Guide to Changing Your Colostomy Pouch for Colorectal and Anal Cancer Patients

Changing Your Colostomy Pouch - The best time to change your pouch is when the bowel is quiet, neither active nor draining. You should change a leaking pouch as soon as possible.

Empty your pouch when it is about one-third to one-half full. A full pouch may become heavy and detach accidentally from your skin. Also, emptying a full pouch is more of a challenge.

When you need to change your pouching system, it is important to gather all your supplies.

You can sit or stand while changing your pouch.

If you need to change your wafer, you first trace the size and shape of your stoma onto the wafer's cutting guide. Then cut a hole in the wafer about 1/16" larger than the stoma. If the opening of the wafer is larger than the stoma, leakage may occur. It is easier to cut the wafer material with curved scissors. Do not cut beyond the last circle on the guide.

Drainable Pouch

• If you wear a drainable pouch, you can empty it and use it again if it has been worn only a few days. Standing near the toilet, remove the pouch clamp or unfasten the Velcro closure to drain the contents into the toilet. If your drainable pouch does not need to be changed, reclamp it and continue to wear it.

• Wipe the end of the pouch with a tissue. Then clean the outlet in one sliding movement away from your body. To avoid odor be sure to wipe all the stool off the end of the pouch.

• If your drainable pouch does not need to be changed, reclamp it and continue to wear it.

Closed-end pouch

• If you use a closed-end pouch, take it off, and discard in a trash bin.

• To gently remove the old wafer, you need to work slowly from top to bottom. It helps if you push down on the skin as you lift it off.

• With a two-piece pouch you don't need to change the wafer every time you change your pouch. If you need to apply a new wafer, trim it to the correct size and remove the protective paper.

• Center the wafer around the stoma. For a better fit around the stoma, press firmly against the skin starting at the bottom and smooth upwards with your fingers. Make sure it is secure around the stoma. Try to avoid wrinkles.

• Wash and rinse the stoma and the skin near it. Then dry thoroughly.

• Check the peristomal skin for any redness or sore spots. If you have any skin problems, call your WOC/ET nurse or doctor for guidance on management.