Colostomy bag

A colostomy bag, also called a stoma bag or ostomy bag is a small, waterproof pouch used to collect waste from the body.

During a surgical procedure known as a colostomy, an opening, called a stoma or ostomy, is formed between the large intestine (colon) and the abdominal wall. This allows waste products to be excreted through the opening in the abdominal wall rather than via the colon through the rectum and anus. Stool and other waste products are drainable into the pouch, which can be emptied at regular intervals.

This procedure is carried out in the treatment of conditions involving damage to the colon or large intestine, such as:

The pouch is placed over the new opening that has been created in the abdominal wall to collect stool and other waste from the body.^[1]

A colostomy bag, therefore, is a reasonably simple device intended to rest the patient’s colon
In the case of a temporary procedure, or to act as an artificial outlet for the bowel when the surgery is intended as permanent.

The use of a pouch to collect waste outside the body:

Is surprisingly common
Is not painful
Does not necessarily involve a huge change of lifestyle

Full guidelines on changing a colostomy bag and/or using a drainable version will be provided by the clinic treating the affected person and advice on finding all necessary supplies, such as replacement pouches.

When is a colostomy bag needed?

Colostomies can be necessary for people of all ages. Typically, they are recommended for those experiencing problems with their colons, such as Crohn’s disease, or when the anal sphincter does not function properly. The temporary or permanent use of a stoma and colostomy bag allows the body’s waste to bypass the colon.^[2]

The diversion of waste from the body via the stoma/ostomy may be necessary for the treatment or management of specific conditions involving inflammation of, or damage to, the large intestine, including:^[3]

Abdominal/pelvic region cancers, including colorectal cancer and more rarely anal, vaginal or cervical cancer
Inflammatory bowel diseases, including Crohn’s disease, ulcerative colitis and, more rarely, diverticulitis)
Bowel obstructions or injuries
Bowel incontinence, in severe cases
Hirschsprung’s disease, a rare disease where the bowel lacks nerve cells

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Colostomy bag surgery

There are two main surgical procedures used to create a stoma in the abdomen:

Loop colostomy: A loop of the colon or large intestine is pulled through the stoma in the abdomen, opened, and stitched to the skin. The pouch is used to collect waste thereafter.
End colostomy: The end of the colon or large intestine is pulled through the stoma in the abdomen and stitched to the skin. The pouch is used to collect waste thereafter.

Both procedures are considered routine. However, the exact method will depend on factors such as:

The medical condition that is being treated
Whether continence is expected to eventually be restored after recovery by means of a follow-up procedure known as colostomy reversal

Both loop and end procedures are usually performed using keyhole surgery as an inpatient procedure at the clinic, but some may require open surgery. Open surgery often has a longer recovery time.

Ileostomy

This similar procedure also entails using a stoma bag, which is sometimes termed an ileostomy bag, to differentiate. It is commonly carried out as a treatment for ulcerative colitis.

This surgery involves bringing the small intestine out of the body to divert waste, then placing a stoma bag over the opening.^[4] Bodily waste is then drainable through the opening and does not need to pass through the colon and rectum.

Urostomy

A urostomy also called an ileal conduit, is a procedure that creates a stoma specifically to drain urine when passage through the bladder and urethra is not possible. A urostomy bag, which is similar to a colostomy bag, is used to collect the urine, which is then drainable via the stoma. A urostomy is a permanent procedure.

Is a colostomy bag permanent?

Use can be temporary or permanent, depending on the type of surgery needed to treat the underlying medical condition. Temporary colostomies tend to be “loop colostomies,” whereas permanent colostomies tend to be “end colostomies.” ^[5]

Colostomy reversal

In the case of a temporary colostomy, surgery is needed to reverse the colostomy. This involves removing the colostomy bag and reconnecting the bowel. Waste can then exit the body normally via the rectum and anus; the stoma will no longer be required. This is generally carried out 12 weeks or more after the initial surgery, but this time can be longer if complications arise during recovery. The procedure is considered straightforward and can usually be carried out using keyhole surgery.

