How to Manage Your Pouch and Stoma After Colon Surgery

Updated on December 23, 2017
AloBeDa profile image

Adjusting to a colostomy is tough. For me, it was like a horrible dream. But with a positive mindset, I soon adjusted wonderfully.

The thought of having to wear a colostomy bag is one of the most distressing (to say the least) thoughts that'll bother you for some time after having gone through colon surgery.

It’s like chaos in your mind with questions, jumbled thoughts, and deep concern all rolled in one.

  • How will I cope?
  • Can I do this on my own?
  • Will people notice?
  • Will my lifestyle have to change?
  • Oh, my goodness, how will I live with this, day in, day out?

However, the most nagging question of all is:


Feelings and thoughts like these are not uncommon because all new ostomates feel this way when the realization that they'll have to wear a bag finally sinks in. When you know that’s the way you'll be expending your body waste, you won’t be happy about it.

You may even discover that weeks after surgery you are still grappling with these thoughts.

Believe me, this is certainly going to be a 'new way of life' and it requires inner strength to get used to it. It doesn't matter if your colostomy is temporary or permanent,

But one thing is for sure, to pluck up courage and adapt to a few changes to your lifestyle with a stoma is easier than many new ostomy patients may believe.

It's just that initial shock and . . . it will eventually pass.

Most colostomy patients find that after the initial short-term distress, they develop a strong will and calm acceptance. Positive thoughts begin to emerge. This, coupled with proper ostomy management will make an ostomate realize that quality of life can really remain the same.

It might spur on a sense of confidence and even become better. I can personally attest to that!

Function of a Colostomy Pouch

First, I'll briefly explain what a colostomy is.

It's a surgical procedure that involves the diversion of a part of the colon to the exterior through an opening attached to an incised hole in the walls of the abdomen. The round pinkish 'button' at the opening is referred to as a stoma.

Because the opening is external, a colostomy bag (pouch) must be attached to the stoma for the collection of human waste which comes out involuntarily and most times unexpectedly.

This is to say that colostomy bags are meant to collect the waste that under normal conditions pass through the colon to the rectum, and out via the anal opening, down into the toilet and flushed away.

With the bag, waste that collects there is either emptied at intervals or changed completely. This depends on the type of bag you use.

Coping with using an ostomy bag has never been easier. Wearing a bag is no more a big deal either.

When they calmed me and kept reassuring that first week after surgery, I always burst into tears, thinking they are just words to make me feel better.

But it is true that you will get over it sooner than you will ever expect.

Its really not so hard to live with a colostomy anymore, what with today’s technological advancement in the production of essential and easy to use ostomy supplies that have allowed modern day ostomy appliances to become extremely discreet, secure and most importantly (you'll want to hear this) . . . ODOUR FREE!

And the great thing about it all is that no one, except those who you choose to tell, needs to ever know you are wearing a stoma bag.

People are usually oblivious to your condition anyways.

Today, you will find ostomates that flaunt their pouches while wearing their bikini or crop tops and jeans!

So, how about that?

Ostomy Supplies

Today, ostomy supplies can be delivered to your doorstep, wrapped in unmarked boxes or with discreet labels.

Home delivery of medical supplies like these is also great in helping you manage and cope successfully with a colostomy because you don’t need to go out to purchase appliances to the glaring view of others.

Colostomy Patient
Colostomy Patient | Source

Colostomy Pouches

There are two different types of colostomy bags also referred to as pouches:

  1. Stick on types
  2. Strap on types

We all have different choices when it comes to our preferences. The stick on type is the modern one, the preferred type, and it's virtually fuss-free.

It is affixed over the stoma 'button' with a thick waxy faceplate that's sticky on one side. With this type, you have to carefully stick it on to ensure it is totally sealed. There must be no air pockets which may widen and encourage leakages.

It may sound complicated to fit, but it isn't, once you get the hang of it. Many ostomates use the stick-on types.

The strap on colostomy bag, on the other hand, is fitted over the stoma and held with a belt that goes around your abdomen to hold it in place. Some users find this type fairly uncomfortable but that's a matter of opinion.

Other Supplies You Will Need Include

  • Cleaners
  • Deodorants
  • Bonding adhesives
  • Adhesive removers
  • Odor removers
  • Skin barriers

Changing your Bag

You will almost gag the first week or so that you start to change your ostomy bag by yourself because of the strong stench that 'hits' you. But no worries . . . you will get used to that soon enough

Having said that, management is fairly straightforward, and after a few tries, you'll master how to apply your colostomy bag within 7 to 10 minutes. And soon you'll become an expert, changing within 5 minutes and emptying in a couple of minutes.

