How To Change Your Ostomy Pouch or Bag

All aspects of caring for your ostomy bag will to some extent depend on what kind of bag you have chosen, but some general guidelines will be useful to everyone when it comes to changing an ostomy bag.
One way to divide ostomy bags is by the number of pieces in their assembly.

• If your ostomy bag is a one-piece, then its bag and barrier are the same piece.  A barrier is sometimes called a flange or wafer - basically, it's the part of the apparatus that connects to the skin around your stoma.  Most often, the barrier contains an adhesive layer that binds to your skin, but some people prefer to use a belt system to keep the ostomy bag pressed firmly against the body.

• A two-piece ostomy bag, true to its name, has two parts - the bag and a separate barrier piece.  The two function the same as if they were one piece, but can be separated if you wish to remove the bag without breaking the adhesive seal of the barrier on your skin.  Typically the two pieces snap together, much like food storage containers.

For information on cleaning, check out our other article, "How To Clean an Ostomy Bag." 

You may have an ostomy bag that is meant to be replaced after every emptying, or your bag may be designed to be used for about a week.  Here are the steps to take when changing your ostomy bag.

1. If you want to change the ostomy bag in a one-piece system, or change both the bag and barrier in a two-piece, you must carefully separate the barrier from your skin.  Lift tenderly.  Don't rip the barrier off your skin; if it's difficult and you feel you might irritate or hurt the skin by removing the barrier, you can use some adhesive remover while lifting.  If your bag is open-ended, you should unclamp its end and empty the waste before separating the barrier from your body.

2. Then it's time to clean and inspect the skin around your stoma.  You can use a wash cloth with warm water to clean the area.  Soap can also be applied with the warm water, but be sure to rinse all of the soap off your skin afterward.  And completely dry the skin when you're done.  If necessary, adhesive remover can eliminate any undesirable residue left from the last barrier.

   If the tissue is irritated and discolored, or the appearance has changed since the last time you examined it, you should describe it to your doctor or nurse and ask for advice.

   Hair is generally a dirty thing, and can complicate the process of sealing the adhesive barrier to your skin, so be sure to maintain a clean shave around where you attach your ostomy bag.

3. Measure the stoma and cut a hole out of the barrier just a little larger than the stoma, so that the barrier will rest and adhere neatly and closely around the stoma.  If your ostomy bag is two-piece, then attach the bag to the barrier at this point.
4. Your barrier may have a layer that you must peel off in order to expose the adhesive layer to your skin.  If so, then peel the protective layer off and adhere the barrier around your stoma, pressing to ensure a snug seal.  If you find it helpful for keeping the seal strong, special paste is sometimes applied to this area before pressing the adhesive barrier down on it.
5. If your new ostomy bag is open-ended, then all that remains is for you to apply the clamp to the end of the bag.  If the ostomy bag is a closed end bag (meaning it has no clamped end for emptying the waste), then you've completed your ostomy bag change!