Colostomy Care at Home: A Step-by-Step Guide to Your Daily Routine

Colostomy basics: what you're caring for

A colostomy brings part of your large intestine, the colon, through a small opening in your tummy called a stoma. Poo leaves through the stoma into a bag instead of through your bottom.

Most colostomies sit on the lower left side of the tummy and are made from the last part of the colon, so output is often soft to formed, much like a normal bowel movement. A colostomy higher up, in the transverse colon, usually produces softer output. Where your stoma sits shapes almost every part of your colostomy care, from the bag you use to how often you change it.

A healthy stoma is pink to red, moist and slightly shiny, like the inside of your cheek. It has no pain-sensing nerves, it may produce a little mucus, and it can bleed slightly when you clean it. It is swollen for the first weeks after surgery and shrinks as it heals. If you're not sure which type of stoma you have, our guide to ileostomy, colostomy and urostomy explains the differences, and our stoma colour guide shows what's normal.

Your daily colostomy care routine

Good colostomy care is mostly small habits done consistently. Tick these off as you go; there's a print button below if you'd like a copy on the fridge or in your supplies drawer.

Print this checklist ⎙

How to empty a colostomy bag

If you use a drainable bag, you'll empty it several times a day. Empty when it is a third to half full, so the weight never pulls on the seal.

1. Get comfortable

   Sit far back on the toilet, or sit backwards facing the cistern, or kneel beside it. Pick whatever lets the outlet point straight into the bowl.

2. Stop the splash

   Drop a few sheets of toilet paper into the water first. It cuts splashing and noise.

3. Open and drain

   Hold the outlet up, open the clip or roll-up closure, then lower it and let the output slide out, easing it down with your fingers if needed.

4. Clean the outlet

   Wipe the end of the outlet inside and out with toilet paper or a moist wipe, then close it securely and check it's sealed.

With a closed bag, you don't empty it: you peel it off, wrap it in a disposal bag and put it in the bin. Never flush a stoma bag, even one labelled flushable, unless your plumbing and the manufacturer both say it's safe.

Changing your colostomy bag, step by step

Choose a calm time, ideally before a meal when your stoma is quieter. Lay everything out before you start, so you never have to go looking with the stoma uncovered.

1. Lay out supplies

   New bag or flange, scissors and measuring guide, warm water, soft dry wipes or gauze, adhesive remover if you use one, and a disposal bag.

2. Wash your hands

   Soap and water, then dry them well.

3. Peel off gently

   Work from the top down, pressing the skin away from the flange rather than pulling the flange off the skin. An adhesive remover makes it painless.

4. Clean

   Wipe the stoma and skin with warm water. No soap is needed; if you use it, choose a mild unscented one and rinse it all off.

5. Dry and check

   Pat the skin completely dry. Look at the skin and stoma, and measure the stoma if it's still changing size.

6. Cut to fit

   Cut the opening 2–3 mm larger than the stoma, so it hugs the stoma without touching it.

7. Apply

   Warm the flange between your hands, centre it over the stoma, press it on and hold your hand over it for 30 to 60 seconds so the adhesive grips.

8. Finish

   Close the outlet, wrap the old bag in a disposal bag for the bin, and wash your hands again.

Want to see it done? Our guide to changing a stoma bag walks you through the whole change, step by step. For the gentlest way to clean the stoma itself, see how to clean a stoma and a stoma bag.

Skin care around your colostomy

The skin around your stoma should look just like the skin on the rest of your tummy. If it's red, sore, itchy or weepy, something needs adjusting, and it's almost always fixable.

Skin problems that don't improve within a few days of fixing the fit deserve a call to your stoma care nurse. Our skin care around your stoma hub and our guide to skin problems around a stoma go into each problem in detail.

Food, fluids, wind and odour

There's no lifelong colostomy diet. For the first few weeks after surgery, softer, lower-fibre food is easier on a swollen stoma. After that, most people eat almost everything again, adding foods back one at a time and chewing well.

Wind: beans, onions, cabbage, fizzy drinks and swallowing air (straws, gum, eating fast) make more of it. A bag with a charcoal filter lets it out quietly. Odour: a sealed bag is odour-proof; you'll only notice smell when you empty or change it. Emptying regularly, deodorant drops in the bag and a quick spray in the bathroom help.

For food lists and meal ideas, see our colostomy diet guide and our honest guide to foods to avoid with a stoma. More on diarrhoea and constipation with a stoma and on managing stoma odour. If you'd like a printable food guide too, the free Stoma Nutrition Guide is one click away.

Colostomy irrigation: is it right for you?

Irrigation is a way of emptying the colon on a schedule. You run warm water into the stoma through a soft cone, wait, and the bowel empties into an irrigation sleeve over the toilet. Done every 24 to 48 hours, it can mean little or no output in between, so some people wear just a stoma cap or mini bag.

Bathing, exercise, sleep and travel

Showering and bathing

Water won't get into the stoma, so you can shower or have a bath with the bag on, or with it off on change days. Pat the flange dry afterwards, and cover the filter with the sticker that comes in the box so it doesn't get wet.

Exercise and lifting

Walk from the start and build up gradually. Avoid heavy lifting until your surgeon says it's OK, often around three months, because straining can lead to a parastomal hernia. When you do go back to the garden or the gym, lift with your legs, keep loads close and breathe out as you lift. A wide stoma belt holds the bag close while you bend and move.

Sleep

Empty or change the bag before bed. If your output comes at night, a slightly larger drainable bag or an earlier evening meal can help. Sleeping on your back or stoma side with a pillow under the bag keeps it from being squashed.

Travel

Pack at least double the supplies you expect to use, in your hand luggage, with a few flanges pre-cut at home. Drink plenty on flights, and carry a stoma travel certificate for security checks.

Clothes and confidence with a colostomy

You can wear almost anything with a colostomy. A few pieces just make it easier: something that holds the bag flat, something that smooths its outline, and something soft between the bag and your skin.

High-waisted styles sit above the stoma rather than across it, so belts and waistbands don't press on the bag. If you prefer a dress or fitted top, a soft wrap smooths everything underneath. And a fabric stoma bag cover makes the bag feel softer against your skin and more private if your top rides up. More outfit ideas in how to hide a stoma bag under clothes.

Caring for someone with a colostomy

If you're a partner, parent or carer, the most helpful thing you can do is support independence. Most people want to do their own colostomy care as soon as they can.

• Learn alongside them. Ask to join a session with the stoma care nurse, so you both hear the same advice.
• Help with the set-up, not the stoma: keep supplies stocked, pre-cut flanges, take the bins out.
• Protect privacy and dignity. A locked bathroom door and a calm, matter-of-fact tone go a long way.
• Know the warning signs in the section below, especially if the person is older or recovering slowly.
• Look after their mood too. Body-image worries are common; talking, peer support from charities such as Colostomy UK, and counselling all help.

Nurses and carers looking for teaching resources can also find practical handouts in the free guide above, and our article on stoma care nursing explains who does what in your care team.

When to call your stoma care nurse or doctor

Out of hours, NHS 111 can tell you where to get help. Go to A&E or call 999 for severe pain, repeated vomiting, heavy bleeding, or a stoma that has turned black.

Colostomy care: your questions answered