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How to Care for Your Colostomy or Ileostomy

Colostomies and ileostomies are ways to let stool leave the body when it cannot go through the rectum and anus. The opening made is called a stoma. Taking proper care of the stoma, skin, and pouch will help prevent infection and other problems.

What You Will Need

  • Toilet tissue
  • A new ostomy pouch, which covers the stoma and collects the stool—if possible, have more than 1 bag available
  • Scissors
  • Hypoallergenic tape
  • Mild soap and water
  • A soft cloth

Steps to Take

Have all of your supplies ready. Clean and change your pouch and stoma on a regular schedule. Your care team will tell you how often you need to do this.

The skin of the stoma has no feeling, so you will not know when stool passes through it. Check the pouch throughout the day. Empty the pouch every time it is 1/3 to 1/2 full. You may find it easier to empty their pouch after passing urine.

To clean out the pouch:

  1. Wash your hands thoroughly with soap and water.
  2. Place tissue on the toilet water. It will decrease the chance of splashing when the stool drops into the toilet.
  3. Colonostomy_2.jpg Sit as far back on the toilet as you can. Hold the bottom of the pouch up. Open the clamp at the bottom of the pouch.
  4. Colonostomy_4.jpgTurn the end of the tail inside out like a cuff.
  5. Let the stool drain out. Wrap toilet paper around the pouch and push out stool that is not liquid. Try to keep the drainage end of the pouch clean.
  6. Wipe the inside and outside of the tail with toilet paper. Turn the cuff back and reclamp it.

Replace the pouch every 3 to 4 days (2 to 3 days for a child).

To replace the pouch:

  1. Wash your hands thoroughly with soap and water. Have supplies nearby.
  2. Colonostomy_6.jpg Remove the paper backing from the new pouch.
  3. Colonostomy_10.jpg Prepare your new pouch by cutting an opening to fit your stoma. Make sure that the opening is no more than one-eighth inch larger than the size of the stoma.
  4. Apply ostomy paste around the stoma opening on the pouch.
  5. Put the new pouch on a clean surface nearby.
  6. Colonostomy_8.jpg Gently peel old pouch off of skin. Throw it out.
  7. Colonostomy_9.jpg Carefully wash the skin around the stoma. Use warm water and soap. Dry it thoroughly with a soft cloth. Look for redness or irritation on your skin. Apply any cream or ointment your care team has recommended to irritated skin.
  8. Put the new pouch on. Press firmly on every part of the tape to make sure it sticks to your skin.
  9. Clamp the bottom outlet of the pouch.

Common Questions

Q. Do I need to remove the ostomy pouch when I shower?

A. No. You can even swim wearing the ostomy pouch.

Q. Does the ostomy smell?

A. You will notice little or no smell if you clean and change the pouch often. There are deodorizing solutions you can use if you find there is a smell.

Q. What do I do if my organs bulge through the belly wall or out of the stoma?

A. This is not an emergency, but you will need to call your doctor.

Q. Do I need to change my diet?

A. Potatoes, pasta, creamy peanut butter, and bananas will help thicken the stool. You may want to limit or stay away from foods that cause gas. Common ones are beans, cabbage, eggs, or fish. Other foods that can cause problems are popcorn, nuts, or foods with skin or seeds.

For an ileostomy, drink at least 64 ounces (almost 2 liters) of water each day to prevent constipation.

Problems to Look Out For

Contact your doctor if at any time you:

  • Pass a bloody stool
  • Have sore skin around the ostomy lasting more than 1 week (even after you treat it)
  • Have belly pain or nausea
  • Have a hernia or prolapse—organs bulge from the belly or stoma

Possible mishaps to watch out for:

  • No stool comes through the stoma—There may be a block in the stoma or intestine. It may cause belly cramps, nausea, vomiting, watery diarrhea, a swollen stoma, or bloating.
  • The adhesive does not seem to be working well—There may be lotion or oil on the skin around the stoma.

Signs of dehydration:

  • Thirst
  • Weakness
  • Dark urine or not passing a lot of urine
  • Lightheadedness
RESOURCES:

United Ostomy Associations of America
https://www.ostomy.org

Wound Ostomy and Continence Nurses Society
https://www.wocn.org

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca

Ostomy Canada Society
https://www.ostomycanada.ca

REFERENCES:

Caring for a colostomy. American Cancer Society website. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/ostomies/colostomy/management.html. Accessed March 29, 2021.

Caring for an ileostomy. American Cancer Society website. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/ostomies/ileostomy/management.html. Accessed March 29, 2021.

Caring for your ostomy. Registered Nurses' Association of Ontario website. Available at: https://rnao.ca/bpg/fact-sheets/caring-your-ostomy. Accessed March 29, 2021.

Colostomy guide. United Ostomy Associations of America website. Available at: https://www.ostomy.org/wp-content/uploads/2018/03/ColostomyGuide.pdf. Accessed March 29, 2021.

Ileostomy guide. United Ostomy Associations of America website. Available at: https://www.ostomy.org/wp-content/uploads/2018/03/IleostomyGuide.pdf. Accessed March 29, 2021.

Ostomy care: An overview. EBSCO Nursing Reference Center website. Available at: https://www.ebscohost.com/nursing/products/nursing-reference-center. Accessed March 29, 2021.

Last reviewed March 2021 by EBSCO Medical Review Board Shawna Grubb, RN  Last Updated: 3/29/2021