Tips for Managing Output During Ileostomy Pouch Changes

Jeez, you guys, do I have to spell everything out?! LOL! It starts with 'S', I mean we are talking about poop here after all!!

Hi, Cplumber-
I thought I was the only one who emptied my bag in the bathroom sink. It's just so much easier! I live alone and my greyhounds don't care. I have a colostomy, but my output is most often runny.
Cheers,
Riff

In my youth, a group of pals decided to make a band, and one of the proposed names was Machine-Gun Cron (corn.) Although in our imaginations, the corn was emitted from another orifice due to a fistula.
Yes, we were vile young wrenches. Now we're vile old wenches, still having fun!
- Riff

I tried the paper towel "hat" today that you linked to show me about it. That site was so helpful! And, the little hat really helped a lot. It absorbs more than the gauze, tissues, and towel I had been using. Does it solve all my issues? Not really, but it did allow me to build up some Somahesive Powder (I think that's the name) to help protect my peristomal skin that's pretty raw without having to clean up after the stoma and start again. It made the pouch change much easier. Great info! Thanks, everyone.

Start paying attention to what time of the day you have the least amount of output. For me, it's about 2-3 hours after I wake up, but I help this by not eating prior. Starvation from supper the night before I choose to change things up. I then tuck a chunk into my underwear and lay the other end on the sink and weight it down to keep it there. I skip having everything ready to go and then go like hell to get it done. I can do this in about 5 minutes.

Welcome. Every suggestion is a good suggestion.
Education is key on this new journey of yours. I suggest you check out UOAA, United Ostomy Association of America. It's our national organization. There you will learn about foods, blockages, skin care, clothing, products, travel, activities, and a whole host of other tricks of the trade. You might also want to check out a local support group near you. Just remember you are not alone on this new journey of yours. Best of luck.

Hi, you received a lot of good advice and hints, but the best advice after 55 years with an ileostomy, is pick what you think is the best time...and go for it.....It's sometimes a "crap shoot". Most of the time early morning, before even a drink of water is the best time to change, but I don't always have that option....especially when I was working. I also like to give the wafer a time to "set", before I bend, or sit... sometimes, it takes 5 minutes...and sometimes an hour... Prep first... take out, and prepare all the supplies you need. Prepare the wafer.. Instead of a reg. bath mat, I use what would be called a dish mat.....for out of the shower (I have a few of them) If I leak on it.... I rinse it, and it goes in the wash... Before preparing my skin I fold about 2 squares of toilet paper into a thin strip, to wrap around the stoma, giving me a few seconds, to let the skin dry, before reaching for the wafer.. When I first got my ostomy, I was wearing a back brace, and had to change lying down. That was a fiasco.. so since the back issue cleared up, I always stand over the toilet bowl.. In my other house, the sink was right next to me......but in this one, the sink is opposite.. So I wet some toilet tissue.... to wipe up any drips.....and then redo the skin with prep / powder.. My advice... The "faster the better.". I have it down to a science, except when the stoma doesn't cooperate.. Corn was a funny experience.....but a bout of the runs / with gas....was worse.. I sprayed green gook all over the bathroom walls, toilet, floor.... It was awful, and I just wanted to cry.. Which is exactly what I did.. But I managed to eventually catch a calm moment or two, and slap on the bag... Oh the language I used......... It's all a challenge, but once you figure it out, and it works, life is good.... best wishes.. Marsha

Our experiences do differ so much it is hard to know what is going to work. I was discharged with a high output stoma, and had had an ileostomy after removal of an internal pouch that had gone rogue. I had been prescribed 24mg of loperamide to control it! It did subside however, and I now take loperamide only when I need it. This might help? I too was advised to take regular small meals, but in my experience this just made the output relentless, and I now have a small breakfast and dinner, and a larger (root vegetables really help) lunch with a couple of snacks in between. This gives me a large output in the early evening, and less in the day and usually a quiet period in the morning when I can change. This is not 100% reliable, and I'm always half prepared for a surprise. I find sipping fluid is still the best way of keeping hydrated. If I drink too much at once it will make the output very watery.

I've learned to change on a regular schedule. For me, that means every other day, before breakfast but after I go to the gym and/or walk the dog, and immediately after I shower, so it's part of the shower routine. It can still be a pain, especially if I ate something the night before that you need your colon to digest fully, like mushrooms. That can be a "life is weird" moment. But the regularity of it all keeps the variables to a minimum and therefore mess. Good luck!!!

I've learned to change on a regular schedule. For me, that means every other day, before breakfast but after I go to the gym and/or walk the dog, and immediately after I shower, so it's part of the shower routine. It can still be a pain, especially if I ate something the night before that you need your colon to digest fully, like mushrooms. That can be a "life is weird" moment. But the regularity of it all keeps the variables to a minimum and therefore mess. Good luck!!!

