cut the pouch if you’re using a one-piece appliance.

Step Five:  Apply New Appliance

1. Remove the paper backing from the skin barrier. You can also remove the paper from the adhesive tape border if it’s there.
2. If you have leaking problems, apply a small ring of ostomy paste around the hole of the skin barrier (on the sticky side). Wait about 1 minute for the paste to set. Urostomy patients - do not use paste, as it melts when urine touches it.
3. Remove the paper towel or washcloth from the stoma and place the skin barrier over it. Make sure the hole is centered over the stoma. If using a two-piece appliance, attach the pouch securely.
4. Hold the appliance in place with your hand for 2-3 minutes. The heat from your hand will help the skin barrier form a strong seal.
5. If you haven’t already, remove the paper backing from the tape edges and smooth them onto your skin.
6. Double-check that the pouch is closed tightly!

Tip: For the first 30 minutes after changing your appliance, try to limit your activity to allow the skin   barrier to fully stick for better wear time

How to Empty Your Pouch

It’s important to empty your pouch when it is about 1/3 to 1/2 full. This helps prevent the pouch from pulling away from your skin or leaking.

1. Clean the opening: Wipe the opening with toilet paper to keep it clean.
2. Let out air: If the pouch is filled with gas and puffed up, let the air out. This helps prevent the pouch from popping or splitting open.
3. Odor control: If you have a problem with smell, you can use a room freshener before and after emptying your pouch.
4. No need to rinse: All pouches are odor-proof, so there is no need to rinse your pouch after emptying it. If you feel you must rinse, use cool water. Warm water can affect the pouch's odor-proof quality and might make it wear out faster.

When to Contact Your Healthcare Provider

If you have a colostomy or ileostomy, call your ostomy care nurse if you notice any of the following:

• You are changing your pouching system more often than expected
• Skin irritation and/or pain
• Leaks under your pouching system or skin barrier
• Excessive bleeding from your stoma
• Blood in your stool
• A bulge around your stoma
• Persistent diarrhea
• Diarrhea with pain or vomiting
• A stoma that seems to be getting longer

If you have a urostomy, call your ostomy care nurse if you notice:

• Any signs of a urinary tract infection
• Skin irritation
• Urine crystals around your stoma
• Leaks under your pouching system or skin barrier
• Warty or discolored skin around your stoma
• Excessive bleeding from your stoma
• Blood in your urine