What is a Colostomy Bag?
A colostomy bag is a pouch made of heavy-duty plastic that’s worn on your body and collects your poop. You will need to use one of these bags if you had a colostomy, a form of surgery that changes how your body gets rid of waste. You may need to wear a colostomy bag temporarily if your doctor determines that your bowel needs to rest and heal while you recover from a health problem. Or you may need a colostomy bag permanently if your colon is diseased or damaged and needs to be removed.
Normally, you get rid of poop through your anus. In a colostomy, the doctor brings the end of your colon (large intestine) through an opening in your belly to form what's called a "stoma." This is where your poop will come out. Unlike your anus, your stoma doesn’t have muscles or nerve endings. That means you can’t control when you move your bowels. Instead, you will place a colostomy bag over the stoma to receive your poop when it comes out.
Whether you'll only need a colostomy bag for a brief time or it's a permanent change, wearing and using these pouches can take some getting used to. But most people adjust and soon return to their normal lives.
Colostomy Bag vs. Ostomy Bag
A colostomy bag is a type of ostomy bag. Ostomy is the term for a surgery that creates an opening in your body for waste to pass through, called a stoma. If you have an ostomy, you wear a bag over the stoma to collect waste. A colostomy is one type of ostomy procedure. Others include:
- Ileostomy, which creates an opening for stool to pass through in the ileum (small intestine)
- Urostomy, which creates an opening for urine to exit the body if your bladder has been removed
Your doctor can explain what type of ostomy bag is best for you.
Types of Colostomy Bags
One colostomy bag doesn't fit all. There are different types to choose from:
- One-piece system.This type of bag fits around your stoma and is attached with a gentle adhesive. When you need a fresh bag, you take the whole thing off and replace it with a new one. Some of these systems use flushable liners.
- Two-piece system.A base plate fits tightly around your stoma, and you attach a colostomy bag to it. You'll change the bag as needed; you typically change the base plate every two to three days.
- Closed bags.These colostomy bags are best if you have firm stools. You'll change it twice a day. Some have special liners inside that can be flushed down the toilet.
- Drainable bags.These are best if your stools are very liquid. You empty them through an opening at the bottom. They need to be changed every two or three days.
- Mini pouches.These are small bags you wear for only a short amount of time.
Your doctor or a nurse who is trained in stoma care will help you choose the colostomy bag that’s right for you and your lifestyle. Finding the right bag for you may take some trial and error.
Living With a Colostomy Bag
Your medical team will show you how to care for your colostomy bag. But here are a few tips to help you fit it into your daily life:
- Decide how to share your news.You may feelless self-conscious if you show your colostomy bag to loved ones or talk about it with friends. You also may decide to tell your boss or a co-worker in case you need their help or understanding at work.
- Get an honest opinion.Ask someone you trust if they can see your colostomy bag under your clothes or hear the noises it makes. You may realize you're worrying about your bag more than you need to.
- There are ways to hide it. For example, you can empty your colostomy bag once it's one-third full so it doesn't stick out under your clothes. A secure bag should not have leakage and should be odor-resistant.
- Wear what you want.A colostomy bag should fit under your normal clothes. If not, some companies make special high-rise pants and underwear with a special pocket to hold your bag. You also can find swimwear with a mesh lining or gathered fabric to hide any bulges.
- You can have a good sex life.While you might feel self-conscious at first, try to relax. Change your colostomy bag right before you're intimate. You can also take off the bag and temporarily use a small stoma cap instead.
- Stay active.You can still exercise if you use a colostomy bag. Talk to your doctor about when to wear a support garment or a hard plastic shield called a stoma guard.
- Give yourself time to get used to foods.Some are more likely to cause gas, diarrhea, or constipation. Try them at home one by one so you know how your body will react.
- Remember to laugh.Don't worry if you have an awkward moment or two while you're getting used to your colostomy bag. That's normal. You may handle it better if you can keep your sense of humor.
Colostomy Bag Maintenance
Wearing a colostomy bag requires routine upkeep to make sure it works properly and your stoma remains healthy. Check every day to make sure that the stoma and skin around it look and feel normal. The stoma should be pink or red, and you shouldn’t feel any unusual sensations, such as burning. You will develop a routine that works for you, but most people who use a colostomy bag drain it two or three times a day and change the pouch every three or four days.
