Caring for Your Stoma
Proper stoma care is crucial to ensure your comfort and well-being while living with a stoma. From cleaning the stoma site to maintaining your peristomal area (the area of skin that “sits” under the stoma bag), you will be given professional guidance to help you manage your stoma, even from the comfort of your home.
Cleaning the Stoma and Peristomal Area
After the second or third day after surgery, a nurse or doctor will teach you how to clean your stoma and change your stoma bag (which we will discuss in the next section). Proper stoma hygiene is essential, as faeces or urine expelled through the stoma can cause irritation or inflammation if they come into contact with your skin.
Tips for Maintaining Hygiene
- Always wash your hands with soap and water before and after cleaning the peristomal area.
- Ensure that the stoma bag is cut to the correct size to prevent leaks that cause soreness on your skin.
- Ideally, you should gently wash your skin with warm water (never with hot water) and then pat the peristomal area carefully with a dry cotton wipe or soft cotton towel. You should do this every time you clean or change your stoma bag or if your stoma happens to leak. Prompt cleanups are essential to ensure your skin is not damaged over time.
- Avoid using paper towels to dry the area; they can stick to the stoma and potentially damage it. Even if it is just for a quick wipe, only use dry or soft cotton wipes.
- You can shower with the stoma bag on or off, but avoid using products that leave a residue on the skin. Cover up the bag’s filter to prevent it from getting clogged.
- Avoid using skincare products that contain alcohol, as they can make your skin too dry and make it difficult to attach the stoma bag. As a precaution, avoid those that contain fragrances as well.
- Avoid using baby oil or similar products on the peristomal area, as these can also prevent the stoma bag from attaching to the stoma correctly.
- Hair around the peristomal area may interfere with attaching the stoma bag, so you may need to shave the area carefully. You can use trimming scissors, a safety razor, or an electric shaver, but be gentle during the process. Rinse the area carefully once you are done.
Other Helpful Tips
- If you notice any skin redness or changes, immediately notify your doctor for prompt medical attention. Avoid letting it worsen over time, which can cause other health complications.
- If your stoma seems to be sticking out, use a cold compress to “push” it back into your body and to its normal position. Learn more about managing common stoma complications.
Handling the Stoma Bag
The stoma bag is where waste matter accumulates as it exits the stoma. Regular cleaning helps maintain your hygiene at all times, especially as waste matter can cause problems to your peristomal area if a leak or mishap occurs. Typically, you must clean your stoma bag every time after every bowel movement, which generally translates to one to three times a day.
It is essential that you pick the right stoma bag for your daily needs. Stoma bags come in two forms: one-piece or two-piece. The two-piece set consists of a baseplate and the bag (or pouch) itself; the baseplate sticks to the peristomal area and shields the stoma from irritation due to waste matter exposure. Meanwhile, the stoma bag attaches to the baseplate in the same way a Tupperware cover works. You may need to change the baseplate once or twice a week or as the manufacturer recommends.
As for the one-piece set, the baseplate and stoma bag are all one piece, hence the name. Please note that the one-piece set is a single-use product, so you should dispose of it properly when the bag is full. Some stoma bags may also be drainable, where the bag has an outlet that lets you drain the bag’s contents. There is also a filter on the bag that lets gas escape from the bag.
When you sleep, you may need to attach a larger stoma bag that can help you manage bowel movements at night without worry.
How to Change the Stoma Bag
The following steps outline how to change your stoma bag, a procedure a nurse will teach you while you are still in hospital post-surgery. We have provided these steps here in case you forgot about parts of the changing procedure. When in doubt, always speak to your doctor or nurse for assistance.
- Before you begin, ensure that you have all the necessary items on hand, including non-fragranced wet wipes, dry wipes, replacement stoma bag, barrier ring (an additional protective item for your skin) or paste, and a disposal bag (for the waste-filled stoma bag).
- As a healthcare precaution, ensure that you have washed your hands thoroughly with soap before beginning.
- Most stoma bags may need to be cut to size; you can do it yourself using the provided size guide or have someone help you.
- If you use a drainable stoma bag, open the outlet over the toilet and let the contents drain. Carefully clean the outlet with toilet tissue or a dry wipe. Roll the outlet back to its original position and seal it. Some bags may allow you to tuck the outlet back into the bag.
- You can place dry wipes around your waistband to avoid waste from spilling onto your clothes or body.
- First, hold the skin around your stoma taut. Starting from the top, slowly and carefully peel the stoma bag back; an adhesive remover can be helpful in this process. Make sure you are in a comfortable position when doing so. Remove and seal the bag carefully, then place it in the disposal bag.
- Gently clean the peristomal area with warm water and dry wipes. If you are not home, you can use non-fragranced wet wipes.
- Dry the peristomal area thoroughly with dry wipes. It is better to pat your skin than rub it with dry wipes.
- Toss all used dry or wet wipes into the disposal bag as well. Avoid throwing them into rubbish bins or down toilet bowls.
- If you use a barrier ring or paste to protect your peristomal area, position it in place before applying the new bag.
- Carefully remove the backing covering the new bag. Fold the top half of the adhesive back, then position the bag’s opening around the stoma. Slowly roll the bag over your stoma from the bottom portion, smoothing the wafer down to remove creases or air gaps.
- You can use the warmth of your hands to mould the bag to your skin and allow the bag to adhere to your skin correctly.
- Seal the disposal bag tight to prevent leakage and throw it into a trash can.
Other Tips on Your Stoma Bag
- The baseplate comes in different variations, from mouldable baseplates for irregularly shaped stomas to convex flanges for stomas that are below skin level. Choose the right one for your stoma to ensure the stoma and stoma bag are sealed tight. Learn more about retracted stoma and how to manage it.
- Stoma bags also come in different sizes. Pick the right size for when you are home or heading out for exercise or other social activities.
- If you are trying a new stoma bag, test it at home first to avoid unwanted accidents. Take a few days to familiarise yourself with the stoma bag; if it is not suitable for you, revert to your usual bag and wait a few days before trying another new one.
- Always get your doctor’s advice about your stoma bag needs or concerns when you need help.
Care Advice for Urinary Diversions
You may have undergone a urostomy, a type of urinary diversion. This surgical procedure detaches the ureters from the kidneys and attaches them to a small part of your ileum (small intestine), which is then used as a stoma to allow urine to be excreted. While it is similar to a stoma from a colostomy or ileostomy, you should pay close attention to the following care tips to manage possible complications.
Some forms of urinary diversions require using a small, thin catheter to remove urine from a pouch made from a small part of your small intestines. To drain your urine, insert one end of the catheter into the stoma and the other into a stoma bag. You should do this regularly every four hours.
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