Colostomy: Changing Your Pouch

Your healthcare provider gave you a stoma (new opening for stool to pass from the body) during surgery. Stool starts to pass from the stoma soon after surgery. That means you will need to learn how to change your pouch before you go home.

You will need to change your drainable pouch every 4 to 6 days or twice a week, but you should empty your pouch more often.

To change your pouch, follow the steps below and always wash your hands for at least 15-20 seconds before AND after caring for your pouch (hum “Happy Birthday” twice if you need a timer).

Start by gathering what you will need:

• Plastic bags
• Paper towels
• New pouch
• Extra skin protection (if desired)
• Scissors (if needed)
• Clean towel

1. Remove the used pouch

Steps to removing the used pouch are as follows:

• If you use a drainable pouch, empty it first. Sit on or next to the toilet. Set the clamp aside (if applicable).
• Start at the upper edge of the skin barrier. Carefully push the skin away from the skin barrier with one hand.
• Slowly peel back the skin barrier with the other hand.
• Peel all the way around the skin barrier until the pouch comes off.
• Seal the pouch in a plastic bag. Then put it in a second plastic bag.
• Throw it away in a trash bin. Some people empty the pouch into the toilet first. 

2. Clean around the stoma

Steps to cleaning around the stoma are as follows:

• Wipe any stool off the skin around the stoma with paper towel.
• Clean the skin with warm water. Wash right up to the edge of the stoma.
• Pat the skin dry with a clean towel.
• If needed, put on extra skin protection, such as powder and/or skin prep.

3. Put on the new pouch

Steps to putting on the new pouch are as follows:

• If you do not use a pouch with a precut skin barrier, size and cut the opening (no more than 1/8 inch bigger than the stoma) and peel the backing off the skin barrier
• Carefully place it over the stoma.
• If you use a 2-piece pouch, snap the pouch onto the barrier.
• Start at the bottom and work your fingers around the flange.
• Press the barrier against your skin with your hand over the barrier and hold it in place for 45 seconds. This molds the barrier to your skin.
• If you use a drainable pouch, clamp the tail (if applicable) or close the pouch using the Velcro.
• Wash your hands again for at least 15-20 seconds when you are done.