Stoma care guides - Colostomy management

1. Learning to look after your colostomy
Whilst in hospital your stoma care nurse will assess your appliance needs, measure your colostomy and make sure that the bag fits snugly around the stoma to avoid leakage and sore skin. You will be shown how to change your bag and how to look after your skin. Your stoma care nurse will also show you how to cut the right size hole from a gauge chart or template which you will take home and will discuss your prescription needs, bag disposal and how to obtain further supplies.

2. Stoma bags and accessories - what will suit me?
Your stoma care nurse will help you to decide what best suits your needs immediately after your operation. As you progress at home you will soon discover that there are very many different types of stoma bags available, such as one-piece, two-piece, bags with flushable liners, stoma caps etc. You may want to change to an alternative and your stoma care nurse will explain what is available and where samples can be obtained.

The Association provides a list of companies (Go to Factsheets) who give a free sampling service, but you should consult your stoma care nurse for advice before changing to a new product. There is a wide range of accessories available to help make life as comfortable as possible. These include girdles, support belts, deodorisers, wipes, skin protective wipes, lotions and creams, adhesive removers, stoma paste, rings, disposal bags, underwear, swimwear etc.

3. Changing your pouch or bag
It is a good idea to begin to establish a routine for changing the bag. As you get used to your stoma you may find that at certain times of the day it is more active than others – such as shortly after a meal. Don’t choose this time to change the bag but select a time when it is relatively inactive – perhaps first thing in the morning.

Here's a simple guide to take you through the changing routine.
• Check you have everything you need - warm water, soft wipes, a new bag and a plastic disposal bag.
• If you are using a drainable bag open the closure at the bottom and drain the contents into the toilet before removing it. To do this you can sit well back on the toilet seat, although some people find it easier to kneel or bend over the toilet.
• Now remove the old bag, working slowly and gently from the top to the bottom.
• If you are using a closed bag there are several alternatives available to you. Your stoma care nurse will advise on the best option for you.
• Wash the stoma and surrounding skin with warm water. Don’t use harsh solvents, soaps or disinfectants.
• Use the soft absorbent wipes to dry the area (soft kitchen roll is ideal).
• Fit the new bag, making sure that it is secure all the way around. Periodically, when changing your bag, check the size of the stoma with the guide provided with your bags to make sure that you are still using the correct size.

4. Obtaining supplies
An initial supply of bags will be given to you before you leave the hospital, together with your prescription information card giving full details of all your requirements. Take the card along to your GP who will retain the details on your medical records and issue prescriptions in future. You can either take your prescription along to your chemist, post it to your supplier delivery company, or order on line and have your supplies delivered direct to your door.
Remember: always allow sufficient time to send your prescription and never leave yourself short of supplies. Most delivery companies will obtain prescriptions on your behalf.

5. Will there be any prescription charges?
All patients who have a permanent colostomy are exempt from prescription charges irrespective of age. However, an exemption certificate form FP92A must be obtained from the family health services authority. Contact your GP/local health authority. A temporary colostomy is not exempt from prescription charges. For future supplies of products it may be more cost effective to obtain a pre-paid certificate for prescription charges. Men and women aged 60+ are automatically exempt from prescription charges.

6. Disposal of used pouches/bags

Once it has been emptied and removed, the bag should be sealed inside a plastic bag and put in the dustbin. Don’t try to flush it down the toilet as it will cause a blockage. Some local authorities provide a collection service for clinical waste i.e. used bags. Bags with flushable liners are also now available and your stoma care nurse can give you more information on these.