Colostomy Bag Use: Helpful Tips for Beginners

I'm back after a two week trip to Colorado to care for my dad after his operation. He came down with a bad case of diverticulitis, which is an inflamed, infected intestine. The symptoms of diverticulitis are much like those of stomach flu: nausea, fever, cramps, chills, and vomiting ¹. After being on antibiotics for a month with no change for the better, my dad had a CAT scan (Computerized Axial Tomography scan) ² and they discovered the problem. They removed twelve inches of his intestine and fitted him with an ostomy bag, commonly called a colostomy bag.

Dad is lucky. He will have to wear the colostomy bag three months or so while his intestine heals. In the two weeks I cared for him after coming home from the hospital, we learned a few helpful tricks that make the whole process much easier all around. These hints are probably things they should have written down in the brochures and booklets they send you home with after an ostomy operation, but don't. If you or a loved one must wear a colostomy bag appliance at any point in time, my dad and I hope these tips will make the process easier for you.

Colostomy Bag Helpful Tip #1:

When putting on a new colostomy bag put a few drops of baby oil or cooking oil into the bag and rub the sides together to spread it around on all the internal surfaces. This will make emptying the bag of fecal matter much easier when it has to be done. Also, each time the bag is emptied, add a few more drops of oil.

Colostomy Bag Helpful Tip #2:

Have a chair without arms that has a seat as high as the toilet bowl handy in the bathroom for the colostomy patient to sit on while emptying his or her colostomy bag. If your bathroom is small, a small, folding camp stool or armless chair that can be brought out as needed works well. It is so much easier on the back if one is sitting during the bag emptying process.

Colostomy Bag Helpful Tip #3:

Chances are, when the colostomy patient first comes out of the hospital, his or her bowel movements will be somewhat loose. Stool will begin to form normally as one resumes a normal diet. When the colostomy patient has his or her first harder and formed bowel movement, it often feels quite different than other sensations as it passes into the colostomy bag. It startled my dad so, he thought his intestines were coming out into the bag. Assure the patient that it is impossible for his or her intestines to come out into the bag. Explain that formed bowl movements will exert more pressure than fluid ones.

Also, each stool should be removed from the bag as soon as it is passed if possible, as the weight of too much fecal matter in the bag could compromise the skin barrier seal and cause it to leak. Remember the baby oil. It will aid greatly in this process!

Colostomy Bag Helpful Tip #4:

If the seal around the colostomy bag is compromised prior to scheduled removal (typically after one week), don't panic. This can be another stressful event for a newly fitted colostomy patient. It is helpful to remain calm and help him or her set up a new bag and skin barrier seal ring, then remove the leaking skin barrier seal ring and old bag. A folding TV tray works well as a temporary work surface to have all the necessary supplies ready to change to a new bag. These supplies generally are: skin barrier seal ring paste, skin barrier seal ring, scissors (to cut the seal ring to the correct size), and bag. Also, have the colostomy patient stand if possible during this procedure, as it is important to clean the area around the stoma (the intestinal opening) and the stoma itself thoroughly with baby wipes before applying a new appliance (seal ring and bag). It also makes it easier to apply the skin barrier seal ring.

Note: Don't try to cut corners by pre-cutting skin barrier seal rings to size. Each seal ring is individually packaged in a sealed package. If you remove them from this package much sooner than you will need to use them, the adhesive on them may dry out and provide an ineffective seal.

Be sure to read the hospital directions for applying a new bag thoroughly before leaving, and pay attention to any demonstrations and actual changes by the nurses. This way, you will be able to calmly and confidently walk the patient through the procedure at home the first few times, until they are comfortable in doing it solo.

Colostomy Bag Helpful Tip #5:

The process of emptying or changing a colostomy bag can be very embarrassing for the patient because of the pungent odor. Have a can of Lysol or other disinfectant on hand in the bathroom for the patient to deodorize and disinfect the bathroom with. In addition, it is helpful to have an air freshening/deodorizing spray handy outside the bathroom to freshen areas in the immediate vicinity. My favorite is Renuzit spray (non-aerosol) which is also a sanitizing deodorizer. It smells really nice and is not too heavy. It also instantly destroys the pungent odors from the colostomy bag.

Colostomy Bag Helpful Tip #6:

Supplies you should have on hand for a colostomy bag cleaning or change are as follows:

1. Baby wipes for cleaning the skin around the stoma area (the stoma itself should be cleaned, too, and can be wiped off with toilet paper).
2. Lysol, disinfecting wipes for disinfecting bathroom surfaces after bag cleanings and changes.
3. Renuzit deodorizer.
4. Small plastic bags (grocery bags work well) to put the dirty wipes and old colostomy bag into that can be tied shut and immediately removed and thrown away in an exterior garbage can to cut down on odor in the house.

My dad is going to be just fine and I am happy to report that he will probably be healed enough to have his "replumbing" operation at the three month mark, which he is eagerly awaiting. In the meantime, we both hope these tips will help another first time colostomy bag wearer's life a bit easier.

Sources:

1. "Diverticulosis and Diverticulitis," digestive.niddk.nih.gov/ddiseases/pubs/diverticulosis/#symptoms.
2. "CT Scan (Computerized Axial Tomography or CAT Scan) Procedure Information on MedicineNet.com," medicinenet.com/cat_scan/article.htm.
3. Personal experience.