Foods to Avoid if You Have a Colostomy Bag
After you have a colostomy and begin using a colostomy bag, your doctor will likely advise you to eat bland, easily digested foods for the first few weeks. During this period, you should avoid:
- High-fat dairy foods, such as whole milk and ice cream
- High-fiber foods, such as beans, raw vegetables and fruit, and whole-grain bread
- High-fat sources of protein, such as fried meat, chicken, and fish
- Carbonated and alcoholic beverages
When your doctor gives you the OK, you can start adding foods back to your diet, one at a time.
If you use any form of ostomy bag, you may develop certain problems that can be fixed by avoiding certain foods. For example, a well-fitted colostomy bag should not give off odors, but you may be bothered by the smell when you empty it. In that case, you may want to avoid:
- Alcohol
- Asparagus
- Beans
- Broccoli
- Cabbage
- Eggs
- Fish
- Garlic
- Onions
You may also develop gas. If so, try limiting or avoiding:
- Aged cheese
- Beans
- Beer
- Cabbage
- Carbonated drinks
- Coffee
- Onions
- Raw fruits
- Spinach
- Sprouts
How to Change a Colostomy Bag
Your nurse will explain in detail how to change your colostomy bag and give you a list of all the supplies you will need. Here are the basic steps to changing a colostomy bag.
1. If your used pouch needs emptying, dump its contents into the toilet.
2. Wash your hands thoroughly with soap and water. Dry them with a clean towel or paper towels.
3. Remove the used bag by pushing your skin back with one hand and slowly removing the skin barrier with the other.
4. When the bag is off, put it in a plastic trash bag
5. Clean the skin around the stoma with warm water and a soft washcloth. Pat the skin dry. If you use wipes or toilet paper, place them in the trash bag.
6. If necessary, measure the stoma and use the dimensions to cut an opening in the new bag’s skin barrier. Alternatively, you can get bags with precut openings.
7. Place the opening over the stoma and press the barrier against your skin for at least 45 seconds.
8. If the colostomy bag you use is drainable, clamp its tail.
9. Throw away the trash bag and wash your hands thoroughly.
Colostomy Bag Reversal
For many patients, a colostomy is permanent and they will wear a colostomy bag for the rest of their lives. But some colostomies are temporary – their purpose is to let a patient’s bowel heal and recover from a disease or injury. In that case, the patient will likely be a candidate for a colostomy bag reversal. In this procedure, the surgeon closes the stoma and reconnects your intestines to your anus. That means you no longer need a colostomy bag and can resume pooping in the usual way.
How to Avoid Getting a Colostomy Bag
In some cases, you may be able to choose an alternative to using a colostomy bag. A few possibilities include:
Colonic irrigation.Instead of wearing a colostomy bag, some patients can choose to remove waste from their intestines with special irrigation equipment. To perform colonic irrigation, you put water into a bag equipped with a tube and regulator. You insert the tube into your stoma, then slowly release water into your intestines, flushing them out. The procedure takes about an hour, and not all patients are candidates.
Ileal pouch. If you have had your colon and rectum removed, your surgeon may be able to create a pouch in your ileum, or small intestine, that collects waste. In that case, you would poop normally and not need a colostomy bag.
Colonic stents. Some people with colon cancer develop blockages in the intestines that need to be treated fast. Often, doctors will perform a colostomy to ensure that the patient can eliminate waste. However, special tube-like devices called stents can be implanted in the colon that allow waste to exit the body, instead.
Takeaways
Hearing the words “I think it’s time for a colostomy bag” from your doctor can be upsetting, but for many people, these devices can be life-changing. It may take you time to adjust to using a colostomy bag, but by working with your medical team, it can become just another part of your daily routine. Following an appropriate diet and good maintenance habits can help ensure that you have a positive experience with these devices.
Colostomy Bags FAQs
What are some common problems with colostomy bags?
If your colostomy bag doesn’t fit snugly over your stoma, you could get irritated skin. It’s also possible for problems to happen with your stoma, such as sinking into your skin or sticking out too far. If you notice any changes to your skin or stoma, tell your doctor. Some people who use colostomy bags have gas, diarrhea, or constipation. Working with your care team can help you come up with a diet that will keep these problems to a minimum.
Are colostomy bags permanent?
Not necessarily. If you are recovering from a disease or injury affecting your intestines, your doctor may recommend a temporary colostomy to let them rest and heal.
What can you eat with a colostomy bag?
Doctors typically recommend that you eat bland, easily digested foods as you adjust to using a colostomy bag. Over time, you can gradually begin to eat a wider variety of foods, though sticking to a healthy, balanced diet is always the best advice.
Do colostomy bags smell?
If your colostomy bag is carefully fitted and well-maintained, it should not smell. Bags have charcoal filters that neutralize odors.
