If you have a colostomy bag, mastering the skill of changing it can take a few tries. The most crucial aspect is to have patience with yourself. The good news is that with time and practice, adjusting your colostomy bag will become second nature to you. Follow the instructions in this step-by-step guide.

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To begin, empty your colostomy bag. If your colostomy bag contains urine or faeces, it is important to clean it before replacing it. The toilet is the safest place to do this. Over the toilet, open the bottom of the bag. When it comes to faeces, gently squeeze it out of the container; when the bag is opened, urine will immediately spill out.

Some colostomy bags have liners and flanges that can be flushed down the toilet. Place the biodegradable flange and inner lining of the bag you’re using in the bowl and flush. The outer layer is unblemished. It can be kept in a purse or pocket until you’re ready to get rid of it.

Hands should be washed properly with soap and water. If this isn’t an option, antibacterial hand sanitizer may be used instead. To protect your clothes, place a clean bath towel on your lap and tuck the top of it into your trousers. When changing your colostomy bag, maintain proper hygiene.

Remove the pouch with care. Slowly ease the pouch off your skin with one hand, using the built-in tab for easier removal. If required, carefully remove the flange with an adhesive remover.

Examine your skin. If it’s a little red and swollen, don’t panic. However, if it looks particularly bruised, or it is painful to touch, give your health care provider a call.

Check your stoma in general — it should always be a red colour, not pale or light pink. If it grows larger, goes further into or out of your skin, leaks pus or blood, or becomes bluish, see your doctor right away.

Make sure your stoma is clean. While this seems like a given, some people actually miss this crucial step. Gently clean around the stoma with warm water and a dry wipe soaked in mild soap. Do not rub. Use only soaps that are free of oils and fragrances. Baby wet wipes are also good to use. Dry the skin gently.

Next up, calculate the size of your stoma with a measuring card system (provided by your doctor or nurse).

Before putting on the fresh pouch, make sure to wash your hands once more. This will ensure that the new pouch is fully sanitised, since you don’t want it to be contaminated with nasty germs.

Use a skin barrier, such as stoma powder, to protect the skin. This is optional, but many people use it to protect their skin as well as provide the ideal foundation for the new colostomy bag to stick to. Over the stoma, sprinkle stoma powder. Make sure the powder doesn’t get on the stoma. Using a dry wipe, gently dust the area and allow it to dry for about 60 seconds.

Good to know: Stoma powder is NOT made of the same type of powder that is found in baby powder or body talc. Also known as stomahesive powder, or peristomal skin protection, it can be purchased through your health care provider.

Make sure the new pouch is ready. To suit your stoma properly, the stoma pouch flange may need to be adjusted. If this is the case, cut out the circle on the flange with scissors. The circle should be about an eighth of an inch wider than the stoma. Pre-printed guides are available on some flanges to assist you.

Some stoma users choose to add a few drops of baby oil in the stoma bag. Why, you may ask? This comes in handy when it’s time to empty waste from your bag as the oil ensures that the waste does not stick to the bottom or sides of the bag.

Cover the stoma with the flange (the adhesive plate to secure an ostomy pouch to the body). Begin pressing on the part of the flange underneath the stoma and work your way up the sides and to the tip. Start smoothing the flange to eliminate the creases once it has been adhered. This aids in the formation of a stronger seal around the stoma.

Begin in the centre (near the stoma) and work your way outward. Remember that the colostomy bag can leak if all creases are not smoothed out, so take a little time to ensure this step is done properly.

Good to know: You’ll need to use stoma paste or a ring seal as the adhesive when changing the baseplate for a two-piece closed colostomy pouch.

Keep the flange in place for about 45 seconds. The adhesive adheres to the skin better when your hands are wet.

When should your colostomy bag be changed? The pace at which you can adjust it depends on the patient and the type of bag you’re using. People with one-piece pouches will need to change the entire colostomy bag each time; on the other hand, people with two-piece pouches can change the pouch as much as they want, while the flange will only need to be changed every two to three days.

Good to know: Unless your doctor or nurse advises otherwise, you can never go more than seven days without changing your colostomy bag and appliance.

Did you know: According to research, eating marshmallows leads to a small reduction in ileostomy output. For more on this research, click here.