This topic is about managing persistent odor from a colostomy bag, specifically for a 90-year-old man who is very active but seems unaware of the odor issues his daughter has noticed. She is seeking practical solutions to help eliminate the smell and improve his pouching routine. Here are some helpful suggestions:

1. Involve professionals:
- Consult with the surgeon, general practitioner, or a stoma/wound-care nurse to understand why he might not notice the odor. They can also check his application technique and emphasize the importance of using deodorizer and proper burping habits.
- Sometimes, a social worker or home-care nurse can be more persuasive than family members.

2. Reduce or eliminate burping:
- Frequent venting is likely the main source of odor. Encourage him to burp only in the bathroom with the exhaust fan on.
- Consider adding an EZ-Vent to the pouch or switching to pouches with effective integrated filters so gas can escape without opening the bag.

3. Switch to a better-filtered pouch:
- Some people find Coloplast SenSura Mio, especially the Flex line, to be virtually odor-free. Hollister filters have been described as less effective.
- If he prefers his current system, try adding a filter accessory or experimenting with different brands.

4. Use in-pouch deodorants/lubricants:
- Encourage him to use Hollister M9 drops, adding a few drops each time he empties the pouch.
- Consider using a lubricating deodorant with about 1 teaspoon plus 1 tablespoon of hydrogen peroxide per empty to keep output sliding and neutralize odor.
- Try Coloplast anti-pancaking/absorbent sachets with built-in deodorant.
- A European tip is to place 1–2 crushed paracetamol/acetaminophen tablets in the pouch.

5. Dietary tweaks:
- Some people have found that daily cottage cheese or yogurt can change the odor. Antibiotics can also alter stool odor.

6. Confirm housekeeping and plumbing basics:
- Ensure the pouch outlet, toilet, and trash are wiped clean, and used bags are removed promptly.
- Have a plumber inspect drains and toilet wax seals to rule out other sources of smell.

7. Odor control in the home/for visitors:
- Use Nilodor or Neutradol concentrated drops for trash cans and toilets.
- Consider whole-room air purifiers or timed professional-grade deodorizers, avoiding sprays that simply mask odors.
- For particularly sensitive visitors, personal options like a CPAP or high-grade mask with a HEPA filter might help.

8. Behavioral/interpersonal tips:
- Share these suggestions with him, emphasizing that they come from other people with similar experiences.
- Focus on love and health rather than criticism, and set boundaries for visits, such as meeting on an outdoor porch if the odor persists.