Ileostomy: Changing Your Pouch

Stool starts to pass from the stoma soon after surgery. At first, a nurse will change your pouch. But you'll need to learn how to change it yourself before you go home. Depending on the type of pouch system you have, you will need to change your pouch 1 or 2 times a week and when it leaks. Empty the pouch when it is 1/3 full. Don't let it get more than 1/2 full. Your doctor or nurse will guide you better about how often you need to change the pouch. To change your pouch, follow the steps below.

Start by gathering what you'll need.

• Plastic bags
• Clean towel
• Toilet paper
• Extra skin protection, if desired
• Soft washcloth
• New pouch

• If you use a drainable pouch, empty it first. Open the hook-and-loop closures. Or remove the clamp and set it aside.
• Sit on or next to the toilet.
• Start at the upper edge of the skin barrier. Carefully push the skin away from the barrier with one hand. Slowly peel back the skin barrier with the other hand.
• Peel all the way around the skin barrier until the pouch comes off. Seal the pouch in a plastic bag. Then put it in a second plastic bag. Throw it away in a trash bin.

• Wipe any stool off the skin around the stoma with toilet paper.
• Clean the skin with warm water and a soft washcloth. Wash right up to the edge of the stoma.
• Pat the skin dry with a clean towel.
• Put on extra skin protection if desired. This may be a moisture barrier paste, powder, or gel. Wipe away excess paste, powder, or gel.
• Don't use skin care products that contain alcohol. Alcohol can make your skin too dry.
• Don't use creams, oils, and lotions on the skin around your stoma. These types of products can make it hard to attach the pouch to your skin.

Follow any specific instructions your doctor or nurse gives you on cleaning your stoma.

• If you don't use a pouch with a precut skin barrier, size and cut the opening.
• Slowly peel the backing off the barrier. Carefully place it over the stoma.
• If you use a 2-piece pouch, snap the pouch onto the barrier. Start at the bottom. Work your fingers around the flange.
• Press the barrier against the skin with your fingertips. Lay the palm of your hand over the barrier. Hold it in place for 45 seconds. This molds the barrier to your skin.
• Secure the hook-and-loop closures shut. Or clamp the tail of the pouch.

Contact your wound, ostomy, and continence nurse (WOCN) right away if:

• The skin around the stoma is red, weepy, bleeding, or broken.
• The skin around the stoma itches, burns, stings, or has white spots.
• The stoma swells, changes color, or bleeds. If there is a large amount of bleeding, call 911 immediately.
• The stoma becomes even with or sinks below the skin. Or it sticks up more than normal.