Living with a colostomy bag

After a patient is fitted with a colostomy bag, doctors, nurses, and stoma care experts or colostomy specialists will thoroughly explain how to maintain the stoma and what lifestyle changes may be necessary to adapt to using the pouch. Below is some general information and advice that all colostomy bag users should note.

How does a colostomy bag work?

Generally, colostomy bags consist of two pieces:^[6]

The flange, which adheres to the skin and should be changed every one to two days
The detachable pouch, which catches the waste.

One-piece systems, where the flange and bag are attached and are both disposed of and replaced simultaneously, are also available.

Choosing a colostomy bag

Bags come in a wide variety of sizes and capacities, and most brands offer each bag they make with a one-piece or two-piece option. Different bags may be suitable for different occasions and purposes. For example, a person may choose to use:

A larger size stoma bag while sleeping, e.g., one which can hold around 650 ml of waste. This will help them to avoid leakage, because they cannot control or predict the volume of their nightly waste output.
A small stoma bag during their waking hours, when it can be changed as needed. For example, one which can hold around 400 ml of waste.

It is generally recommended that people empty their colostomy pouch when it is one-third to one-half full. The smaller a colostomy pouch is, the more often it will need to be emptied.

Colostomy specialists will assist in deciding which type of colostomy bag suits the individual needs of a person. Factors that will be considered in helping a person choose the right kind(s) of a bag for them include:^[7]

Where the stoma is in relation to the rest of the person’s digestive tract. This helps determine the volume of waste output. The higher up the digestive tract the stoma is, the greater the volume of waste output will be.
What kind of procedure the person had and how much of their gastrointestinal system will still be functioning as normal when the bag is in use, which will help determine the volume of waste output and the expected firmness of stools. In general, the smaller the section of the colon that is removed, the firmer a person’s stool will be.
Their lifestyle, including diet and physical demands of daily life, as well as any environments or activities that may require a particular size or style of pouch. For example, a person wearing tight-fitting clothing may prefer a less bulky option.

Choosing a disposable or reusable bag

All colostomy bags are designed to be changed and replaced regularly, but some need to be changed more often than others. Choosing which type of colostomy bag to use is largely a matter of preference. Many people swap between different types, depending on their day’s activities.

The two main types of colostomy bag, both of which come in a wide range of sizes and capacities, are:

Closed-end pouches

These are designed for one-time use. They are often fitted with a filter designed to reduce gas buildup and prevent odors. Changing a closed-end pouch can be done as often as a person wishes and involves discarding the used pouch in a disposable bag, which is often provided with the pouch, and attaching a new pouch to the stoma.

Many people who have undergone a colostomy choose to use closed-end pouches every day. Others choose to use them at certain times, e.g., for going to the beach or before sexual activity, when having a fresh/empty pouch may be considered ideal.

Drainable pouches

Rinse-and-reuse drainable pouches are suitable for people who have had all types of colostomy and ileostomies. They can be emptied into the toilet as needed, cleaned with water, and resealed with a clip or velcro fastening.

Many people prefer drainable pouches to single-use, closed-end pouches, as they do not need to be changed as often and are therefore more economical and environmentally friendly.

Drainable pouches are usually fitted with a filter to reduce odors and drain the gas. A drainable pouch should be discarded and replaced with a new one every three to four days. The filter’s functionality may decrease after this time, increasing the possibility that the bag could begin to smell. Furthermore, although it is easy to keep the outer parts of drainable pouches clean, changing the appliance regularly reduces any potential bacteria buildup and minimizes the risk of infection around the stoma.

Good to know: People who have undergone an ileostomy often choose to use a drainable pouch in everyday life and a closed-end, single-use pouch for particular occasions only. A high volume of liquid stool is average following an ileostomy. Many people find changing a single-use bag frequently costly and inconvenient.

