General Ostomy Management

How Often Should You Change Your Appliance?

Whether you choose a two or one-piece system, seven days is the recommended maximum time a flange should be on your body. Some people can successfully stretch this considerably longer without compromising skin health or hygiene but don’t endeavor to set records. Three to four days is perfectly acceptable wear-time. We’re all different.

How Do You Empty your Pouch?

Most people sit to empty their pouch. Let it fall between your legs, open the end closure and let the stool or urine drop into the toilet. Colostomates and ileostomates should wipe the inside of the pouch end with a tissue before closing to avoid odor. Some people prefer to kneel, facing the toilet, although this can be hard on the knees. Some prefer to stand — if you choose this method, you should put some tissue in the toilet bowel first to control splashing.

How Often Should You Empty?

All categories — colostomy, ileostomy and urostomy — should empty when the appliance becomes one-third full or sooner. Waiting longer than this can make you uncomfortable, puts unnecessary strain on the flange and can contribute to leakage. How many times do most people empty per day? It depends on the type of ostomy, what you’ve been eating and drinking, and your tolerance for having waste present in the bag. Very generally speaking, colostomates empty 3-4 times a day, ileostomates 6 to 8 times a day and possibly during the night, and urostomates 8 to 10 times per day.

Night Drainage Systems for Urostomates

Urine will collect in the appliance continuously throughout the day and night. Many urostomates use a night drainage system rather than waking up to empty a full pouch created during the night. Letting a urostomy appliance get overfull during the night is asking for leakage. Night drainage systems consist of a tube connected to the drain spout at the bottom of your appliance and then connected to either a collection bag or bottle kept beside your bed. Most of the major ostomy manufacturers make night drainage tubing and collection devices. You should discuss these with your NSWOC.

High Output Ostomy Appliances

Like the urostomy night drainage system, persons with a high output ileostomy can also find specialized products helpful. High output ostomy appliances have a much higher capacity for stool, which is often enough to prevent waking up to a full pouch during the night. If additional capacity is needed, they have a spout to which a night bag can be attached. Some ostomates use a two-piece system to wear a regular capacity pouch during the day and switch to a high output bag at night. If your sleep is affected by your ostomy, it is worth speaking to your NSWOC about these options.

How Should You Clean Your Appliance?

Trying to clean inside an appliance while you’re still wearing it is largely a waste of time (not to mention near impossible). It would be best to wipe inside the pouch end with toilet paper after each empty and before closing to avoid odor. If stool is ‘pancaking’ inside or near the top of your pouch, you can use a plastic squirt bottle of water to rinse this out. (Take care not to flush water around the stoma as this may get under the flange.) Adding a few drops of ostomy lubricating deodorant inside the pouch before applying it helps stool slide to the bottom rather than collecting at the top.

If you wear a flange with a two-piece system, sometimes the inside of the ring can become soiled, which bothers some people. Q tips can help clean this but don’t make yourself crazy trying to get the flange ring 100% clean. You can break the seal if you scrub it too hard. You’re going to cover it anyway once the pouch is applied.

Urostomates should rinse the night drainage system every day — it’s advisable to use a mild vinegar/water solution and flush the tubing and collection device. Some manufacturers also market cleaning products specifically for your urostomy night drainage system.

How Should You Dispose of Used Appliances?

Once you’ve drained the pouch into the toilet, put it (and the flange if you are changing that as well) in a plastic bag like one of those you get from the grocery store, a doggie bag or a small zip lock bag. Some companies offer opaque odor-proof bags for disposal. You can use a small plastic wastebasket with a lid, keep it under the bathroom sink, put your bagged waste in there and take it out regularly. If you’re in a public washroom and must dispose of a used appliance and don’t have a plastic bag, wrap it up in toilet paper and put it in the nearest wastebasket. Ladies have the added advantage of having disposal units for menstrual products inside public cubicles – you can use these. Far too many people are anxious about this subject – believe us, nobody is watching what you throw away, and so long as you’re tidy.

You can also have some of these discussions at your Chapter or Support group meetings – everyone has had to deal with similar questions.

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