How to Change Your Ileostomy Bag: Tips and Techniques

How to change an ileostomy bag. Do you use toilet paper, rags, or tissue? Do you use a ring or stoma sheet? Standing up or lying down?

Good morning. Welcome to the community.

Many here will have varied responses, but the how to is up to you.

I change my ilio bag, the complete mounting plate, also referred to as a wafer, and ring and bag all in one standing over the sink.

Where I can use the water spray nozzle to clean around the stoma area. Lukewarm.

Hair dryer on the side to dry it and I use regular paper towels.

The appliance box should have disposable gray-colored bags inside them.

If not, zip lock bags are an alternative.

Wear time has been addressed in a separate thread. I asked the same question.

Got replies stating 3 to 5 days.

Wear time.

So in short, I do it standing over the sink. Hair dryer to warm the area and appliance. A ring. Paper towels.

I use a thin belt which is part of the mounting plate plus a wrap-around thicker belt every day, 24/7. Several years now.

Hope this helps. Welcome again. Ask whatever you need answered.

Just remember too, no two people are the same with their routines.

 

Hi CC, welcome to the site. I've been an ileostomate for 30 some years. My routine is, after a shower on the morning of the 4th day before breakfast, I set out the supplies I am going to use. Standing over the toilet, I slowly peel off the wafer after draining the pouch first. Then, I wipe around my stoma with toilet paper, wash around my stoma with a cloth and warm water, and dry around my stoma with toilet paper. I then warm up the Brava brand ring in my hands, stretch it to the size of my stoma, cut the hole in the Convatec flat wafer, warm it up in my hands, and then put it on. If I have a gap by my stoma after putting the ring on, I spread some paste in the gap with a Q-tip. After the wafer is on, I put the drainable pouch on. I put the old pouch and wafer in a Ziploc bag and take it out to the garbage can. 

Hello there

Standing, Braun bag with brown thin elastic belt, salts moldable ring, stoma has a little irritation now and then, hurt, no.

Standing after a shower. I get a week out of my one-piece drainable ileostomy bag, but I live in AZ where it's dry. When I lived in Chicago, I had to change twice a week due to humidity breaking down the integrity of the adhesive. I change mine every Sunday AM after a shower and before I eat or drink anything. I cut off my meals on Saturday around noon, so I'm pretty empty and the output is slow - none when I change the bag and barrier ring. I have my new bag already lined with adhesive paste, and I also use an adhesive spray before I put the ring around the stoma, then the bag. I do use a baby wipe around my stoma just as soon as I'm out of the shower, and once I'm dry, I toss it. There are times when my gut/stoma just won't cooperate, so I work fast once I'm out of the shower. Good luck!

1. I remove my appliance while standing in front of the bathroom mirror. I put a rectangular bucket on the floor in front of me to catch any droppings that may occur because I couldn't stop myself from eating a little the night before.
2. I use an adhesive removal spray to loosen the tape, followed by adhesive removal wipes as I gently remove the wafer.
3. I then deposit the bag and wafer into the bag provided with the pouches and clean the ileum with flushable wipes that also go into the bag with the pouch.
4. I jump in the shower and enjoy the bagless event. Once I am done with all the things normal people do in the shower, I thoroughly clean the peristomal skin with an antibacterial soap, such as Dial.
5. After drying myself, I use a hair dryer on low to completely dry the peristomal area. I also use a soft paper wipe such as ones that Kleenex sells (not Kleenex tissues). I do this back in front of the mirror.
6. I use pre-cut convex wafers and a barrier ring to aid the seal. Once the ring is applied to the wafer, I warm it up with the hair dryer on low and apply it to my skin. That is followed by the bag and presto, Wham-O, I am done.

The longest part of this process is the shower from which I often have trouble extricating myself because it feels so damned good. I've run out of hot water a couple of times! :-))

Daniel

Hi CC,

My first thought is why are you asking? I mean, haven't you seen a stoma nurse and been advised on how to change your barrier? I'm hoping you have, but your questions make it sound like you're about to do it cold-turkey for the first time. As alluded to, you really need to find what works best for you, and what others do really doesn't matter.

Personally, I do mine over the kitchen sink. I live alone, so it's okay. I've always done it standing up... never even considered doing it laying down. What would you do if you had output? I take one of the grey bags that come with the bags and tuck it into my sweatpants like a bib for my waist. Then I put a long piece of 3M Micropore tape over the junction where the tape meets my skin for a watertight path to the sink for any errant output. I use the pre-cut paper towels that break into 4 squares each. After I remove my old barrier and bag, I cut each of them in half to make sure an animal won't get stuck in either at the landfill... or the ocean... or wherever garbage magically disappears to these days. Probably New Jersey... but that's another story (just seeing if you're paying attention, Bro!).

I've always used a ring, but again, that's what works for me. After I remove the barrier/ring combo, I shave, do a Domeboro soak followed by a diluted vinegar soak, dry well (with a hair dryer on low), apply ring, then barrier and periphery tape... slap on the bag and go eat something! Takes me about an hour all said and done, but that includes two 20-minute soaks, so if you skip that, we're talking 15-20 minutes tops including cleanup. For me, it's the only time I get to read all week... so it works!

I still can't imagine anyone changing a barrier while laying down... do folks really do that? I hope they're in the bathtub when they do it!

;O)

Wow, so many different methods! This has been fun to read. For me, I just do it on the toilet. Takes me only a few seconds now, just cut the flange (my stoma is basically always the same size), apply the barrier ring, bingo-bango, pop the pouch on, and I'm off. I've only tried it standing up in an emergency bathroom stall situation.

