Colostomy Bag

How long a colostomy takes depends on the initial reason for the colostomy, the risks involved and how much of the digestive tract has been removed.

As many as a third of people consider a colostomy to be only temporary, but they end up keeping their stoma permanently. This may be the result of unexpected risks or personal choice.

For those who are able to reverse their colostomy, this usually happens within 3-6 months of the initial surgery, after the tissue has healed or the acute problem has been treated. However, some people undergo colostomy reversal even years after the initial surgery.

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Supplies Needed
New colostomy bag (one-piece or two-piece system)

Adhesive remover wipes/spray

Soft washcloth, mild soap, and warm water (or pre-moistened ostomy wipes)

Skin barrier paste/ring or powder (if recommended)

Measuring guide/scissors (to size the flange)

Disposable gloves

Plastic disposal bag

Dry gauze or tissue

Step-by-step guide
Prepare the Environment

Wash your hands thoroughly with soap and water.

Gather supplies in a clean, well-lit area.

Remove the used bag.

Wear gloves.

Gently peel the used bag downward, using adhesive remover if necessary to avoid skin irritation.

For two-piece systems, separate the bag from the flange (base plate) if only the bag is being replaced.

Cleaning the stoma and skin

Gently wipe the stoma (pink, moist bowel opening) with a damp cloth or stoma wipe. Note: The stoma may bleed slightly; this is normal.

Cleanse the peristoma skin with water.

Pat dry with a soft towel or gauze. Make sure the area is completely dry before applying a new ostomy bag.

Checking the stoma and skin

Check for changes in stoma colour (healthy = red/pink), swelling or skin irritation (redness, sores). Report these problems to your healthcare provider.

Preparing a new stoma bag

Measure the stoma diameter using the guidelines provided. Cut the flange opening 1/8-1/4 inch larger than the stoma to prevent chafing.

For two-piece systems, install the new ostomy bag onto the flange (skip this step if replacing the entire system).

Apply skin protectant (if necessary)

Apply a skin barrier cream/ring around the stoma or apply powder to irritated skin (dust off excess powder).

Installing the new pouch

Remove the liner from the adhesive of the flange.

Centre the flange over the stoma to ensure a tight fit without squeezing the stoma.

Press firmly on the edges to ensure a seal. Place your hand over the stoma bag for 30 seconds to activate the temperature-sensitive adhesive.

Final check

Ensure that the stoma bag is correctly orientated (end stoma down).

Securely close the bag end clip or Velcro closure.

Disposal of used bags

Place the used pouch in a plastic disposal bag, seal and discard.

Wash your hands again

Maintain post-operative hygiene.

Tips for success
Timing: Change the bag when there is less stoma activity (e.g. before meals or in the morning).

Skin care: Use products designed for stoma use; avoid oils or lotions that weaken adhesives.

Monitor bowel movements: Watch for changes in stool colour, consistency or volume, which may indicate dietary or health problems.

When to seek help
Change in stoma colour (dark red, purple or black).

Excessive bleeding, pus or severe skin irritation.

Persistent leakage or inability to secure the stoma bag.

Sudden change in bowel movements (e.g. no stools for 24 hours or watery diarrhoea).

With practice, changing a colostomy bag becomes routine. Always follow your healthcare provider’s specific instructions and attend follow-up appointments for optimal care.

The life expectancy of a person with a colostomy bag (also called a colostomy) is not usually shortened directly by the colostomy itself, but rather by the underlying condition that necessitated the procedure, such as colorectal cancer, inflammatory bowel disease, or traumatic injury. With proper care and management, most people can maintain a normal lifespan and quality of life.

To avoid the need for a colostomy bag, consider the following strategies, which focus on prevention, early intervention, and informed medical care:

1. Preventive measures for colorectal disease
Colorectal cancer:

Regular screening: Colonoscopies starting at age 45 (or earlier for those at high risk) to detect and remove precancerous polyps.

Lifestyle choices: Maintain a diet rich in fiber, fruits, and vegetables; limit red/processed meats; exercise regularly; avoid smoking; drink alcohol in moderation.

Inflammatory bowel disease (IBD):

Medication adherence: Control inflammation with prescription immunosuppressants, biologics, or anti-inflammatory medications.

Dietary management: Work with a dietitian to identify trigger foods and reduce disease flare-ups (e.g., a low FODMAP diet for Crohn’s patients).

Diverticulitis:

High-fiber diet: Prevent diverticula from forming with fiber-rich foods and hydration.

Prompt treatment: Treat infection with antibiotics early to avoid complications such as perforation.

2. Early Detection and Intervention
See a doctor immediately if you have symptoms such as persistent bowel changes, rectal bleeding, or severe abdominal pain so that the problem can be addressed before it gets worse.

Treat bowel obstructions (such as those caused by hernias or adhesions) promptly to avoid emergency surgery.

3. Surgical Alternatives
If resection is necessary, discuss minimally invasive surgery or sphincter-sparing surgery (such as J-pouch surgery for ulcerative colitis) with your surgeon.

Explore temporary stoma options that may be reversible after healing.

4. Lifestyle and Safety
Prevent trauma: Use seat belts, avoid high-risk activities, and pay attention to workplace safety to reduce the risk of abdominal injury.

Manage comorbidities: Control diabetes, obesity, and other conditions that may complicate surgery.

5. Medical Collaboration
Consult a specialist (gastroenterologist, colorectal surgeon) to develop a personalized treatment plan and explore alternatives to a permanent ostomy.

Consider genetic counseling if you have a family history of colorectal cancer or inflammatory bowel disease (IBD).

6. Postoperative Care
If a temporary colostomy cannot be avoided, follow postoperative care closely to improve your chances of reversal.

Note: While these measures can reduce risk, some conditions (e.g., advanced cancer, severe trauma) may require a colostomy. Always prioritize individualized medical advice over general guidelines.

Once you have had your surgery and your bowels have settled down you generally can eat anything. On an individual basis you may find that certain foods cause you problems such as loose stool but it is worth trying the same food on three separate occasions before avoiding it altogether. There are some foods that may cause problems with flatus, odour and loose stool for some people.

With an ileostomy it is best to be careful with any food that has a skin or is solid for example nuts, pith on citrus fruits, raw vegetables, skins on tomatoes, grapes, sweetcorn and potatoes. It is possible for these foods to cause a blockage in the bowel occasionally. You are able to have them but it is wise to have small amounts, chew them really well and drink a good amount of fluid with it.