What Is a Colostomy Bag? Why Is It Fitted and How Is It Emptied?

What Is a Colostomy Bag?

A colostomy bag is a plastic bag that collects stool from the digestive tract through an opening in the abdomen called a stoma. A bag is attached to the stoma after colostomy surgery. In anatomy, a stoma means any opening in the body. There is normally no stoma in the abdomen; one is created surgically when medically necessary.

During a colostomy operation (creation of a stoma), the surgeon brings part of the person’s large intestine out through the stoma and joins it to the skin. The colostomy bag can collect stool as it passes through the bowel.

The creation of a stoma and a colostomy bag are simply illustrated below:

People may generally need a colostomy because of abdominal cancers (most commonly colon and rectal cancer), injuries, or other bowel problems. In some cases, a colostomy is temporary, while in others, such as removal of the colon or rectum because of colon cancer, it may be permanent.

What Types of Colostomy Are There?

Pouching systems come in various styles and sizes. A system generally includes a border (flange) that surrounds the stoma and adheres to the skin, and a pouch attached to the flange that collects stool from the stoma. There are two main types of pouching system: a one-piece system in which the bag attaches directly to the skin around the stoma, or a two-piece system in which the flange attaches to the skin around the stoma and the bag attaches to the flange.

After a colostomy is created, a person can choose the type of bag they want. However, not every type is suitable for everyone. Individuals need to choose the system best suited to them and their situation.

A colostomy bag can be fitted at different parts of the colon. One stoma is created for each patient. Its location depends on which part of the colon is affected by the disease.

Things to consider when choosing a colostomy bag;

• Odor resistance
• Ease of fitting and removal
• Leakproof for up to 3 days
• Invisible or barely visible under clothing
• Does not damage the skin around the stoma

People should choose the style and size that best meet their needs. They can choose between reusable and single-use bags. They may also prefer a smaller bag during the day and a larger one at night. People should speak with a specialist about the available bag options.

Other products are also available to help protect the skin or keep the bag from shifting.

• Stoma paste to help the bag adhere
• Stoma powder to absorb moisture and help keep the bag in place
• Wipes to help keep the area clean
• Belts to help keep the bag securely attached

Living with a Colostomy Bag

A person with a colostomy bag will be able to continue most of the activities they did before surgery. Most other people will not notice the condition unless the person with the bag tells them.

These people will need to avoid carrying heavy objects. They will also need to use the bathroom more often than usual to check the pouching system. Apart from these points, a colostomy bag will not greatly affect everyday life.

If the bag is securely in place, a person with a colostomy bag can participate in most sports and physical activities, including running and swimming. Even when careful during these activities, people may sometimes want to wear a protective belt.

Some points people living with a colostomy should consider;

• Carry extra spare bags, particularly when traveling
• Take care when wearing a seat belt; the belt should not pass over the stoma
• They may prefer to avoid gas-producing foods
• Take extra care around children and pets to prevent accidental injury
• Remove the bag or the stoma when showering, or cover the stoma with something if not removing it
• They may buy high-waisted clothing and underwear or special clothing

Having a colostomy bag should also not affect a person’s sex life or pregnancy.

How Often Should It Be Changed?

The American College of Surgeons (American College of Surgeons) recommends changing the bag when it is more than one-third but less than half full. This precaution can help prevent the bag from pulling away from the skin and leaking.

How often a person changes their colostomy bag depends on its size. A smaller bag is most convenient during the day and will need to be emptied frequently. A larger bag is generally suitable at night or during sleep and is emptied less often.

Some bags are reusable, while others are single-use.

To remind you when the bag was last changed, you can put tape on the bag or write the date on it. Change the bag immediately if you feel itching or burning in the skin around the stoma (where the colostomy enters your body). These sensations may be a sign of a leak.

How Is a Colostomy Bag Changed?

To change a colostomy bag;

1. First, wash your hands with antibacterial soap and warm water
2. Then gently detach the bag from the stoma
3. Detach or cut the bottom of the bag and empty its contents into the toilet or put it in a garbage bag
4. Gently clean the stoma with warm water and a mild soap
5. Dry the stoma completely
6. Prepare the next bag (and the flange if using a two-piece system)
7. Attach the bag with adhesive around the outside of the stoma

Some people may also want to use wipes or other products in case of accidental spills.

Is a Colostomy Bag Permanent?

Whether a colostomy bag is permanent depends on how much of the colon (large intestine) is affected by the disease and where. In some cases, it may be temporary. However, a temporary colostomy can last weeks, months, or even years.

When the area below the colostomy has healed, the bowel is returned inside and the stoma is closed, allowing the person’s bowel to work as it did before.

In some cases, a colostomy may be permanent, and a person may need to live with a colostomy bag for the rest of their life. Some conditions that generally result in a permanent colostomy include;

• Bowel injuries
• Ulcerative colitis
• Obstruction
• Diverticulitis
• Irritable bowel syndrome
• Rectal cancer - particularly in the lower area near the anus
• Crohn’s disease
• Problems with bowel structure present at birth
• Abnormal growths in the colon called polyps that may be cancerous (a large number of polyps)

Summary

People may use a permanent or temporary colostomy bag. A colostomy may be needed after cancer or something that injures, damages, or infects the large intestine.

Colostomy bags do not affect everyday activities. Most people do not notice unless the person using a bag tells them.

People should consult specialists to choose the colostomy bag that best meets their needs. Many different types and sizes are available, so a person should find one that meets the demands of their lifestyle.

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