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You will need to learn how to care for your colostomy when you go home. You might also want a family member, caregiver, or friend to learn in case you need help.
There is more than one way to care for your colostomy. Before you leave the hospital, make sure that you are comfortable choosing a pouching system, emptying and changing your pouch, and managing problems that can come up when you have a colostomy.
You will most likely be taught how to manage your colostomy by an ostomy nurse or other special nurse. An ostomy nurse or Wound Ostomy Continence nurse, sometimes called a WOC nurse, is a specially trained nurse who takes care of and teaches people how to take care of their ostomies.
Right after surgery, your colostomy will likely have a clear pouch placed over it. The type of pouch used right after surgery is usually different from those you’ll use at home.
Right after surgery, your stoma may be quite swollen. There may also be bruises and stitches around it. While a stoma normally is moist and pink or red, it may be darker at first.
Your stoma will change a lot as it heals. It will get smaller and any bruising will go away, leaving a moist red or pink stoma. This could take several weeks.
Your colostomy does not have a valve-like sphincter muscle to control when your stool comes out. You’ll need to wear a pouch over your colostomy. Your ostomy nurse or doctor will help you find a pouching system that’s right for you.
A pouching system can help prevent stool from leaking, protect the skin around your stoma, and contain odor. A good pouching system should:
When you’re trying out your first pouching system, talk with an ostomy nurse or someone who has experience managing colostomies. Someone at the hospital should be able to get you started with equipment and instructions after surgery. You might also want to ask for a referral to home care or an ostomy nurse.
Pouches come in many styles and sizes. Your choice of pouching systems should focus on the ones that prevent leakage and protect the skin around your stoma. An ostomy nurse or other nurse who has experience with ostomies can help you choose the best one for your situation and lifestyle.
All pouching systems have a pouch to collect stool that comes out of your stoma and an adhesive barrier (called a flange, skin barrier, or wafer) that protects the skin around your stoma. There are 2 main types of systems available:
Some pouching systems can be opened at the bottom for easy emptying. Others are closed and are taken off when they are full. Still others allow the adhesive skin barrier to stay on the body while the pouch may be taken off, washed out, and reused.
Pouches are made from odor-proof materials and vary in cost. They can be either clear or opaque and come in different lengths.
It is important to choose a skin barrier for the pouching system that fits your stoma. The opening should be no more than 1/8 inch larger than your stoma.
You may need to cut or mold a hole in the skin barrier to fit your stoma. Or you might be able to buy a skin barrier already sized and pre-cut for you. The size of the hole in the skin barrier is important because it is designed to protect the skin near your stoma from stool and be as gentle to the skin as possible.
Your stoma's size can change if it becomes swollen or for other reasons. For example, after surgery, your stoma might be swollen and will go down in 6 to 8 weeks. During this time your stoma should be measured about once a week. A measuring card might be included in boxes of pouches, or you can make your own template to match your stoma shape.
Some people like to wear an ostomy belt to help hold their pouch in place. A belt might make you feel more secure by applying pressure to improve the seal of the skin barrier. Some pouching systems come with loops to attach a belt to.
If you choose to wear a belt, adjust it so that you can get 2 fingers between the belt and your waist. This helps to keep you from getting a deep groove or cut in the skin around the stoma. This can cause damage to your stoma and sores (pressure ulcers) on the nearby skin.
People in wheelchairs may need special belts. Supply companies often carry these special belts, or an ostomy nurse can talk to you about making one yourself.
If your colostomy puts out stool at regular times, you might be able to use a stoma cap instead of always wearing a pouch. Stoma caps are small, closed pouches with absorbent material inside. They can help absorb small amounts of mucus or other drainage and are often used after irrigation.
Once you have determined the colostomy supplies that work best for you, you will need to find a place to purchase them. Ask your doctor or ostomy nurse for recommendations of ostomy suppliers, such as mail order companies, medical supply stores or local pharmacies, and how to purchase from them. You can also search the internet for “ostomy supplies.”
Many private insurance plans, Medicare part B and Medicaid will cover the cost of your ostomy care and supplies. However, there are differences between plans that you should know about.
If you have time before your surgery, you might want to contact your health insurance plan and find out whether they cover the costs of ostomy care and supplies and how they pay for these costs. You might want to ask:
An ostomy nurse or the staff in your surgeon’s office may be able to help you find out the answers to these questions as well. They can also help you figure out what types of supplies you are likely to need.
If you have trouble paying for your supplies, there are organizations that might be able to help you. Some companies that make ostomy supplies have assistance programs to help you get free supplies for a while. There are also organizations that help people with ostomies find the supplies they need. Ask your ostomy nurse for suggestions for support options.
The skin around your stoma should look the same as skin anywhere else on your abdomen. But ostomy output can make your skin tender or sore. Here are some ways to help keep your skin healthy.
