Changing your pouch, step by step

Prepare before you start

Change the pouch when output is least active. For many people this is first thing in the morning, before eating or drinking.

Gather everything first so you are not searching mid change: a new pouch, scissors and measuring guide if you cut your own, warm water, soft cloth or gauze, a dry towel, a bag for waste, and any accessories such as paste or powder.

The steps

• Wash and dry your hands.
• Support the skin with one hand and gently peel the pouch downwards from the top with the other. Never pull it off quickly.
• Put the used pouch straight into a waste bag and tie it.
• Clean the stoma and surrounding skin with warm water and a soft cloth. Do not use soap with oils or perfumes, antiseptics, or baby wipes with lotion. Plain warm water is best.
• Dry the skin thoroughly by patting, not rubbing. An adhesive will not stick to damp skin.
• Look at the stoma and the skin. Check the colour, and check for soreness, rashes or broken skin.
• Measure the stoma with the guide. The opening should match its shape, leaving about two millimetres of clearance, no more.
• Cut the new pouch to that size if it is not pre cut, and smooth any rough edges.
• Apply the new pouch from the bottom edge upwards, pressing gently around the stoma outwards.
• Hold your hand flat over the adhesive for about thirty seconds. Body warmth helps it seal.

Measure again as you heal

A stoma changes size in the weeks after surgery, usually becoming smaller. Measure at every change for the first eight weeks, then check monthly. A hole cut too large exposes skin to output and causes damage. A hole cut too small can injure the stoma.

If the pouch keeps leaking

• Check whether the opening is cut too large for the stoma
• Check for skin creases or dips that stop the adhesive sealing, which paste or a convex pouch can solve
• Make sure skin is completely dry before applying
• Empty the pouch when it is one third full, because weight pulls the seal away
• Ask about a belt if the pouch moves during work or walking

Emptying and wear time

Empty a drainable pouch when it is about one third full. Most people empty several times a day.

How long a pouch stays on varies by person and by stoma type. Changing a pouch too often can irritate the skin, and leaving one on past its seal causes leaks. Your stoma care nurse can help you find your pattern.