Yes, bro, paying attention to your details. Nice smack on NJ, your former home. I am thinking Newark, any corner would do a dump. Probably increase real estate value too.

You mentioned "doing it" in front of the sink. Bet you keep the blinds open, huh? Those farm animals must think it's movie night.

No wonder we both live alone 🤔.

RE: laying down to change appliance? Stoma nurses prefer this. That is the only time I had it done for inspection. It's gross. They wipe the area if there is output. Yuck, embarrassing.

But I agree, laying down replacing the appliance, gotta be careful. Not a good idea being alone doing it that way.

I do mine after a shower standing up at the bathroom sink in front of the mirror. I used to shower with the bag off but got sick of having poop coming out while I shower. These stomas be like... oh, I'm naked so I'm going to sh#t up a storm! Lol! I use about 3 adhesive remover wipes. Then I use paper towels. Wet them, soap them up real good. Soap up the stoma a couple of times and using clean paper towels I rinse about 3 or 4 times to get any soap residue off. Take a dry paper towel and pat dry. Stand there a few minutes, in front of my mirror at the bathroom sink. I use a Hollister Cera ring on my bag. Slap on the bag, attach the clip, and ready to go. I have a plastic dish pan (Dollar Tree bought) lined with a garbage bag under me sitting on a disposable bed pad. This way everything I'm using to change I can just plop that in there and dispose of it when done. If the stoma decides to act up it can just go in there too.

My thing is to have everything I need right there so I'm not running around for supplies with my naked stoma. lol

At one apartment our mirror did not sit low enough so I bought a handheld mirror and set that up so I could see to get the bag on right. I dunno, I'm just one that has to be able to see that I get the hole of the bag exactly right. I can't imagine trying to do that sitting or laying down.

I think I've figured out a real good way to keep smells off of the ostomy support garments too. I take toilet paper and use a lot but not too much, and fold it over the end of the bag and the clip. I do this after every empty for the last month now. This way if any poop residues are left behind even after wiping it with wipes it helps keep that from setting deep into the fabrics of your garments.

Welcome to the club. I too have an ileostomy. You are in Kansas City. You need to be seen by an enterostomal therapist and develop a routine. Personally, I made a checklist so I would not forget something. Enterostomal therapists are available through Visiting Nurses and St. Luke's Home Health in your own home, plus other services. Also, there are stoma clinics at Menorah, KU, University Health, and in the Northland. I highly recommend the clinic at University Health. I know the nurse. Good luck.

My ostomy journey started with a colostomy and is now an ileostomy. Due to the amount of trauma and drama associated with my first surgery, five days in ICU, seven days on the step-down unit, and three days in a general ward --- I learned to change my appliances lying down.

After all, nearly twenty days of stoma and wound care nurses changing my appliance lying down is how I learned. I attempted to transfer the skills and steps so that I could change my appliance like all the cool kids. Alas, that was a shit show from which I am still woken by nightmares.

My routine is much like others have described-- early in the morning, before breakfast, I gather my supplies.

I remove the soiled appliance, gray bag it, clean the peri-stomal area, and remove left-behind adhesive.

I use my blow dryer to dry the area. Then I apply the powder and magical 3M spray --- twice. Then I take my Eakin ring, apply it to my convex wafer, and apply a bead of stomahesive paste on the ring.

I place the pouch, which is already prepared, over my very introverted stoma. I use my blow dryer to keep the adhesives malleable and sticky. My final step is to apply the Brava Strips.

I lay in bed for about fifteen minutes after changing the appliance. I watch the news and plan my day... and then get dressed for the day.

There are probably as many ways to change our appliance as there are people who use the pouches.

Know that many people say they prefer to change it standing up in front of a mirror or the sink or whatever, but I have not had luck with this. My stoma is very inverted and kind of sits below skin level, in the valley between what I would call the two layers of my muffin top. If I'm being honest, I have more of a three-tiered wedding cake top than a muffin top, but I digress. (And mentioning that makes me want cake. Darn. )

When I try to do it standing up, I cannot get the area to be flat enough or my stoma to protrude enough for me to put the seals around it correctly. Even if I'm looking in a mirror, this is difficult. For this reason, it is much easier for me to do it lying down, because gravity helps flatten things out enough for me to get the seals nice and flush around it. I have had bad skin issues since I left the hospital; right before I was discharged, even with nurse help, we had to change the whole appliance 7 times within a few hours. Thus, my skin is very damaged and sore. I have to make sure the seals and all the barrier sprays and everything are where they need to be. Because I have so many steps right now to try to heal up my skin, it's a lot easier if I'm lying down, sort of propped up, so I can see the whole thing when it's flat. 

I am still on medical leave, so I don't know how this will work once I have to go to back to work. I don't want to be caught lying on the floor in the bathroom stall when my boss walks in, and the seat in my Camry doesn't recline that much. But for now, that's what I'm doing. I am hoping that once I get back to work, I can work out an eating schedule and everything that will help me avoid the need to ever have to do a change at work.

P.S. At the advice of a stoma nurse I talked to, as well as many on here, I'm gently washing that injured and angry skin with Head and Shoulders in the shower, letting the skin get a little air for a few moments after that, then applying Flonase with my fingers. It's a long process at this point, but I'm sure I'll find a better routine once my skin heals up. Remember: 3 or 4 marshmallows a few minutes before your change will help put your stoma to sleep for a bit, to make your change "dryer". And I warm my wafer and barrier rings on a heating pad while I'm doing the other prep.