Use the right size skin barrier opening. An opening that’s too small can cut or injure the stoma and may cause it to swell. If the opening is too large, stool could get to and irritate the skin. If this happens, change the skin barrier and pouch and replace it with one that fits well.
Use a skin barrier product that best protects the skin around your stoma. There are types of skin barrier products. Many pouching systems include a solid skin barrier that sticks to the skin around your stoma. This may be used alone or along with other products, such as pastes, powders, rings, strips, or liquid barrier films. You might need to try several products to see what works best for you.
Change your pouching system regularly to avoid leaks and skin irritation. Set a regular schedule for changing your pouch. Don't wait for leaks or other signs of problems, such as itching and burning.
Be careful when pulling the pouching system away from your skin and don't remove it more than once a day unless there’s a problem. Remove the skin barrier gently by pushing your skin away from the sticky barrier rather than pulling the barrier away from the skin.
Clean the skin around your stoma with water. Dry your skin completely before putting on a skin barrier or pouch.
Watch for irritation and allergies caused by the skin barrier products you use. Reactions can develop after weeks, months, or even years of using a product. If your skin is irritated only where the plastic pouch touches it, you might try a pouch cover or a different brand of pouch. An ostomy nurse can help you find other options if needed.
If you have a descending or sigmoid colostomy, you might choose to use irrigation to manage your ostomy output. Irrigation means putting water into your colon through your stoma. This stimulates your bowels to empty into your pouch. like an enema.
Not everyone benefits from irrigating their colostomy. Whether you can irrigate your colostomy depends on:
If you are interested in learning to irrigate your colostomy, talk to your doctor or ostomy nurse. They can teach you how to do it.
You’ll be taught how to empty and change your pouching system before you leave the hospital.
Empty your colostomy pouch when it is 1/3 to 1/2 full to keep it from bulging and leaking.
If you are using a drainable pouch:
Roll up the end of the pouch and clip or Velcro shut. Closed-pouch systems will need to be removed, disposed of and replaced with each use. For two-piece systems, just the pouch will need to be replaced. If you use a one-piece system the whole pouching system will need to be replaced.
Most people change their pouching systems twice each week (every 3to 4 days). You may need to change your pouch and skin barrier more often if it is leaking or if your skin is irritated. If your skin around your stoma begins to itch, burn or feel wet you should change your pouching system.
It’s easiest to change your pouching system when you usually have less bowel activity. This might be in the morning before you eat or drink . Or allow at least 1 hour after a meal, when your digestive system has slowed down.
Right after surgery, your ostomy output may be thin and watery. As your stool gets firmer, it should be easier to find the best time to change your pouch.
The skin barrier of your pouching system must stick securely to the skin of your colostomy. When you apply the skin barrier, be sure to apply gentle pressure so that it can create a good seal on your skin.
The length of time the barrier will stay sealed to your skin depends on many things, such as:
If you have problems keeping a tight seal, talk to your ostomy nurse or health care team about other skin barrier options. Different products might help you keep the skin barrier intact for longer.
Exposure to air or contact with soap and water won’t harm your colostomy. Water will not flow into the stoma. Soap will not irritate it, but rinse the soap off well before putting on the new barrier.
If you want to leave your skin barrier and pouch on while you shower or bathe, it can help to dry the collar of your skin barrier with a towel or hair dryer after you are done. This can help prevent your barrier from coming loose.
You will not need to wear special clothes over your colostomy. Many colostomy pouches are fairly flat and hard to see under most clothing.
Snug undergarments such as cotton stretch underpants, t-shirts, or camisoles might give you extra support, security, and help conceal pouches. A pouch cover can add comfort by absorbing body sweat and keeps the plastic pouch from forresting against your skin.
Colostomies change the way your bowels work, but there are ways to handle any problems.
You don’t have to eat a special diet when you have a colostomy. But there are a few things to keep in mind.
When you first get your colostomy, you might have a lot of gas. This can happen after most surgeries on your abdomen (belly). While this gas is not harmful, you may feel uncomfortable with the noises that can happen.
If you worry about other people hearing the rumbling, you could say, “Excuse me, my stomach’s growling.” If you feel as though you are about to release gas when you’re with people, casually fold your arms across your belly so that your forearm rests over your stoma. This will muffle most sounds. Check with your ostomy nurse or doctor about products you can take to help lessen gas.
Certain foods may cause gas, for example: eggs, cabbage, broccoli, onions, fish, beans, milk, cheese, spicy foods, carbonated drinks, and alcohol. To help decrease the amount of gas you get:
Many things can affect the odor of the gas and stool that comes out of your colostomy. Certain foods, medicines and vitamins can cause odor. Even the normal bacteria in your intestine and illness can contribute.