Geez, I love women who curse!!

I use the marshmallow trick too. It helps slow the output. I have an ileostomy and I actually sit on the toilet to do a bag change. I set up a little table with everything I need and a bag for garbage and I sit on the toilet with my knees wide so any output that may come drops right down into the toilet. (I usually drop some toilet paper in first so there is no splash back!) Looks like everyone has given you lots of ideas. The bottom line is you have to do what is most comfortable for you! Good luck and let us know if you need more help!

I strongly suggest that you do not eat any solid food after midnight when you are planning to change your ostomy appliance in the morning.

Also, try sitting up in bed or in a comfortable lounge chair while changing, and take your time. Some people stand up while changing the appliance. This never worked for me.

This practice generally works very well for me. Please let me know if this advice/process helps you when you are changing.

I hadn't thought of that one. But I'll think it through. That may be a great option for me. Thank you!

Since I stopped taking pain meds around the clock, not eating after midnight is now part of my life again. (I had to eat something or I would have an upset stomach when taking pills). I have a chair I've been using so far, and today for the first time, changed the pouch without the help of the home health nurse. I did fine, thanks largely to the paper towel "hat" I learned about from an ostomate above - and less 'round the clock small snacks. Progress!

Interesting the different methods. Once a week I wake up at 6am. I eat 6 large marshmallows and go back to sleep for 1.5 hours or a full sleep cycle. At 7:30 I change the bag while lying in a recliner with my stuff next to me. Zero output. Takes 10 minutes and I'm set for another week. All the best.

I usually put an ostomy disposal bag in my belt or waistband and let the bag hang inside until I have it fully removed. Then I just leave the plastic bag there as it will hang half open and any output will just drop into the bag. But have everything already prepared laid out in front of you on a counter or table, whichever you choose. By having everything ready, I mean the pouch flange cut, the adhesive backing removed, and the cohesive ring already around the hole of the flange. Then I prep the skin and give it a minute to dry, and as soon as I feel it is dry and ready for application, I fit it over the stoma and apply a flat hand across it to press lightly and seat the seal. Then I'm ready to go. As for the disposal bag, I remove it from the waistband and tie the top and dispose of it. I do not have an ileostomy, but the principle should work either way.

Best of luck to you.

Try eating a few marshmallows a half hour before changing. They seem to slow things down.

Sorry to hear about your difficulty. I had the same problem, so I now change mine when I have a shower. I have an ileostomy and a mucous fistula. I prepare new bags, then remove both used bags and get into the shower. I wash in the shower as normal with no bags on. If the stoma or fistula leak, then it's a simple case of rinsing it away with the shower. The drainage from my shower goes to the same waste pipe as the toilet. The shower has tiled walls and a non-slip ceramic floor, so it's easy to keep clean. Once I've finished in the shower, I use a small towel to quickly dry the area around the stoma and fistula. When the area is bone dry, I just put the new bags on and finish off drying myself.

I've had an ileo for 71 years, and I do exactly what Cplumber suggests. I can't go 7-10 days without a change, however. Usually 5 days. I change before breakfast on an empty stomach. Takes me 10 minutes max. I will also pray for you, but I know you will be fine.

I have the same issue. I sometimes suspect my stoma is waiting for the change to happen!

I stand in front of the toilet and have all the bits I need ready.

I tuck a wet wipe over my trousers in line with the stoma so if any drops, it hits that first and then I lean over if more is coming out.

Removing the bag, I remove the top half first so it's still attached and clean. The bag itself is already in a little black bag.

And this generally works for me.

Hi newbie, I'm an ostomy mate. I've had my ostomy since July of '21. Get all your gear before you do your change. Put down in front of the sink a disposal pad with the rubber backing. I call it my catch-all. That squirts out of the stoma while in the sink. I have the basin they send you home with from the hospital with warm, soapy water, Dial soap, and lots of paper towels. I clean my whole stomach with special attention to my stoma area. Then, rinse and dry the area well. Then put my stomahesive powder on with a brush. Then I apply my skin tack on top of the powdered areas. Then I put my skin protector on Silvex wound care just around the stoma area and around my peristomal area. I then make sure everything is really dry. Then I put my prepared base with the barrier ring around the base hole to cover my stoma. I press all around my base. Then I put on my bag to the base, then click it on till it clicks, then I lock it on. Fold up all padding and throw out all refuse from the procedure. Hope this helps.

I always eat 2 marshmallows about 20 minutes before changing

Excellent advice! I also have a new ileostomy. I found the PDF that you mentioned and it is very helpful. Good to note that I did not find it on US Coloplast site but entered the exact title in the browser. Thank you!