Taking care of your ostomy might be difficult during the first few weeks after surgery. Going to the toilet now requires extra steps and more time. You might splash, cause a mess, and let the nasty odour out.

But no need to worry. We’ve got you covered! We’ve put together a full guide to make bag emptying a simple routine. 

No matter if emptying a colostomy, ileostomy, or urostomy bag – it is an essential part of stoma care for each kind of ostomy. Chances are, you’re going to be doing it multiple times daily for a foreseeable future.

But, is there a wrong way to empty an ostomy pouch? And what is the best way to do it?

We will provide you the answer right here:

There is no wrong way to empty your ostomy bag, but the majority of ostomates sit while emptying: About 43%* of empty their bags sitting down forward, making it the most commonly used method. It feels more natural and comfortable to the most. 29%* of ostomates empty their bag standing up. However, in order to reduce splashing, 17%* of ostomates choose to kneel in front of the toilet. Only 7%* are sitting backward on the toilet seat.

*This survey was conducted in April 2021 among international stoma patients. The data results from 141 voluntary respondents. It was published in the following stoma-specific Facebook group: Ileostomy,colostomy, stoma and bowel support

That being said, you just need to find a way that suits you best. We’ve put together a step-by-step guide and valuable tips and tricks to empty your ostomy bag without a mess.

 Furthermore, we will answer the question if rinsing the ostomy bag is necessary, how to do it best, and how often you should empty the bag to keep yourself and your stoma clean.

 Read on to learn more!  

Different types of ostomy bags

A ostomy bag can be either drainable or non-drainable. This largely depends on your personal preferences: 

• Drainable stoma bag: These bags usually have an opening on the bottom that lets you drain the contents out as needed. The opening is usually held tightly closed with either velcro or a plastic clip. 

• Non-drainable stoma bag: Also called closed, closed-end, or disposable bags. These are usually single-use ostomy pouches that you replace once they become full. Emptying a disposable ostomy bag can be done, however, manufacturers usually recommend just replacing it since it’s not built for that.

Different ways for emptying an ostomy bag

Emptying your ostomy pouch can be a hassle, especially when in public. 

Ostomates generally use one or more methods of the following to empty their bags:

• Sitting forward
• Standing up
• Kneeling 
• Sitting backward

1. Sitting Forward

Around 43%* of people with a stoma use the sitting method for emptying their ostomy bags. It’s the most commonly used position. Many patients say that it resembles the natural way and is more comfortable. If you’re a risk-taker, or otherwise have developed a really good aim, you can keep your pants on when doing this for a fast routine.

Here’s how you can empty your stoma bag sitting forward: 

1. Sit down on the toilet seat like you used to do in the past, but further back to create more space between your legs. 
2. Pull your legs further apart than you’re used to. This also helps to give you more space between your legs. This is done to avoid soiling your thighs (especially if you’ve kept your pants on).
3. Aim the tail of your ostomy bag in between your legs. That’s where the content will flow. 
4. Once you’ve got your aim right, open the stoma pouch (explained below) to release the content.
5. Once empty, you can rinse your ostomy bag or just clean the opening with tissue paper or wet wipes.

Emptying your stoma pouch sitting down has its advantages. Arguably it’s the most comfortable position to perform the procedure. It reduces splashing since you’re closer to the toilet seat. Still splashback? We will give you some great tips on that below.

However, emptying your ostomy bag sitting down is not for everyone. If there is very limited room around the toilet, or the toilet seat is too small for example for overweight and obese people, it can be hard to empty the contents through the small space between the legs. 

2. Standing Up

If you’re a man, chances are that you’ve been peeing standing up your whole life. So, emptying your ostomy bag while standing as well should not feel all that weird to you.

Nevertheless, the stakes here are a bit higher. If you miss the mark, or the contents splash back too hard, you can spend the next hour cleaning up yourself and the bathroom floor. But fear not. We have some awesome tips to reduce splash back later on. 

To empty an ostomy bag while standing, follow these steps: 

1. While standing up facing the toilet seat, pull up your shirt 
2. Pull out the tail of your ileostomy, urostomy or colostomy pouch 
3. Try to aim at the middle or inner side of the toilet bowl 
4. You can try to bend over forward to improve your aim 
5. Open the ostomy bag to release the content 
6. Once empty, you can rinse your ostomy bag or just clean the opening with tissue paper or wet wipes.

With around 29%* standing up for emptying an ostomy bag, it is the second preferred method.  Especially when done in public, you don’t have to fear bacteria or other dirt. 

Although emptying your colostomy bag while standing sounds convenient, the most feared disadvantage is the splashback. This can be especially embarrassing when you’re visiting someone and using their toilet.

