Ostomy Care: A Complete Guide for Colostomy, Ileostomy and Urostomy

Ostomy care is the everyday routine that keeps your stoma healthy, your pouch sealed and the skin around it comfortable. It sounds like a lot at first. For most people it soon becomes a short, familiar habit, like brushing your teeth. This guide covers what every stoma has in common, what changes with each type, and when to ask your ostomy nurse for help.

Reviewed with stoma care nurses · Updated October 29, 2026 · Sources: UOAA, WOCN Society, Cleveland Clinic, NHS

Ostomy care in 60 seconds

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Every day: look at your stoma and the skin around it, and empty the pouch when it is about a third to half full.
At every change: remove the pouch gently, clean with warm water only, dry the skin completely, and fit a pouch cut to your stoma’s size.
Every week: check that the opening still fits, as stomas often shrink in the first 6–8 weeks, and review your supplies.
Always: call your ostomy nurse if the skin breaks down, the stoma changes color, or output stops with pain.

Ostomy care by type: what changes

All stomas need the same basic care. What changes is the output, and so the pouch and the things to watch.

Colostomy care

A colostomy uses the colon, so output is usually soft to formed and arrives once or a few times a day. Many people use a closed pouch and change it daily, and some learn irrigation. Full routine: colostomy care at home.

Ileostomy care

An ileostomy uses the small intestine, so output is looser and more frequent, and it contains digestive enzymes that can irritate skin. A drainable pouch, a good seal and plenty of fluids and salt matter most. Read our ileostomy care tips.

Urostomy care

A urostomy carries urine, which flows almost all the time. The pouch has a tap, and at night it connects to a larger drainage bag. Keep well hydrated and watch for signs of infection. More in urostomy care.

Not sure which one you have? Start with what is an ostomy and ileostomy vs colostomy.

Woman kneeling on a rug at home, playing tug with her beagle in a cream Basic ostomy wrap and strapless bra

Your daily ostomy care routine at home

Check your stoma

A healthy stoma is moist and pink to red, a bit like the inside of your mouth. It has no pain nerve endings, so look rather than feel. A dark red, purple, gray or black stoma needs a same-day call to your nurse or doctor.

Empty the pouch before it gets heavy

Empty a drainable pouch when it is a third to half full. A heavy pouch pulls on the seal and is the most common reason for leaks. Sit well back on the toilet, or kneel in front of it, and lay toilet paper on the water to stop splashing.

Keep supplies where you use them

A small basket in the bathroom (pouches, dry wipes, disposal bags, adhesive remover, measuring guide and scissors) makes each change quicker and calmer.

Changing your pouch: the short version

How often you change it depends on your system. Closed pouches are often changed one to three times a day, and the skin barrier of a two-piece system every one to three days. Change sooner if you feel itching or burning under the seal.

Get everything ready, and empty the old pouch first.
Peel it off slowly, top to bottom, holding the skin flat.
Clean the stoma and skin with warm water only, without soap or oily wipes.
Pat dry and check the skin.
Measure, and cut the opening to fit snugly.
Warm the skin barrier in your hands, fit it from the bottom up, and hold it for 30–60 seconds.
Wrap the used pouch and put it in the household trash. Never flush it.

Step by step, with videos: how to change an ostomy bag · how often to change and empty your pouch.

Skin care around the stoma

Healthy peristomal skin looks like the skin anywhere else on your belly. Redness, soreness or weeping usually means output is reaching the skin, because the opening is too big, the seal has lifted, or the pouch stays on too long.

Re-measure the stoma and cut the opening to fit, with no more than about 2–3 mm (1/8 inch) of gap.
Use a barrier ring or seal if your skin has folds or dips.
Use only products your ostomy nurse suggests. Creams and powders can stop the pouch from sticking.

If the skin is broken, bleeding or very itchy, see skin problems around a stoma and contact your nurse.

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Food, fluids and output

In the first weeks, soft, low-fiber food eaten little and often is easiest. Then bring back one new food at a time. Drink regularly through the day, especially with an ileostomy, which loses more fluid and salt. Foods that are hard to digest, like nuts, popcorn, fruit skins and raw celery, can cause a blockage if eaten in large amounts without chewing well. Our ostomy diet guide covers what to eat and avoid. Learn the signs of a stoma blockage too.