Use odor eliminators such as ostomy deodorant liquids or tablets in your pouch.
Medicines also might help. Some things many people have found help with odor are chlorophyll tablets, bismuth subgallate, and bismuth subcarbonate. Check with your doctor or ostomy nurse about these products and how to use them. And think about using air deodorizers in the room when you empty your pouch.
Spots of blood on your stoma are not a cause for alarm. Cleaning around the stoma as you change the pouch or skin barrier may cause slight bleeding. The blood vessels in the stoma's tissues are very delicate at the surface and are easily damaged.
Any bleeding should stop quickly. If it doesn’t, use gauze to put pressure on the stoma and call your ostomy nurse or your doctor for guidance.
If you find pills or capsules in your pouch, it could mean you may not be getting all the medicine you were prescribed. This is more likely to happen with ascending or transverse colostomies.
If you notice this, talk with your health care provider or pharmacist. There may be other medicines or formulas you can use to make sure you’re getting what you need. Liquid or liquid gel medicines tend to absorb faster and may work better for you.
If you have a lot of hair around your stoma, you might have trouble getting your skin barrier to stick well. The hair might also pull out when you take off the skin barrier which can be painful. Shaving or trimming the hair with scissors may help with this.
It’s recommended that you use stoma powder to dry shave the skin around your stoma. Soap and shaving creams have lotions and oils that might make it hard to get a good seal with the skin barrier. After shaving, rinse and dry the skin around your stoma well before applying your pouching system.
Your stoma most often will not cause pain or discomfort since there are no nerves in your bowels. But the skin around your stoma might become irritated.
Skin breakdown around a colostomy stoma may be caused by damage from skin barrier removal, being too rough when cleaning the skin around the stoma, and reaction to skin barrier or pouching system materials. Breakdown can lead to skin that is red, sore, and sometimes weeping (wet all the time).
Skin problems can keep you from getting a good skin barrier seal around your stoma. It’s important to treat minor irritations right away.
Get in touch with your doctor or ostomy nurse if your skin irritation doesn’t get better or gets worse over time. They can help you determine the cause of your skin problems and give you medicine or other options to help heal your skin. The pouching system could need changes to give a better seal.
How often you have a bowel movement into your colostomy bag will be different for each person. Some people have 2 to 3 movements a day, while others have a bowel movement every 2 to 3 days. It may take some time after surgery to figure out what’s normal for you.
There might be times when you don’t move your bowels as often or your stool is harder than usual. This may mean that you are constipated and should take steps to soften your stools more. Here are some tips for preventing and managing constipation.
Diarrhea from a colostomy usually means that something is irritating the bowel. Diarrhea is defined as frequent loose or watery bowel movements in greater amounts than usual. Diarrhea can come on fast and may cause cramps. It can cause your body to lose a lot of fluids and electrolytes.
Loose stools that come from eating certain foods, such as raw fruits and vegetables, milk, fruit juice, and prune juice, are not usually a reason to worry. If your loose stools only last a short time, they usually don’t need to be treated.
Several things can cause diarrhea:
If you have diarrhea, be sure that you are drinking enough fluid to prevent dehydration. You should drink at least 1 cup of liquid (such as water, sports drinks, or bouillon) after each loose bowel movement to replace lost fluids.
Talk with your doctor or ostomy nurse if you have ongoing diarrhea. Let them know what you eat and drink, when you eat, how much you usually eat, and any medicines you are taking. You may be given medicine to help slow things down.
If you had a perineal resection for rectal cancer, you might still have the urge to move your bowels the way you did before surgery. This can happen at any time and may go on for years after surgery. Some people who have this feeling say that it is helped by sitting on the toilet and acting as if a bowel movement is taking place.
Some people with cancer may need an ostomy while they are receiving other cancer treatments. You may need help caring for your ostomy if you are too tired or sick after treatment. If you are getting radiation therapy in the area of your ostomy, you may need to remove the pouch during treatment. Radiation therapy may also cause skin changes near your ostomy. Ask your health care team about any special precautions you should take to care for your ostomy during cancer treatment.
You should call the doctor or ostomy nurse if you have:
Call your doctor or ostomy nurse if anything unusual is going on with your ostomy. They can help you figure out what the problem is and how to deal with it.
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
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United Ostomy Association of America (UOAA). Are you covered? Know your health care insurance and what you need. Accessed at https://www.ostomy.org/are-you-covered-know-your-health-care-insurance-and-what-you-need/ on May 13, 2025.
United Ostomy Association of America (UOAA). New Ostomy Patient Guide. Accessed at https://www.ostomy.org/wp-content/uploads/2024/04/UOAA-New-Ostomy-Patient-Guide-2024-04.pdf on April 29, 2025.
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Last Revised: July 1, 2025
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