How to change a colostomy bag

The pouch can be changed as often as needed – usually shortly after a bowel movement.
At first, the procedure may prove difficult but will get easier with practice. For basic guidelines, follow these six steps:^[8]

Thoroughly wash your hands using antibacterial gel or soap.
Gently ease the pouch from the stoma, using adhesive remover to help if necessary.
By removing or cutting away the bottom section, empty the pouch of stool and other waste, into the toilet. If you don’t want to do this, pouches can be disposed of in their entirety into a disposal bag.
Clean the stoma with warm water and mild soap and thoroughly dry with a dry wipe.
Prepare the new pouch by removing the protective cover from the flange.
Place the flange over the stoma, ensuring there are no creases.

Ensuring good adherence

To ensure a tight seal over the stoma in the abdomen, the skin should be clean and dry. Humid conditions and increased sweating may lead to reduced wear-time, so keeping ready stock of replacement pouches is advised.

Colostomy bag accessories and supplies

Aside from the essential components (flanges, pouches), there are a variety of accessories available to help with stoma care and use. The most commonly-used accessories include:^[9]

Belts: Belts help secure the colostomy bag to the body, reducing the risk of dislodgement and leakage.
Stoma paste: These pastes help adhere the flange to the skin of the abdomen.
Stoma powder: Used to dry sore or inflamed skin around the stoma, allowing the flange to be applied more easily and effectively.
Wipes: Wipes can be used to clean the skin, remove adhesive residue or to form a protective film between the stoma and flange.

Day-to-day life

Generally, colostomy bag users can lead an everyday life and participate in all the activities they wish to. There are, however, a few tips to keep in mind to avoid damage to the colostomy bag.

Spare colostomy bags and accessories should be carried whenever possible. Patients typically have less control over continence following a colostomy, meaning the pouch may need to be changed unexpectedly when away from home.
Caution should be taken with pets or children who may unintentionally dislodge or damage the colostomy bag.
Food and drinks that cause flatulence, such as carbonated drinks, beans, cauliflower, cabbage, etc. should be avoided.
Once the stoma has healed, sports and exercise are possible. Specialized supports and smaller, more agile pouches are available to aid in this.

Bathing and showering

When bathing or showering, the colostomy bag can be left in place or removed. If left in place, the outside of the filter should be covered using a sticky patch (the hospital/doctor should supply that) to prevent any damage. If removed, it is best to select a time when the stoma will be less active – before, rather than following, a meal, for example. Before refitting the colostomy bag, ensure the skin around the stoma is completely dry.

Clothing

Generally, clothing comfortably supports a colostomy bag can be found in regular clothing outlets. However, clothing designed specifically with users” needs in mind is also available from specialist outlets. Items include:

High-waisted trousers to suit those with a waist-level stoma
High-waisted underwear
Specially designed swimsuits

Sexual activity

Healthy sex life is generally possible for people living with a colostomy pouch. The main obstacle may be an embarrassment, which may be helped by using a smaller pouch or by wearing clothing that covers or secures the device in place.

Replenishing supplies

After surgery, the clinic supplies appliances and accessories and a prescription detailing the person’s requirements. When running low, the prescription can be taken to a doctor or pharmacy to replenish all essential items.

Good to know: It is usually possible to obtain a certain amount of free supplies on a long-term basis on prescription from one’s national healthcare provider. The National Health Service (NHS) in the U.K. recommends a monthly allowance of 30 to 90 single-use bags or 15 to 30 drainable (ileostomy) bags and around 15 flanges.^[10] Medicare in the U.S. offers a policy that covers around 80 percent of the cost of a person’s supplies after a doctor has confirmed the specific items and quantities required.^[11]

