A colostomy bag is a plastic bag that collects fecal matter from the digestive tract through an opening in the abdominal wall called a stoma. Doctors attach a bag to the stoma following a colostomy operation.
During a colostomy, a surgeon will bring out a portion of a person’s large intestine through the stoma. The colostomy bag can then collect stool as it passes through the gut.
A person often needs a colostomy due to injury, disease, or another issue with the lower bowels. In some cases, the colostomy is temporary. In other situations, such as the removal of the colon due to colon cancer, the colostomy may be permanent.
Keep reading for more information about colostomy bags, the types, uses, and how to live with one.
Following a colostomy, a person will have some choice about what type of bag they want to use. People often refer to each option as a pouching system. Pouching systems come in a variety of different styles and sizes.
Not every system works for all people. An individual must find the pouching system that performs best for them and their circumstances.
Useful things to look for when picking a pouching system include:
- odor resistance
- a bag that is easy to put on and take off
- a leakproof seal that lasts for up to 3 days
- a bag that is hard or impossible to see under clothes
- a bag that is gentle on skin around the stoma
A pouching system consists of:
- A flange, wafer, or skin barrier that attaches to the skin around the stoma.
- A pouch that attaches to the flange and collects the stool as it passes through the stoma.
Pouching systems come in two basic types:
- A one piece system where the bag attaches directly to the skin around the stoma.
- A two piece system where the flange attaches to the skin around the stoma and the bag attaches to the flange.
The type that a person selects is largely up to them. They should choose the style and size that best fits their needs.
For example, a person can choose between a reusable or single use bag. Also, a person may want some larger bags for overnight and smaller ones for the daytime.
A person should talk to their doctor about potential choices and what their recommendations are for pouch systems.
There are also other products a person may want that can help better protect the skin or help keep the bag in position. These products include:
- stoma paste to help the bag stick
- stoma powder to help absorb moisture and help the bag stay in place
- wipes to help keep the area clean
- belts to help keep the bag securely attached
What is life like with a colostomy bag?
A colostomy bag should not prevent a person from doing most regular activities.
A person with a colostomy bag will be able to continue with many of the same activities that they did before their surgery. Most other people will be unaware that someone uses a colostomy bag unless that person tells them.
People with a colostomy bag will need to avoid lifting heavy items and may need to visit the bathroom more frequently to manage their pouching system. Otherwise, a colostomy bag should not impact too much on someone’s daily routine.
If a pouch is in position securely, an individual with a colostomy bag should be able to take part in most sports and physical activities, including running and swimming. Although people should be careful if taking part in contact sports, they may wish to wear a belt or guard for protection.
Some things a person has to consider when living with a colostomy bag include the following:
- Carrying extra bags and spare supplies when traveling.
- Taking care when using a seat belt, so it does not lie across the stoma.
- Thinking about maybe avoiding foods that cause flatulence.
- Taking extra care with children and pets to avoid damaging the bag.
- Leaving the bag in place or removing it when showering and covering the stoma if removing.
- Looking for high waisted clothes and underwear or considering buying specialty clothes.
Having a colostomy bag should not affect a person’s sexual activity or pregnancy.
How long do they last?
The American College of Surgeons recommend changing the bag when it is between one-third and one-half full. This precaution can help prevent the bag from pulling away from the skin and leaking.
How often a person needs to change their bag largely depends on the size of the bag itself. A smaller bag will need to be emptied more frequently and is the best type to use during the day. A larger bag can last more time without emptying and is often good for overnight or sleeping hours.
Some bags are reusable while others are disposable after a single use.
Changing a bag
To change a colostomy bag, a person:
- First, washes their hands with antibacterial soap and warm water.
- Next, gently peels the bag from the stoma.
- Removes or cuts the bottom of the bag and empties it into the toilet or puts it into a disposal bag.
- Cleans the stoma using warm water and gentle soap.
- Dries the stoma thoroughly.
- Prepares the next bag (and flange if using a two piece system).
- Attaches the bag with adhesive to the outside of the stoma.
A person may want to have wipes or other products around in case of accidental spills.
Is a colostomy bag permanent?
A person can talk to their doctor about the type of colostomy bag that best suits their lifestyle.
Whether a colostomy is permanent or not depends on the condition that is affecting the colon.
A colostomy can be temporary in some cases. However, according to the American Cancer Society, a temporary colostomy may last weeks, months, or even years. Once the area below the colostomy heals, a surgeon can often reverse the colostomy, allowing the person’s bowels to work as they did before.
In other cases, the colostomy will be permanent, and the individual will need to live with a colostomy bag for the rest of their life. Some conditions that typically result in the colostomy becoming permanent include:
- injuries to the bowels
- ulcerative colitis
- irritable bowel syndrome (IBS)
- colorectal cancer
- Crohn’s disease
- structural problems with the bowel that are present at birth
- abnormal growths in the colon called polyps that could become cancerous
People use colostomy bags when they have a permanent or temporary colostomy. Colostomies are required when something injures, infects, or otherwise damages a person’s lower bowels.
Colostomy bags are widespread and do not interfere with most daily activities. Most people will not know that a person is using a colostomy bag unless that person tells them.
People should discuss their colostomy bag options with their healthcare team to find the system that works best for their needs. Many different types and sizes are available, so a person should be able to find one that fits the demands of their current lifestyle.
What do colostomy bags smell like?
The outside of the bag smells like plastic. The contents would smell like feces.
Saurabh (Seth) Sethi, MD MPH Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.