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How to Change a Colostomy Bag Step-By-Step

A woman stands with an ostomy bag attached.

Kara Miller |

A colostomy is a type of ostomy procedure that reroutes a portion of the large intestine to the abdominal wall, creating a stoma. This stoma allows waste to exit the body and be collected in a colostomy bag, sometimes called an ostomy pouch. 

For those who have undergone this procedure, maintaining the cleanliness of the colostomy bag is essential for personal comfort and overall health. While the process may seem daunting at first, with the right approach and a little practice, changing your colostomy bag can become a routine task.

In this user-friendly guide, you’ll learn how to change a colostomy bag step-by-step. We’ll also offer some tips and insights to make maintaining your colostomy bag as hassle-free as possible.

Tools for changing an ostomy bag.

Changing a Colostomy Bag Step-By-Step

Many medical supply stores will deliver everything you need right to your door, and the best place to conduct the process is in your bathroom. Here’s how to change a colostomy bag step-by-step to ensure a smooth experience.

Step 1: Gather Your Supplies

Before you begin, gather the necessary supplies. This includes:

  • A clean colostomy bag
  • Adhesive removing skin wipes, if required
  • A washcloth, mild soap, and a towel
  • Scissors and a template, if required
  • A disposal bag 

Having everything prepared will streamline the process and make the experience more efficient.

Step 2: Clean Your Hands

Maintaining personal hygiene is a crucial aspect of any ostomy bag change. Wash your hands thoroughly before you begin to minimize the risk of introducing bacteria to the stoma site. Be sure to clean in between your fingers and under your fingernails, then dry with a clean towel.

Step 3: Prepare the Replacement Bag

You may need to prepare the replacement colostomy bag by cutting the opening to the correct size. Using your measuring card, find the circle size that matches the size of your stoma. Be careful to avoid touching the card to your skin. Trace the circle size on the back of the ring seal and cut it to size, ensuring that the edges are smooth.

Step 4: Remove the Used Colostomy Bag

Carefully pull your clothing to the side and gently peel off the used colostomy bag, starting from the edges and working toward the center. Gently press on the skin around your stoma with one hand and remove the seal with your other hand. 

Take your time to avoid any unnecessary discomfort or irritation to the surrounding skin. Use adhesive removing wipes if needed to loosen the adhesive gently. Be sure to keep the clip that is with your old pouch.

Step 5: Dispose of the Old Colostomy Bag

Dispose of the old colostomy bag by sealing it in a disposal bag, ensuring that it’s securely closed to contain any odor. Place the bag in the trash, not the toilet

Step 6: Clean the Stoma Site

Once the old colostomy bag has been removed and disposed of, it’s time to clean the stoma site. Use mild soap and water on a clean washcloth to cleanse the area, ensuring that you remove any residue. Pat the skin dry with a clean towel, avoiding any harsh rubbing.

Step 7: Apply the New Colostomy Bag

Before applying the new bag, wash your hands thoroughly. Check your skin carefully for signs of irritation. A little pinkness or redness is normal, but you should call your doctor if the skin is purple, black, or blue. 

Sprinkle a bit of stoma powder on the application site and pat the skin with the dry wipe that comes with your colostomy bag. Ensure that the area is completely dry. Then remove the backing film from the adhesive of the new bag. 

Fold the top half of the adhesive back, then position the new colostomy bag carefully over the stoma, working from the bottom and smoothing upward with your fingers. Smooth out any wrinkles in the adhesive to create a tight seal. 

Use the warmth of your hands to mold the bag to your skin and ensure that it is well-adhered. If you use a drainable bag, clamp the tail, then attach the bag to the pouch clip. Wash your hands, and you’re done! 

Flushing a toilet.

How to Empty and Clean a Colostomy Bag Between Changes

Some colostomy bags are designed to be emptied in between changes. Emptying and cleaning your colostomy bag as directed is essential to maintain hygiene and comfort. Begin by finding a suitable restroom with easy access to supplies. 

Carefully pull your clothing to the side, remove the clamp, and empty the bag into the toilet by gently squeezing the contents out. After emptying, the inside of the bag can be cleaned with paper towels, mild soap, and water or flushable wipes. 

Be sure to clean the inside and outside of the tail, then check the pouch carefully for tears or holes. If you find any, you’ll need to replace the pouch. Finish up by rinsing the clamp if needed and re-closing the pouch. 

Multiple ostomy bags.

How Often to Change an Ostomy Bag

The frequency of ostomy bag changes is influenced by several factors, including the type of ostomy surgery you received, stoma type, skin sensitivity, and individual preferences. As a general guideline, ostomy bags should be emptied when they are ⅓ full and changed every 2 to 4 days. 

Regular checks for signs of wear and leaks are essential. If you notice any skin irritation, redness, or discomfort around the stoma site, consider changing the bag sooner. Additionally, be attentive to weaknesses in the adhesive seal and change the bag promptly to avoid potential leaks.

Most people with a colostomy bag opt to empty or change it after every bowel movement, but ultimately, it’s up to you. Your routine should be based on your specific needs and the advice of your healthcare provider. 

Tips for a Hassle-Free Ostomy Bag Change

The routine of changing your ostomy bag can be further simplified with the right strategy. Let’s explore some practical tips to help ensure that your experience is manageable and hassle-free.

Find a Comfortable Routine

Establishing a consistent routine for your ostomy bag changes can contribute significantly to your comfort and confidence. Choose a time that aligns with your daily schedule and allows you to focus without interruptions. Keeping everything you need in a convenient location will also ensure that the process goes smoothly.

Managing Potential Messes and Smells

To minimize the potential for messes and odors during a colostomy bag change, consider emptying the pouch shortly before the required time. This reduces the volume of waste, making the process more controlled.

It can also be helpful to keep flushable cleansing wipes and odor-neutralizing sprays on hand to manage odors at home or on the go. When you’re out and about, consider keeping an extra pouch, change of clothes, and other supplies in your bag, just in case you need them.

Troubleshooting Common Problems

Encountering challenges during an ostomy bag change is not uncommon, especially if you’re new to the process. But being prepared can make a significant difference. If you experience issues such as poor adhesion, leaks, or discomfort, start by checking the fit of the bag. If the problem continues, reach out to your healthcare provider for advice. 

When to Call a Doctor

Call your doctor right away if the stoma itself has a foul odor, is draining pus, or is bleeding. If your stoma is changing color, getting longer, bulging, or pulling into your skin, you should also consult with your doctor immediately as these can be signs of an infected stoma.

However, if you develop a fever, feel sick to your stomach, have belly pain, there’s blood in your stool, or have no gas or stool for four hours, it’s best to seek emergency care as this can indicate a more serious issue.

Changing Your Colostomy Bag with Confidence

With the right approach, ostomy care can become seamlessly integrated into your daily life. By establishing a comfortable routine and managing potential challenges proactively, you can navigate the process of changing your colostomy bag with confidence. Don’t hesitate to consult with your healthcare provider if you need additional guidance.


Hollister Incorporated. (2017). Routine Care of Your Ostomy. 

National Institute of Diabetes and Digestive and Kidney Diseases. (June 2021). Types of Ostomy Surgery.

Oakmed Ltd. (n.d.). What Are the Signs of an Infected Stoma?

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