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 belly called a stoma. Stool leaves through the stoma into a pouch instead of through your bottom.

Most colostomies sit on the lower left side of the belly 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 pouch 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 ileostomy vs colostomy guide explains the differences, and our stoma color 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 pouch, 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 tank, 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 pouch, you don't empty it: you peel it off, wrap it in a disposal bag and put it in the trash. Never flush a pouch, even one labeled 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 pouch or barrier, 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 barrier rather than pulling the barrier 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 about 1/8 inch (2 to 3 mm) larger than the stoma, so it hugs the stoma without touching it.

7. Apply

   Warm the barrier between your hands, center 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 pouch in a disposal bag for the trash, and wash your hands again.

Want to see it done? Our ostomy pouch change guide covers one-piece and two-piece systems, how often to change each, and the most common mistakes. For the gentlest way to clean the stoma itself, see how to clean a stoma and an ostomy bag.

Skin care around your colostomy

The skin around your stoma should look just like the skin on the rest of your belly. 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 nurse. Our skin care around your stoma hub and our guide to stoma skin irritation go into each problem in detail.

Food, fluids, gas and odor

There's no lifelong colostomy diet. For the first few weeks after surgery, softer, lower-fiber 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.

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

For food lists and a week of meal ideas, see our colostomy diet guide and the 7-day colostomy diet menu. More on diarrhea and constipation with a stoma and on managing ostomy odor. If you'd like a printable food guide too, the free Ostomy 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 small cap or mini pouch.

Bathing, exercise, sleep and travel

Showering and bathing

Water won't get into the stoma, so you can shower or bathe with the pouch on, or with it off on change days. Pat the barrier 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 ostomy belt holds the pouch close while you bend and move.

Sleep

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

Travel

Pack at least double the supplies you expect to use, in your carry-on, with a few barriers pre-cut at home. Drink plenty on flights, and carry an ostomy 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 pouch flat, something that smooths its outline, and something soft between the pouch and your skin.

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

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 nurse, so you both hear the same advice.
• Help with the set-up, not the stoma: keep supplies stocked, pre-cut barriers, take out the trash.
• 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 groups 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 the stoma care nurse explains who does what in your care team.

When to call your stoma nurse or doctor

Go to the emergency room or call 911 for severe pain, repeated vomiting, heavy bleeding, or a stoma that has turned black.

Colostomy care: your questions answered