What is important to teach a patient who is learning to manage a colostomy?

Colostomy care includes how to change, empty, and clean your pouch system. You and your family will be taught colostomy care before you leave the hospital.

What do I need to know about colostomy care?

• Wash your hands before and after you do any colostomy care. Use soap and water. Dry your hands with a clean towel or paper towel. Use clean medical gloves each time you care for your colostomy.
  
  
  
• Colostomy care also helps you prevent or manage problems with your stoma. Most stoma problems happen during the first year after surgery. Problems include changes in the height, narrowing, and intestine bulging into or around the stoma (called a hernia). You may need to change the type of pouch you use or wear a hernia belt.

How do I empty my pouch?

• Wash your hands. Then put on clean medical gloves.
• Empty the pouch when it is ⅓ to ½ full and before you change the system. Do not wait until the pouch is completely full. This could put pressure on the seal and cause it to leak or spill.
• Hold the pouch up by the bottom end. If the pouch has a clamp system, remove the clamp. You may need to roll the end back to keep it from getting soiled.
• Drain the pouch. Place toilet paper into the toilet before you empty the pouch to reduce splash back. Drain the pouch by squeezing the contents into the toilet.
• Clean the end of the pouch. Use toilet paper or a moist paper towel. You may also rinse the pouch, but it is not necessary. Keep the end of the pouch clean.
• Close the end of the pouch. Unroll the end of the pouch. Replace the clamp or close the end of the pouch as directed.
• Take off your gloves. Put the gloves in the trash. Then wash your hands.

What do I need to know about changing my pouch system?

• How often you change your pouch system depends on the type you have. The type of system you use affects the amount of time it can be worn. Some pouch systems can stay in place for 3 to 7 days. Others can last 1 to 3 months, and the pouch is changed more often.
• Look at the skin around your stoma each time you change your pouch system. Your stoma should be pink or red and moist. You may have a small amount of bleeding when you clean your stoma. This is normal. Your stoma will get smaller and become its normal size in about 8 weeks.

How do I change my 1-piece pouch system?

Your healthcare provider will give you specific instructions on how to change your system. The following is general information:

• Wash your hands. Then put on clean medical gloves.
• Remove the pouch. Empty the pouch before you remove it. Gently remove the pouch by pushing the skin down and away from the adhesive skin barrier with one hand. With the other hand, pull the pouch up and away from the stoma.
• Gently clean the skin around your stoma. Use mild soap and water. Do not use soaps that have oil or perfumes. Pat your skin dry.
• Use a pouch with the right size opening. Use a pouch that has an opening that is ⅛ of an inch larger than your stoma. You may need to cut the opening to fit around your stoma. If the opening is too large, bowel movement can leak onto your skin and cause irritation.
• Use skin barrier products to help reduce irritation. These products can help protect your skin and keep it dry.
• Use slight pressure to place your pouch. Center the pouch over the stoma and press it firmly into place on clean, dry skin. It may be helpful to hold your hand over the new pouch for 30 seconds. The warmth of your hand can help stick the adhesive skin barrier into place.
• Dispose of the used pouch correctly. If the pouch is disposable, place the old pouch in another plastic bag and throw it in the trash. If your pouch is reusable, talk to your healthcare provider about how to clean it.
• Take off your gloves. Put the gloves in the trash. Then wash your hands.

How do I change my 2-piece pouch system?

Your healthcare provider will give you specific instructions on how to change your system. The following is general information:

• Wash your hands. Then put on clean medical gloves.
• Remove pouch and faceplate. Empty the pouch before removing. Gently remove the faceplate by pushing the skin down and away from the adhesive skin barrier with one hand.
• Gently clean the skin around your stoma. Use mild soap and water. Do not use soaps that have oil or perfumes. Pat your skin dry.
• Use a faceplate with the right size opening. The opening needs to be ⅛ of an inch larger than your stoma. You may need to cut the opening to fit around your stoma. If the opening is too large, bowel movement can leak onto your skin and cause irritation.
• Use skin barrier products to help reduce irritation. These products can help protect your skin and keep it dry.
• Use slight pressure to place your faceplate. Center the hole in the faceplate over the stoma. Press it firmly into place on clean, dry skin. It may be helpful to hold your hand over the new faceplate for 30 seconds. The warmth of your hand can help stick the adhesive skin barrier into place.
• Dispose of the used pouch correctly. If the pouch is disposable, place the old pouch in another plastic bag and throw it in the trash. If your pouch is reusable, talk to your healthcare provider about how to clean it.
• Take off your gloves. Put the gloves in the trash. Then wash your hands.

Where can I find support and more information?

• United Ostomy Associations of America, Inc.
  P.O. Box 512
  Northfield , MN 55057-0512
  Phone: 1- 800 - 826-0826
  Web Address: http://www.ostomy.org
  

• Wound Ostomy and Continence Nurses Society
  15000 Commerce Parkway
  Mount Laurel , NJ 08054
  Web Address: www.wocn.org
  

Call your local emergency number (911 in the US), or have someone call if:

• Your bowel movements are black or bloody.
• Your stoma is bleeding and you cannot stop the bleeding.
• You are too weak to stand up.
• You have severe abdominal pain.

When should I call my doctor or ostomy specialist?

• You have a fever.
• You have a foul odor coming from your colostomy bag or stoma that lasts longer than a week.
• Your skin around the stoma becomes red and irritated.
• You have nausea, vomiting, pain, cramping, or bloating.
• You do not have regular bowel movements through your stoma.
• The size of your stoma changes.
• You have questions or concerns about your condition or care.

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