How the stoma works
When the bowel moves, wind and waste matter come out through the stoma. You cannot control when this happens, so a small bag is worn on the outside of the body to collect the waste matter. This is called a stoma bag or an appliance. Stoma bags have adhesive on the back so they stick securely to the skin and provide a leak-proof, odour-proof system. A filter lets out any wind (but not the odour), which should stop the wind inflating the bag. If your bag keeps filling up with air, ask your stomal therapy nurse if there are things you can do to prevent this.
Attaching the bag
A stomal therapy nurse will help you choose a bag that suits your body shape and the stoma, and will explain how to attach it securely.
Emptying the bag
Stoma bags can be drainable (able to be emptied) or closed (thrown out after each bowel movement). After a colostomy, you may be able to wear a drainable or closed bag, depending on the consistency of your waste matter. After an ileostomy, you wear a drainable bag.
How often you need to empty or change a stoma bag is affected by what you eat and drink.
- Closed bags may need changing 1–3 times a day. They should be put in a rubbish bin, not flushed down the toilet.
- Drainable bags have to be emptied in the toilet when about one-third full, and replaced every couple of days. A colostomy bag may need emptying 1–3 times a day. An ileostomy bag may need emptying 4–6 times a day because the waste is more watery.
If you have a colostomy in your descending colon, you may be able to wash out the colon with water (colostomy irrigation) to remove the faeces, then wear a small cover rather than a stoma bag. Talk to your doctor or stomal therapy nurse about this option.
A/Prof David A Clark, Senior Colorectal Surgeon, Royal Brisbane and Women’s Hospital, QLD, The University of Queensland and The University of Sydney; Yvette Adams, Consumer; Dr Cameron Bell, Gastroenterologist, Royal North Shore Hospital, NSW; Katie Benton, Advanced Dietitian Cancer Care, Sunshine Coast University Hospital and Queensland Health, QLD; John Clements, Consumer; Dr Fiona Day, Medical Oncologist, Calvary Mater Newcastle, NSW; Alana Fitzgibbon, Clinical Nurse Consultant, GastroIntestinal Cancers, Cancer Services, Royal Hobart Hospital, TAS; Prof Alexander Heriot, Consultant Colorectal Surgeon, Director Cancer Surgery, Peter MacCallum Cancer Centre, and Director, Lower GI Tumour Stream, Victorian Comprehensive Cancer Centre, VIC; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Dr Kirsten van Gysen, Radiation Oncologist, Nepean Cancer Care Centre, NSW.
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