How to Change an Ostomy Pouch/Stoma Bag and Recommended Supplies

Chad Birt

Written by Chad Birt on Tue Apr 18 2023.

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How to Change an Ostomy Pouch/Stoma Bag and Recommended Supplies

An ostomy pouch or stoma bag is a sturdy, plastic container that collects stool. You may need to toilet through a stoma after surgery on your large or small intestine. 

Some people use an ostomy pouch for a few weeks or months, but for others, it’s a permanent necessity. Regardless, you need to know how to change your ostomy pouch if you have one.

We’ve put together a simple guide to help you remember what to do. But if you have any questions, contact your doctor. They can provide step-by-step instructions for changing your stoma bag.

What You’ll Need

Our Checklist for Those Who Toilet Through a Stoma covers this topic in more detail, but as a general rule, we recommend having the following items on hand:

Tricia Holderman, who’s had an ileostomy stoma since 1987, recommends keeping a few small binder clips on hand as well.

“I’ve been using a small binder clip rather than the plastic clip that holds the pouch closed,” Holderman said. “A binder clip is small and doesn’t show under my clothing. It adapts to the curve of my body and doesn’t have to be continually adjusted like the big clunky ones that come with the pouches.”

“Plus, the binder clip is much sturdier and more secure, and I can get them in cute colors.”

How to Change a Stoma Bag/Ostomy Pouch on Yourself

Changing an ostomy pouch takes a little bit of practice, but you’ll have it down in no time. Here’s how to do it yourself:

Steps 1: Prepare your changing station

When it’s time to change your stoma bag, gather all of the necessary supplies and set them out at a changing station.

“I start by laying my supplies out on a small table next to the toilet,” Holderman said. “I have a clean ostomy pouch, ostomy barrier paste, binder clip, and the skin prep materials (e.g. gauze, wipes, and adhesive remover). I open everything in advance so the items are all unwrapped and ready to put on.”

Step 2: Wash your hands

Changing your stoma bag presents the risk of infection, so always wash your hands with antibacterial soap and warm water first. 

Run the water for at least 20 seconds, making sure to scrub between your fingers and beneath your fingernails.

Step 3: Remove your ostomy pouch

Gently press on your stoma with one hand and pull up on the barrier seal with the other. You may have some difficulty, depending on the type of barrier paste you use. That’s why we recommend including an adhesive remover in your ostomy kit. 

Step 4: Throw away or empty your used ostomy pouch

If you have a disposable pouch, close it with a clip, place it inside another bag, and throw them both in the trash.

If you have a reusable pouch, carefully unroll the drain spout and empty your bag over the toilet. If there’s stool on the top or sides (something called pancaking), gently squeeze the bag and slide your hand downward to help clear it out.

Caregiver Tip

People with reusable ostomy pouches recommend putting some toilet paper in the bowl before draining it. This helps prevent splashback and makes cleanups easier. 

Step 5: Examine, clean, and seal your skin

Whenever you drain or change your ostomy pouch, take time to examine your stoma –– the opening in your abdomen where waste exits your body.

Mild bleeding and discharge are normal, but discoloration may indicate infection.

Carefully clean the skin around your stoma with a hypoallergenic wipe or adult washcloth. Then, let it air dry.

Step 6: Measure your stoma

It’s normal for stomas to change shape and size. Measure your stoma with the manufacturer’s stoma measuring guide before changing into a new ostomy bag. This will help prevent leaks and protect your skin.

Step 7: Put on your new ostomy pouch

After measuring your stoma, cut out the new ring seal and attach it to your ostomy bag. Then, pull the adhesive off the ring seal and place the opening of the ostomy pouch over your stoma.

Once your ostomy pouch is in position, squeeze the barrier paste out of the tube and carefully spread it around with your finger, sealing any opening where the ring isn’t flush with your skin.

When the barrier paste finishes drying, tuck your ostomy pouch inside a support belt to help hold it in place.

Commonly Asked Questions

1) How long should it take to change my ostomy pouch?

Learning how to change an ostomy pouch takes guidance at first. After surgery, your doctor provides a complete list of instructions and explains how to reduce the risk of infection and other common problems. 

Be patient, and remember not to be too hard on yourself. Holderman says that with years of practice, she can now change her ostomy pouch in three minutes or less. 

2) What are some signs or indications I’m changing my stoma bag incorrectly?

Changing your ostomy pouch is relatively straightforward, but it can be easy to make mistakes –– especially if you’re new to toileting with a stoma. 

Fortunately, Holderman says there are telltale signs to watch out for, including:

  • Pain - “If your stoma is painful, the hole may not be cut wide enough for a comfortable fit.”

  • Improper seal - “Without a proper seal, your ostomy pouch will leak.”

  • Skipping skin prep - “Cleaning and preparing your skin during changes is crucial. If you don’t prep correctly, you’re more likely to experience a rash or skin irritation.” 

3) How can I prevent my ostomy pouch from producing odor?

After ostomy or colostomy surgery, many people worry about keeping their pouch clean and odor-free. While it’s natural to be concerned about smells, you can do plenty of things to keep them at bay.

“To help reduce odors, empty and clean (or change) your ostomy pouch regularly,” Sandra Macsweeney, a family nurse practitioner at AlivioHealth said. 

“It’s important to keep your pouch clean, as debris within it may cause odors. You can also try using deodorizing products within the pouch, such as charcoal, baking soda, or an ostomy pouch deodorizer.”

Have Questions?

Do you still have questions about ostomy supplies? Maybe you want to know more about the brands we carry. Whatever the case, our friendly Care Specialists are here to help!

They’re available around the clock and are standing by to assist. Call (800) 696-CARE or send an email to support@carewell.com.

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Chad Birt
Chad Birt

Chad Birt is a freelance medical writer who resides in Astoria, Oregon. When he isn't behind a keyboard, you can find him hiking, camping, or birdwatching with his wife Ella and their two dogs, Diane and Thoreau.