Changing a Pouch

Changing your ostomy pouch is an essential part of maintaining good hygiene and comfort. Whether you have a colostomy, ileostomy, or urostomy, learning how to properly change your pouch can help prevent skin irritation, leaks, and infections. This guide provides a step-by-step approach to changing your ostomy pouch effectively and confidently.

When to change your pouching system

• Urostomy: Change before drinking fluids in the morning for ease.
• Colostomy: Best changed when the stoma is least active, often in the morning.
• Ileostomy: Similar to colostomies, change when the stoma is quiet, typically before breakfast.

What you’ll need - Supplies

Before you begin, gather all necessary supplies:

• New ostomy pouch (either a one-piece or two-piece system)
• Adhesive remover wipes (optional)
• Stoma powder (if needed)
• Stoma paste or barrier ring (if needed)
• Skin barrier wipes or spray
• Scissors (if you need to cut the pouch to size)
• Clean washcloths or gauze
• Warm water and mild soap (optional)
• Disposal bag

Step-by-Step Instructions

1. Preparation

1. Wash Your Hands: Thoroughly wash your hands with soap and water to ensure cleanliness.
2. Prepare Your Supplies: Lay out all your supplies within easy reach. If using a two-piece system, ensure the flange and pouch are ready to be attached. Bring cleaning cloths and adhesive remover if needed
3. Empty the Old Pouch: If your pouch is not already empty, drain the contents into the toilet.

2. Removing the Old Pouch/system

1. Gently Peel Off the Pouch: Start at the top and gently peel the pouch away from your skin. Use one hand to hold the skin taut and the other to peel the pouch away. If you’re using adhesive remover wipes, use them to help loosen the adhesive.
2. Dispose of the Old Pouch: Place the used pouch in a disposal bag.

3. Cleaning the Stoma and Surrounding Skin

1. Clean the Stoma and Skin: Use warm water and a clean washcloth or gauze to gently clean around the stoma. Mild soap can be used, but ensure all soap is rinsed away. Pat the area dry with a clean towel. Avoid direct contact with the stoma itself.
2. Inspect the Skin: Check the skin around the stoma for any signs of irritation or breakdown. Use stoma powder if needed to absorb moisture.
3. Dry and Prepare the Skin: Pat the area dry with a lint-free cloth, then apply a ring or gasket if used.

4. Applying the New Pouch

1. Cut the Skin Barrier to Size: If using a cut-to-fit pouch, measure the size of your stoma and cut the opening in the barrier to fit snugly around the stoma.
2. Apply Stoma Paste or Barrier Ring: If recommended, apply stoma paste or a barrier ring around the opening of the pouch to provide extra protection and a better seal.
3. Attach the Pouch: Center the opening of the pouch over the stoma and press it firmly onto the skin. If using a two-piece system, attach the flange first, then snap the pouch into place. Ensure a snug fit around the stoma without touching it directly.
4. Smooth Out the Edges: Ensure the edges of the skin barrier are smooth and secure. Use your fingers to press down gently, ensuring a good seal.

5. Final Steps

1. Check for Leaks: Run your fingers around the edge of the barrier to ensure it is securely in place with no gaps or leaks.
2. Dispose of Waste Properly: Dispose of the used pouch and any waste materials in a disposal bag.
3. Wash Your Hands: Wash your hands again thoroughly with soap and water.
   Source: https://www.ostomycanada.ca/ostomy-care-basics/general-management/changing-your-pouching-system/

Tips to follow

• Frequency: Change your pouch every 3-5 days or as needed. Do not wait until it leaks. Frequency varies for everyone, from everyday changes to a change every 7-10 days. Trial and error is your best friend in this process.
• Skin Protection: Always protect your skin with a barrier wipe or spray.
• Comfort and Fit: Ensure the pouch fits comfortably and securely. If you experience any issues, consult with your healthcare provider or ostomy nurse.

Troubleshooting:

• The purpose of the flange/barrier is to protect your skin from your ostomy drainage. Stoma output can be sitting on your skin even if there is no visible leakage.
• Some people are more comfortable changing their pouching system more frequently.
• Liquid output (e.g. ileostomy or urostomy) will break down the flange/barrier more quickly than thicker
  output.
• Taking the time to apply your pouching system correctly will result in a longer wear time than a hurried application in the mall washroom. Planning your pouching system changes rather than waiting for leakage can result in better wear time.
• Pouching systems are expensive so you don’t want to change unnecessarily.
• If you are sweating more than usual (hot weather, exercise) you may need to change more often.

Take the time needed to figure out what works best for you, your stoma, and your skin. It is not a competition and longer wear time is not necessarily better.

If you have any questions or concerns regarding your pouching system, please book an appointment with one of our Nurses Specialized in Wound, Ostomy and Continence (NSWOC).

By Laureen Sommerey, RN, MSN, WOCC(C)

Read more ostomy-related content in our quarterly Ostomy Newsletter

Useful Resources

• For detailed video guides on how and when to change your pouching system, visit the Coloplast Website
• Feel confident and secure with Ten Aces Medical Adhesive Spray – Stick with us!

Regularly changing your ostomy pouch is crucial for maintaining your health and comfort. By following these steps, you can ensure a secure fit and prevent skin irritation and leaks. For personalized advice and support, consult with your healthcare provider or ostomy nurse.