What is a colostomy bag?
A colostomy bag, or stoma bag, is a small pouch used to collect waste from the body. During a surgical procedure known as a colostomy, an opening is formed between the large intestine (colon) and the abdominal wall, allowing waste products to be excreted at this point rather than from the anus. A colostomy bag is placed over the opening – known as the stoma or ostomy – in order to collect stool and other waste from the body.
A colostomy bag, therefore, is a fairly simple device intended to rest the patient’s colon in the case of a temporary colostomy or act as an artificial outlet for the bowel when the procedure is intended as permanent. The use of colostomy bags is surprisingly common and doesn’t necessarily involve a huge change of lifestyle.
When is a colostomy bag needed?
Colostomy bags can be necessary for people of all ages, typically for patients experiencing problems with their colons or when the anal sphincter does not function properly. The colostomy allows the body’s waste to bypass the colon either permanently and temporarily.
A colostomy bag may be necessary for the treatment or management of certain conditions, including:
- Abdominal/pelvic region cancers including colorectal cancer and more rarely anal, vaginal or cervical cancer.
- Inflammatory bowel diseases including Crohn's disease, ulcerative colitis and, more rarely, diverticulitis.
- Bowel obstructions or injuries
- Bowel incontinence (in severe cases)
- Hirschsprung’s disease (a rare disease where the bowel lacks nerve cells)
Colostomy bag surgery
There are two main surgical procedures used to create a stoma:
- Loop Colostomy: A loop of the colon is pulled through the stoma, opened, and stitched to the skin. The colostomy bag is then added.
- End Colostomy: The end of the colon is pulled through the colon and stitched to the skin. The colostomy bag is then added.
Both procedures are considered routine, however, the exact method will depend on the medical condition that is being treated. A colostomy is usually done using keyhole surgery, but some situations may require open surgery. Open surgery often has a longer recovery time.
An ileostomy is a procedure similar to a colostomy that also entails the use of a stoma bag, sometimes termed an ileostomy bag to differentiate. This procedure involves bringing the small intestine out of the body to divert waste, then placing a stoma bag over the opening.
A urostomy – also called an ileal conduit – is a procedure that creates a stoma specifically to drain urine when passage through the bladder and urethra is not possible. A urostomy bag, which is of similar design to a colostomy bag, is used to collect the urine, which can then be drained. A urostomy is a permanent procedure.
Is a colostomy bag permanent?
The use of a colostomy bag can be temporary or permanent, depending on the type of surgery needed to treat the underlying medical condition. Temporary colostomies tend to be “loop colostomies” whereas permanent colostomies tend to be “end colostomies.”
In the case of a temporary colostomy, surgery is needed to reverse the colostomy. This involves removing the colostomy bag and re-connecting the bowel. This is generally carried out 12 weeks or more after the initial surgery, but this time can be longer if complications arise during recovery. The procedure is considered straightforward and can usually be carried out using keyhole surgery.
Living with a colostomy bag
After a patient is fitted with a colostomy bag, doctors and nurses will thoroughly explain how to maintain the stoma and what lifestyle changes may be necessary. Below is some general information and advice that should be noted by all colostomy bag users.
The colostomy bag
Generally, colostomy bags consist of two pieces: the flange, which adheres to the skin, and the detachable pouch, which catches the waste. One piece systems, where the flange and bag are attached to each other are also available. The whole system is removed when changing this type of system. Colostomy specialists will assist in deciding which type of colostomy bag suits the needs of the individual.
Ensuring good adherence
To ensure a tight seal over the stoma, the skin should be clean and dry. Humid conditions and increased sweating may therefore lead to reduced wear-time.
How to change a colostomy bag
A colostomy bag can be changed as often as needed – usually, shortly after a bowel movement. At first, the procedure may prove difficult but will get easier with practice. To help, follow these six steps:
- Thoroughly wash your hands using antibacterial gel or soap.
- Gently ease the pouch from the stoma, using adhesive remover to help if necessary.
- By removing or cutting away the bottom section, empty the pouch into the toilet. If you don’t want to do this, the whole pouch can be disposed of in a disposal bag.
- Clean the stoma with warm water and mild soap and thoroughly dry with a dry wipe.
- Prepare the new colostomy bag by removing the protective cover from the flange.
- Place the flange over the stoma, ensuring there are no creases.
Colostomy bag accessories and supplies
Away from the basic components of the colostomy bag (flanges, pouches) there are a variety of accessories available to help with stoma care and use. The most commonly-used accessories include:
- Belts: Belts help secure the colostomy bag to the body, reducing the risk of dislodgement and leakage.
- Stoma paste: These pastes help adhere the flange to the skin.
- Stoma powder: Used to dry sore or inflamed skin around the stoma, allowing the flange to be applied more easily and effectively.
- Wipes: Wipes can be used to clean the skin, remove adhesive residue or to form a protective film between the stoma and flange.
Generally, colostomy bag users are able to lead a normal life and take part in all the activities they wish to. There are, however, a few tips to keep in mind to avoid damage to the colostomy bag.
- Spare colostomy bags and accessories should be carried whenever possible. Patients typically have less control over bowel movements following a colostomy meaning the pouch may need to be changed unexpectedly when away from home.
- Caution should be taken with pets or children who may unintentionally dislodge or damage the colostomy bag.
- Food and drinks that cause flatulence (carbonated drinks, beans, cauliflower, cabbage, etc) should be avoided.
- Once the stoma has healed, sports and exercise are possible. Colostomy bag supports and smaller, more agile pouches are available to aid in this.
Bathing and showering
When bathing or showering, the colostomy bag can be either left in place or removed. If left in place, the outside of the filter should be covered using a sticky patch (that should be supplied by the hospital/doctor) to prevent any damage. If removed, it is best to select a time when the stoma will be less active – before, rather than following, a meal, for example. Before re-fitting the colostomy bag, ensure the skin around the stoma is completely dry.
Generally, clothing able to comfortably support a colostomy bag can be found in regular clothing outlets. However, clothing designed specifically with the needs of colostomy bag users in mind is also available from specialist outlets. Items include high-waisted trousers to suit those with a waist-level stoma, high-waisted underwear and specially designed swimsuits.
A healthy sex life is generally possible for individuals living with a colostomy bag. The main obstacle may be embarrassment, which may be helped by the use of a smaller pouch or by wearing clothing that covers or secures the device in place.
After surgery, appliances and accessories will be supplied by the hospital, along with a prescription detailing the individual’s requirements. When running low, the prescription can be taken to a doctor or pharmacy for replenishment of all essential items.
The Independent. "What is a colostomy bag and what is it used for?" July 7, 2014. Accessed June 28, 2017. ↩
Health Encyclopedia. “Colorectal Cancer: Tips for Living with a Colostomy.” Accessed June 28, 2017. ↩