Ostomy care at home: showering, sleep, exercise and travel

Showering and bathing

You can shower with your pouch on or off. Water will not go into the stoma. Many people shower on change day with the pouch off. See protecting your pouch in the shower.

Sleep

Empty the pouch before bed. With a urostomy or a high-output ileostomy, a night drainage bag helps. Read about sleeping positions and night leaks.

Exercise

Gentle walking usually starts soon after surgery. Your team will tell you when you can lift and do core work. Many people like light support over the stoma when they get active again. See exercise with a stoma.

Travel

Pack twice the supplies you think you need, with some in your carry-on, and bring pre-cut pouches. Guide: flying with a colostomy bag.

Leaks and odor: what usually helps

Most leaks come from an opening that no longer fits, a pouch left too full, or skin folds when you sit. Re-measuring, emptying earlier and adding a seal fix most of them. Modern pouches have filters, and odor should only be noticeable when you empty or change. If it isn’t, check the seal. More in my ostomy bag keeps leaking and managing ostomy odor.

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Clothes and confidence

Feeling secure in your clothes is part of ostomy care too. A soft ostomy belt or wrap holds the pouch flat under clothes and helps you feel more secure when you move, bend or sleep. By carrying the pouch’s weight it helps prevent leaks, and support garments help prevent a parastomal hernia; talk to your nurse about what suits you. See the SIIL ostomy belt, ostomy wraps and ostomy bag covers.

Caring for someone with an ostomy

If you help a partner, parent or child, learn the routine together with their ostomy nurse, keep supplies in one place, and let them do as much as they can for themselves. Privacy and a calm, matter-of-fact tone help more than anything.

When to call your ostomy nurse or doctor

Get advice the same day if:

the stoma turns dark red, purple, gray or black;
the stoma has stopped working for several hours and you have cramps, nausea or a swollen belly;
the skin around the stoma is broken, bleeding or very painful;
you have high, watery output for more than a day, or signs of dehydration: thirst, dark urine, dizziness;
you have a bulge around the stoma that grows, or the pouch suddenly no longer fits.

If you are vomiting and cannot keep fluids down, or have severe pain, call 911 or go to the emergency room. Our stoma care nurse guide explains how to find one.

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Ostomy care FAQs

How often should I change my ostomy bag?

The frequency of changing an ostomy bag varies depending on the type of ostomy, the individual's lifestyle, and the type of bag used (drainable or closed). Generally, a drainable bag is changed every 2 to 4 days, while a closed bag might need to be changed daily or every 2 days. It's important to follow a routine that works for you and to change the bag before it becomes too full to prevent leaks and skin irritation.

Can I shower or bathe with an ostomy bag?

Yes, you can shower or bathe with an ostomy bag attached. Water will not harm the stoma, and many ostomy bags are designed to be waterproof. If you prefer, you can also shower without the bag, as long as you clean the stoma area gently with warm water. Pat the area dry thoroughly afterward before applying a new bag.

What foods should I avoid with an ostomy?

Diet after ostomy surgery varies from person to person, but there are some general guidelines to help manage output and prevent blockages. It's often recommended to avoid high-fiber foods immediately after surgery to allow the bowel to heal. Gradually reintroducing fiber into your diet helps. Be cautious with foods that cause gas, odor, or are known to be difficult to digest, such as corn, nuts, seeds, and raw fruits and vegetables. Monitoring how your body reacts to different foods is key.

How do I prevent skin irritation around my stoma?

Preventing skin irritation involves ensuring a proper fit for your ostomy appliance, keeping the skin clean and dry, and using skin barrier products. Always clean the skin around your stoma with warm water (avoid soaps with fragrances or moisturizers), and dry thoroughly before applying a new appliance. If you notice signs of irritation, consult with an ostomy care nurse for specific products that can help protect and heal the skin.

Can I participate in sports and physical activities with an ostomy?

Absolutely! Having an ostomy should not prevent you from engaging in sports and physical activities. It's important, however, to choose activities that you feel comfortable with and to take precautions to protect your stoma. Using a stoma guard or support belt can provide extra protection during physical activities. Always consult with your healthcare provider before starting any new exercise regimen.

Do I need special supplies for ostomy care at home?

Pouches, dry wipes, a measuring guide, scissors (if you cut to fit) and disposal bags cover most needs. Some people add adhesive remover and barrier rings. See ostomy care products for what each one does.

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