3. Kneeling down

Kneeling to empty your ostomy bag might sound a bit impractical, however, 17%* of ostomates find this the best way to do it. Using this method also depends on the position of your stoma as well as on the height of your toilet.

When you get down on your knees in front of your toilet seat, your pouch will be at the level of the bowl, so you don’t have to worry about splashing.

In contrast, the disadvantage of emptying your stoma bag while kneeling is that it might not be doable in public restrooms due to sanitary concerns.

To counteract this aspect, an alternative would be squatting in front of the toilet. No splash, no dirt, and some exercise! 😉

If this is your method of choice then you might want to invest in a thick bathroom floor mattress. This can make kneeling when emptying your bag more comfortable and smooth. Alternatively, you can fold a towel and use it to support your knees.

4. Sitting Backward

Sitting backward is a method used by around 7%* to clean out your ostomy pouch. 

The idea is that you sit the opposite way around, facing the toilet seat to empty your stoma bag. 

It can be handy, if you have the items you need for cleaning your bag on top of the toilet cistern.

Most ostomates find this position a bit uncomfortable.

Nevertheless, if it works for you, there’s no reason why you shouldn’t do it.

5.  Emptying In A Container or Bag

4%* of ostomates choose to not empty their stoma pouch directly into the toilet but in another container or bag. 

To do this, you can empty your bag into a container or cup to later empty it into the toilet seat. Alternatively, you can choose to empty the contents into a sealable bag, and dispose of it in the bin. 

This method is especially preferred by physically disabled people who can’t get up easily. Moreover, there’s really minimal risk of soiling yourself, since you’ll be emptying your stoma bag directly into the container. Lastly, it is also convenient as it can be done everywhere without searching for a restroom.

When it comes to choosing a position to empty your bag, there’s really no golden rule or “one-size-fits-all”. You need to try out the different methods yourself and see which one suits you best. Maybe use one method at home,  and another in public. Whatever feels right and comfortable to you is really the right way.  

This being said, finding your preferred method at home is one thing, but another one is to feel comfortable when emptying your bag in public or at friends. Therefore we have investigated among many ostomates to find the perfect tips for  emptying your bag in public that you shouldn’t miss.

How to open and empty your ostomy pouch?

Drainable bags have an opening on the tail. This opening is either closed with velcro or a plastic clip. 

After choosing one of the positions suggested above, follow these steps to empty your ostomy bag: 

Emptying a two-piece System

If you’re using a two-piece system, then the process of emptying and cleaning your bag will be especially easy. Since the bag can be detached from the skin barrier wafer, this system offers more flexibility. 

Two-piece ostomy bags can also be either drainable or non-drainable (closed). Here’s how you can empty them: 

• Two-piece drainable bag: You can drain the bag without detaching it from its base, just as you’d do with a one-piece system (explained above). Alternatively, you can detach your bag first, empty it inside the toilet seat, rinse and clean it, and then reattach it. This gives you more control over the bag, and can make the process much smoother.

• Two-piece closed bag: These bags are disposable, so you’ll be replacing yours with a new bag once needed rather than emptying it. To do this, detach the bag from the waver. You can choose to empty the bag in the toilet before disposing of it. This would reduce the chances of it leaving a nasty smell in the bathroom. 

Alternatively, you can put the pouch in a sealed plastic bag or a dog poop bag, and throw that in the trash bin. Once done, attach a new bag to the skin barrier, and you’re ready to go!

Tips for emptying your ostomy bag

Reduce Splashing

Splashback is one of the main concerns of ostomates when emptying their pouches. This is especially true when you’re visiting someone and using their bathroom.

One moment you’re peacefully emptying your bag, and the next you’re cleaning poop off your friend’s bathroom floor (or worse, off their bathroom walls). What’s even worse is getting it all over your clothes as well. Now that wouldn’t be a pleasant sight (or smell). 

So, the struggle is real when it comes to splashing. However, here are some tips to prevent splashback from happening: 

• Throw some crammed-up toilet paper into the water first to soften the splash
• Try to aim at the inner side of the toilet bowl rather than the middle
• Try kneeling or sitting down, as these are the least likely positions to cause splashing 
• When sitting down, sit further back, and open your legs wider apart 

 Rinsing your ostomy bag

After you’ve cleared your bag from all its contents (with a good aim, hopefully), you can rinse the bag with water. Rinsing an ostomy bag during the process of emptying it is optional, but preferred by many ostomates:

Around 44%* of people with an ostomy always rinse their bag after emptying it, 16%* from time to time. Commonly, a cup of water, a peri bottle or a bidet extension is used for that. In contrast, 40%* never include rinsing the ostomy bag in the process of emptying, as it is not necessary for a proper functioning of the appliance.

