Colostomy Procedure: Changing & Emptying Ostomy Pouches - Nurseslab.in (2025)

Colostomy care refers to cleaning of the stoma area using warm water and dry wipes to gently clean around the stoma.
A colostomy is a surgically created opening in the abdominal wall through which digested food and stool passes through the stoma into a pouch attached to the stoma on the outside of abdomen. The pouch, the stoma and skin surrounding the stoma require care and maintenance by patient or caregiver.

Colostomy care is done to help ensure that the patient’s stoma is being assessed for its status, pouches and appliancesare inspected for fit and function, and that effluent is drained to avoid spillage of its content’s irritation to the skin.

Changing Ostomy Pouches

Appliances and pouches are important materials to help the patient adjust to the presence of the ostomy and carry out activities of daily living. While the appliance is used primarily to help protect the skin from the irritating effects of gastric acids and help keep the area dry, pouches serve as a reservoir of effluent.

Care for patients with these appliances should follow facility or hospital policy, and the nurse should be aware of these before resuming care. Safety considerations must also be followed to help ensure the provision of effective care.

• Depending on the type of pouches that the patient uses, remember that these systems should be changed in approximately 3 days to 1 week.
• Any leaks in the pouch system or signs of skin breakdown should be referred to a wound care specialist or physician for proper management.
• Patients and their families/significant others should be encouraged to participate in care.
• The nurse should always consider the patient’s preferences and needs in choosing products to be used in his colostomy.
• Other factors may affect the pouching system and appliance, such as sweating, moisture, oily skin, physical exercise, and environmental temperatures.
• Consider potential weight loss or weight gain as this may cause a need to adjust the colostomy appliance.

Articles Required

A tray containing:

1. Rubber sheet.
2. Long sheet.
3. Towel.
4. Clean gloves.
5. Cotton swabs and gauze pieces.
6. Wash cloth.
7. Water in basin.
8. Soap in dish.
9. Disposable colostomy bag with clamp.
10. Stoma measuring guide.
11. Zinc oxide ointment.
12. Skin barrier.
13. Bedpan with cover.

Procedure

Emptying Colostomy Bag without Changing

Patient Education and Health Maintenance

Mastering the art of changing your ostomy bag takes practice, but with the right techniques and products, it can become a straightforward part of your routine. Prioritize hygiene, monitor your skin condition, and seek support from healthcare providers or support groups if needed. With confidence and preparation, you can manage your ostomy effectively and maintain an active, fulfilling life.

1.Skin Care

1. Instruct the patient to inspect peristomal skin with each pouching system change.
2. Review techniques for treating peristomal skin problems.
3. Recommend alternative products if patient develops allergic reaction to an ostomy product.
4. Teach the patient to notify health care provider when skin care problems do not resolve by usual methods.

2.Colostomy Irrigation

1. Teach colostomy irrigation procedure, to patients with a descending or sigmoid colostomy. Reinforce its purposes of cleansing the colon and stimulating the colon to move at a desired time regularly to regain control of fecal elimination.
2. Irrigation may occur every day or every other day depending on bowel pattern.
3. It usually takes 1 to 2 months to establish control.
4. Patients with a preoperative history of regular, formed bowel movements are more likely to realize success.
5. Set up patient in front of commode with irrigation sleeve directed into the commode and lubricate tip of the enema before gently inserting no more than 3 inches into stoma.
6. Allow solution to flow in slowly, over 5 to 10 minutes, and slower if cramping occurs.
7. Remove tubing and allow fecal matter to drain for 10 to 15 minutes before closing sleeve, which should be left in place for 20 more minutes before cleansing stoma and applying usual colostomy bag.

3.Odor Control

1. Encourage pouch hygiene through rinsing, keeping pouch tail free of stool, airing of reusable pouches, discarding odor-impregnated pouches.
2. Recommend the use of pouch deodorants, room deodorizers, and oral deodorizers, such as bismuth subgallate or parsley.
3. Avoid use of pinholes in pouch.

4.Gas Control

1. Suggest avoidance of straws, excessive talking while eating, chewing gum, and smoking to reduce swallowed air.
2. Instruct about gas-forming foods, such as beans and cabbage, and eliminate when appropriate. It takes about 6 hours for gas to travel from the mouth to colostomy.
3. Recommend using the arm over stoma to muffle gas sounds when appropriate.

5.Burping the Bag

1. Gas collects in the bag and teach the patient to expect this and how to release it
2. One-piece: un-clamp at bottom of bag (may want to do this in the bathroom or when others aren’t around because of the odor)
3. Two-piece: un-snap the pouch from the skin barrier, release gas, and snap back
4. Teach patient about limiting odorous foods
5. Inform about pouches that have filters that allow gas to vent out the pouch and also use pouch drops.

6.Performing Activity of Daily Living

Educate the patient about the following:

1. Encourage the patient to maintain contact with health care providers.
2. Resumption of normal bathing habits (tub or shower) with or without pouching system.
3. Picture framing the edges of the pouching system with water-proot tape, if needed, for bathing or swimming
4. Clothing modifications are usually minimal. Girdles without stays and panty hose are acceptable.
5. Carrying an ostomy supply kit during work or travel in case of an emergency.
6. Participating in sports as desired. Caution must be exercised with contact sports. During vigorous activities, a belt or binder may provide extra security.
7. For additional information and support, refer to the United Ostomy Association, a self-help group for ostomates and other interested people. The official membership publication is the Ostomy Quarterly. Encourage ostomy patients to participate in a local chapter. Chapters usually publish a local newsletter, conduct monthly meetings, and provide trained ostomy visitors on request by health care providers.
8. Ostomy manufacturers offer literature covering a wide variety of ostomy-related topics.

REFERENCES

1. Hinkle, J. L., & Cheever, K. H. (2018).Brunner & Suddarth’s textbook of medical-surgical nursing.
2. Kozier, B., Erb, G., & Berman, A. (2018).Kozier and Erb’s Fundamentals of Nursing(4th ed., pp. 10-14, 497-503). Pearson Australia.
3. Potter, P. A., Perry, A. G., Hall, A., & Stockert, P. A. (2017).Fundamentals of nursing.Ninth edition. St. Louis, Mo.: Mosby Elsevier.
4. Raza A, Araghizadeh F. Ileostomies, colostomies, pouches, and anastomoses. In: Feldman M, Friedman LS, Brandt LJ, eds.Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 117.
5. Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M. Bowel elimination. In: Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M, eds.Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. New York, NY: Pearson; 2016:chap 23.

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