Colostomy bag FAQs

Other names for a colostomy bag

Stoma bag
Ostomy bag

The Independent. “What is a colostomy bag and what is it used for?” July 7, 2014. Accessed: June 28, 2017. ↩
NHS. “Colostomy.” April 28, 2015. Accessed: June 28, 2017. ↩
Healthline. “Colostomy.” Accessed: June 28, 2017. ↩
Colostomy Association. “What is a stoma?” Accessed: June 28, 2017. ↩
Johns Hopkins Medicine. “Colostomy.” Accessed: June 28, 2017. ↩
Health Encyclopedia. “Colorectal Cancer: Tips for Living with a Colostomy.” Accessed: June 28, 2017. ↩
American Cancer Society. “Types of colostomies and pouching systems.” 2018. Accessed: July 13, 2018. ↩
SecuriCare. “How to change your colostomy bag.” Accessed: June 28, 2017. ↩
Stomawise. “Ostomy Accessories.” Accessed: June 28, 2017. ↩
Gastroenterology & Hepatology. “Efficacy and Complications of Surgery for Crohn’s Disease.” September, 2010. Accessed: April 18, 2018. ↩
NHS Cambridgeshire and Peterborough Clinical Commissioning Group. “Stoma products: quantities.” February, 2018. Accessed: July 13, 2018. ↩
Medicare.Gov. “Ostomy supplies.” Accessed: July 13, 2018. ↩
NHS. “Ileostomy.”. March 29, 2016. Accessed: April 18, 2018. ↩
Shield Healthcare. “Famous people with ostomies.” March 29, 2016. Accessed: July 13, 2018. ↩

**What is a Colostomy Bag?**

**Q: What is‍ a colostomy bag?**

**A:**⁢ A colostomy bag is a device used to collect⁤ waste from the colon after a surgical procedure called a colostomy. During a colostomy, a portion of the colon is ⁤diverted through an opening in the abdominal wall ‍(stoma). The colostomy bag ‍attaches to the stoma and allows⁣ the user to collect and manage the waste.

**Q: Who needs a colostomy bag?**

**A:** ‌Colostomy bags⁣ are typically used by individuals who have undergone a colostomy surgery for ‌various reasons, including:

* Colon cancer

* Crohn’s disease

* Ulcerative colitis

* Rectal prolapse

* Traumatic bowel injury

**Q: What are the different types of colostomy bags?**

**A:** There are several types of colostomy bags available, including:

* **Drainable bags:** These bags have an opening that allows the user to drain the waste into a toilet.

* **Non-drainable bags:** These⁢ bags are sealed and must be disposed of when they are full.

* **One-piece bags:** These bags are a ⁢single unit that attaches directly to the stoma.

* **Two-piece bags:** These bags have a baseplate that attaches to the stoma and a collection bag ⁣that can be attached and ‌detached from the baseplate.

**Q: How is a colostomy⁤ bag attached?**

**A:**⁣ A colostomy bag is attached to the stoma using a baseplate. The baseplate has an adhesive ring that adheres to the skin around the stoma. The collection bag then‌ snaps onto ‌the baseplate.

**Q: How often should a colostomy bag be changed?**

**A:** ‌The⁤ frequency of changing a colostomy bag⁤ depends on the individual and the type of bag used. Drainable bags may need‍ to be emptied and ‌changed more often, while⁤ non-drainable bags can typically be worn for longer periods.

**Q: ‌What are some tips for⁤ managing a colostomy bag?**

**A:** Here are some‌ tips for managing a⁣ colostomy bag:

* Clean the skin around the stoma daily.

* Change the⁤ baseplate every 3-7 days.

* Empty a drainable bag as needed.

* Dispose of a full non-drainable bag.

* Avoid activities that could ‌put pressure on the stoma.

* Consult with a ⁢healthcare professional for any⁤ concerns or questions.

**Q:⁣ Are there any lifestyle changes I need ⁣to make with a colostomy bag?**

**A:** While having a colostomy bag may require some adjustments, most people can continue to live an active and fulfilling life. ⁣Some lifestyle changes that may be necessary include:

* Adopting a high-fiber diet to ⁢promote regular bowel movements.

* Limiting dairy products and caffeine, which can thicken‌ stool.

* Avoiding activities that could put pressure on the stoma,⁤ such as⁢ heavy lifting.

* Managing stress, as it can affect bowel function.

**Keywords:**

* Colostomy bag

* Stoma

* Colostomy surgery

* Colon cancer

* ⁤Crohn’s disease

* Ulcerative ⁢colitis

* Drainable bags

* ⁣Non-drainable bags

* One-piece bags

* Two-piece bags

* Baseplate

What is Colostomy Bag?

Colostomy bag

When is a colostomy bag needed?