*This survey was conducted in April 2021 among international stoma patients. The data results from 233 voluntary respondents. It was published in the following stoma-specific Facebook group: “Ileostomy,colostomy, stoma and bowel support”

The process of rinsing surely is easier for two-piece users. If you prefer to detach your bag when emptying it, you can rinse it with water in the sink to clean it more thoroughly. 

When using a one-piece-system or you don’t want to detach your bag, keep holding the stoma bag’s tail with one hand after it has been emptied. Then, use the other hand to sprinkle some water inside, swish it around, and empty it. 

In order to reduce complexity, and avoid making a mess, we collected the top items to use to rinse the bag:

• A peri bottle or squirt bottle: easy, small, and good for the go.
• A simple cup of water
• Reuse a plastic drinking bottles 
• An irrigation syringe: Small and easy to pack.
• A bidet sprayer:  This is for you if you’re serious about rinsing, and want to make it as simple as possible. There are quite cheap ones to purchase on the internet.

Rinsing the ostomy bag is especially done in case of pasty output for easier draining as well as to lessen odours. 

However, sometimes it is recommended not to rinse the bag in order to not compromise the integrity of the seal. Nevertheless, if rinsed carefully without getting too much water on the soma area, it should not impact the wear time of your appliance. 

Disposing of your bag (closed bags)

If you have a closed (disposable) ostomy pouch, you’ll need to find a way to dispose of it properly without it causing a mess or a persistent odour in the bathroom. 

The best way to do this is by using a sealable plastic bag. This assures that the toilet is left clean and odourless once you’re done. You can get bags that are not see-through in order to have more privacy. 

Furthermore, having products like bag drops or a bag deodorant to reduce odour can also make you feel better (and others!).

When to empty your ostomy bag?

The ideal time to empty your ostomy bag is when it is one-third to half-full.  This prevents it from bulging under your clothes and keeps it more discreetly hidden.

The longer you wait, the more likely it will become noticeable under your shirt. Moreover, a fuller bag can cause more odour, something neither you nor the people you’re hanging out with really want.

If you decide to delay emptying or changing your bag till its completely full, you’ll be risking it leaking and causing a nasty mess. 

So, as a rule of thumb: once one-third of your stoma bag is full, it’s time to go.

How often should you empty your ostomy bag?

Stoma bag emptying frequency usually depend on the type of ostomy you have: 

• Frequency of emptying colostomy bags: Your colostomy bag will fill up and require emptying around 6 to 8 times per day. Colostomy bags require less frequent emptying than ileostomies. Since the stoma is drawn from your colon, which is far down your digestive system, the stools will be more consistent and will contain less fluid.
• Frequency of emptying ileostomy bags: You can expect to empty your ileostomy pouch anywhere between 4 and 10 times per day, and sometimes even more. Ileostomates need to empty their pouch more frequently since the feces are drained out before they reach the colon (large intestines), and will contain more liquid and volume. 
• Frequency of emptying urostomy bags: A urostomy bag may need emptying up to 10 times per day.

How many times you empty your ostomy bag per day can also change depending on what you’re eating and how much fluid you ingest. If you are interested in knowing which diet is perfect for you, take a look at these articles:

• Colostomy Diet: What Can I Eat Without Consequences
• Ileostomy Diet: 10+ Tips & Recipes To Keep You Hydrated

If you notice any major changes in your bowel habits, don’t hesitate to inform your treating physician.

Living with an ostomy can present some challenges at first. As the days and weeks pass, you’ll find that taking care of your stoma will become a routine.

Don’t be frustrated if emptying your ostomy bag is taking too long at first. Once you master your own technique, it will become all natural to you. This procedure can be facilitated thanks to the use of the Bioderm Stoma Plus detergent, specific for the hygiene of the ostomy, which we advise you to always carry with you.

The important thing is to know that you’re not alone. There are thousands of people like you, living comfortably with their stoma and making every day count.

Q&A

Could you still not find the answer to your question? We have collected the most frequently asked questions related to emptying an ostomy bag:

Do colostomy bags stink?

As long as they’re properly sealed and well taken care of, an ostomy bag should not stink or release odours. You need to make sure to empty your ostomy pouch when it’s half full at most, so that the smell doesn’t seep out. Properly cleaning your bag and changing it when necessary also plays a big role.

How long does it take to empty a colostomy bag?

Emptying your stoma bag should take around 1-2 minutes from start to finish. Of course, the time needed to empty your ostomy pouch will be longer at first. If you include rinsing the bag in your process, it will take some minute(s) longer.  However, once you get the hang of it, you will be much quicker.