How to Change a Stoma Bag

Written by thomas mcmurchie
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How to Change a Stoma Bag
Medical scissors (doctor’s scissors image by Francois du Plessis from

Patients who have stoma bags need to change them on a regular basis. They should follow the recommendations of their doctor or stoma therapist to determine how often they should change their bag. Stoma bags are used following three types of operations. A urostomy bag is used to redirect urine from the bladder to the external pouch attached to the abdomen. Patients with colostomy bags have had part of their large intestine removed or bypassed. Ileostomates have had their entire large intestine removed and all fecal waste empties into the stoma bag through the ileum, or small intestine.

Skill level:

Things you need

  • Adhesive remover
  • Stoma pattern
  • Pencil
  • Scissors
  • New wafer and pouch or one-piece wafer and pouch
  • Stoma adhesive paste
  • Wash cloth
  • Mild soap and warm water
  • Hair dryer
  • Skin protector
  • Plastic trash bag

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  1. 1

    Remove the clip from the bottom of the bag and empty its contents into the toilet. Save the clip if one is not included with the new bag. Wash hands thoroughly.

  2. 2

    Trace the stoma pattern on the new wafer with the pencil. Your doctor or stoma therapist will help you create your first pattern. Cut out the hole carefully. Prior to removing the backing from the wafer, place it over the stoma. There should be approximately 1/8 inch between the edge of the opening and the stoma. Set the wafer aside.

  3. 3

    Remove the old wafer from around the stoma. If the bag is a two piece system, with a wafer and pouch as separate pieces, remove the pouch from the wafer. A one piece arrangement will be removed in a single step. Carefully remove the old wafer from the skin by peeling it back. If it sticks, pour a small amount of adhesive remover near the edge of the wafer and gently pull at the edges until the wafer is removed. Dispose of the pouch and wafer in the trash bag.

  4. 4

    Clean the skin around the stoma with soap and water. Examine the skin for signs of irritation. Rinse all soap off the skin. If the skin shows signs of irritation, contact your doctor or stoma therapist for treatment recommendations. Dry the skin with the hair dryer. Use the low heat setting.

  5. 5

    Place a small amount of stoma adhesive paste on any indentations or uneven areas of skin to smooth it out. Peel the backing off the wafer and apply it to your skin, making sure the stoma is in the centre of the hole. Press firmly on all areas of the wafer to ensure a proper seal. If you are using a two piece system, snap the bag into place. Give the bag a gentle tug to be certain that it is sealed correctly. Place the clip on the bottom of the bag.

Tips and warnings

  • Resting for ten or fifteen minutes after changing the bag will help the wafer adhere better to the skin, since there will not be any bending or stretching of the area.
  • The stoma adhesive paste contains alcohol, so be careful not to apply it on any areas of sore or irritated skin.

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