But there are certain actions you'll have to take to ensure proper care, hygiene, installation, and fit

  1. Ensure the stoma and its surrounds are shaved occasionally to avoid hair pulling when you change your ostomy bags.
  2. Avoid nicking the stoma whilst shaving to avoid bleeding. Remember the stoma has no pain sensors; you won't know until you notice bleeding.
  3. If bleeding becomes severe, get medical assistance ASAP
  4. Don’t be alarmed if you notice minimal bleeding sometimes. Most times, it’s nothing to worry about and it will stop almost as soon as it happens.
  5. Try to stand erect when installing your pouch. You don't want to create folds on your skin which hampers perfect adherence of the sticky faceplate.
  6. Apply your colostomy bag to clean, dry, oil-free skin. You need maximum adherence.
  7. The stick on types comes with a template in the pack. This template has different sized holes. Find the hole that closely fits your stoma and use this to cut out your stoma size on the waxy faceplate. Ensure it’s not cut tight or it will cause bruising if it pinches the edges of the stoma.
  8. If need be, apply a bit of stoma paste around the edge of the cutout hole. This acts as a seal for protection against any fecal leakage.
  9. Ensure the opening for draining the bag hangs straight down; this makes it easier to clean out between changes.
  10. Always make sure you securely clamp (or fold over & Velcro-fix) the bottom of drain-able colostomy bags. You don't want horrible mishaps, like leaks!
  11. If you feel an itchy sensation in the area of the face plate, don't feel tempted to remove your bag and scratch. The best way to ease this is to apply pressure and gently rub over the spot that itches. Don't scratch around the stoma ring or it will bleed.
  12. Your bag will get filled with air (you still pass gas!) and tend to balloon out every now and then, especially if you take fizzy drinks. You'll need to expel this air. It is simple if you use drainable bags. Just sit backward on the toilet, facing its back, the same way you'd sit when emptying it. Un-clamp the bag, tilt the end up, then gently push out the gas by using the palm of your hand in a slow sliding motion . . . up to down . . . while the gas bleeds out. Expel all built-up gas.
  13. Carry a couple (at least) of extra colostomy bags with you AT ALL TIMES, whenever you go out. You can never be too careful. Today's ostomy supplies are so compact, you can have them in a purse or even your pocket. In the event of an emergency, you will be glad you did.

One point to note, if you are going out for a meal or expecting guests for dinner (for instance), change or empty your bag before the meal. From experience, waste is expelled almost immediately after eating, so it’s good to have ample space for it.

One point to note, if you are going out for a meal or expecting guests for dinner (for instance), change or empty your bag before the meal. From experience, waste is expelled almost immediately after eating, so it’s good to have ample space for it.

After Colon Surgery – What's Next?

Living a happy life and continuing with your lifestyle, career, and/or studies is easy and you will find that coping with a colostomy is relatively simple.

It’s so simple that you’ll be changing colostomy bags in less than 5 minutes once you know how to.

It’s also good to know that having a colostomy is a very common thing with millions of people all over the world wearing a bag.

There are many people walking around with bags, pouches, and other supplies required for your stoma. They are at work, go to school, in the clubs partying, and doing any other day to day activity.

Gone are the days when colostomy patients hid behind closed doors, become reclusive, shy, gradually developing anti-social habits.

Wearing colostomy bags because of colon surgery need not hamper your usual habits as long as you eat and drink sensibly.

There are no hard and fast rules about diet but if you keep to a simple diet and ensure proper stoma care by keeping it clean around the hole, you will be fine and chances are that many times you’ll forget you are wearing a colostomy appliance.

Trust me.

© 2010 Alobeda

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    • AloBeDa profile image

      Alobeda 4 weeks ago from The Global Village

      I understand how you feel @Jojo. Having a colostomy can be quite unpleasant but like I did, you will get used to managing it.

      And good thing, it's only temporary.

      I was able to wear pants as its my favourite mode of dressing but at the time, I wore loose fashion tops over my pants. Worked quite fine for me. Try with stylish loose tops.

    • profile image

      Jojo nielsen 4 weeks ago

      I hate my poo bag, I can't wear pants or skirts an am only really comfy in dresses .I am glad it's only temporary, I don't like it at all.

    • profile image

      Cindy Warner 14 months ago

      I need to know how long it will take After surgery for the stoner bag to work and produce any poo?..

    • AloBeDa profile image

      Alobeda 15 months ago from The Global Village

      Joan, have you tried the protective tube belt or even an ostomy belt that's held in place with velcro strips?

    • profile image

      Joan 15 months ago

      Yes I have a colostomy bag and a feeding tube. I love to swim. What can you cover your feeding tube with so you can swim?

    • AloBeDa profile image

      Alobeda 2 years ago from The Global Village

      @joseph I'm not quite sure i understand your question, but if it's what i think it is, "not going everyday" may be due to a mild constipation (OR not eating enough food that'll make you go everyday). Quite common with a colostomy.

      For mild constipation, my doctor recommended a very mild laxative and it did work.

      Hope i've answered your question.

    • profile image

      joseph strigle 2 years ago

      what about not going everyday