During the first few weeks after surgery, you may have some difficulties living with an ostomy bag. Now, daily actions, such as going to the bathroom, require more time and care.
You may have difficulty emptying the bag and/or experience frustration because you happen to get dirty often during this operation.
Don’t worry, we will help you!
We created this guide to make emptying the pouch a simple routine.
Regardless of your type of ostomy, these guidelines will help you complete this routine correctly and without stress!
If you are wondering which is the best position to empty your ostomy bag, below you will find the answer
Most ostomates, mainly use these four positions to empty the collection system:
- sitting on the toilet (about 43%)
- standing (about 30%)
- kneeling (about 17%)
- sitting on the toilet in reverse (about 7%)
*This survey was conducted in April 2021 and was completed by 141 people of different nationalities. The survey was posted in the following Facebook group: Ileostomy,colostomy, stoma and bowel support
Below, we will explain how to empty the collection system correctly and with complete peace of mind.
We will also answer some frequently asked questions such as: whether you need to rinse the ostomy bag, how best to do it, and how often you should empty the bag for proper hygiene.
Read on to learn more!
Different types of ostomy bags
An ostomy bag can be either a draining or a non-draining type. This depends largely on your personal preference:
- Drainable ostomy bag: these bags have an opening at the bottom that allows you to empty the contents of the bag whenever you need it. The closure is held securely with Velcro tabs or a plastic clip.
- Non-drainable ostomy bag: also called “closed,” or “disposable.” These are disposable ostomy bags that must be replaced once full. It is possible to empty and reuse a disposable ostomy pouch, however, manufacturers usually recommend replacing it since it is not designed for reuse.
In addition to choosing a good bag, it is also important to perform proper peristomal hygiene.
Often, in fact, ostomised people face even severe skin changes due to an incorrect hygiene routine, which cause itching, pain and make them feel more uncomfortable showing those parts of the body, for example at the beach or in intimacy, because they are irritated. With a proper hygiene routine, including ostomy-specific products, you will see noticeable improvements in the skin, which will remain smooth and elastic.
If you want to learn more, about how to perform proper peristomal skin hygiene, check out this article.
Several ways to empty your bag
Emptying the ostomy bag can be a hassle, especially in public places.
Ostomates generally use one or more of the following methods to empty the pouch:
- sitting on the toilet
- standing
- kneeling
- sitting on the toilet backwards
1. Sitting on the toilet
About 43% of people with ostomies prefer to sit on the toilet to empty the collection system. Many ostomates report that this position is the most comfortable. If you are a risk-taker or have developed a good familiarity with this technique, you may also decide not to drop your pants during this routine.
Here’s how you can empty your ostomy bag while sitting on the toilet:
- Sit on the toilet as you used to, but slightly further back to create more leg room.
- Spread your legs wider than you are used to. This, in addition to creating more space between your legs, also allows you to avoid getting dirty (especially if you have decided to do this with your pants on).
- Point the bag opening in the right direction.
- Widen the opening to empty its contents.
- When finished emptying, rinse or simply wipe the opening with some toilet paper or a wet wipe.
Emptying the ostomy bag while sitting has its advantages. In addition to being the most comfortable position to perform the procedure, it also reduces the likelihood of getting dirty (due to any splashing). Did you get dirty anyway? Below we will give you some basic tips on how to avoid getting dirty during this routine.
2. Standing.
If you are a man, chances are you have been peeing standing up all your life. So, emptying your ostomy bag while standing up should not seem so strange to you. However, the stakes here are a bit higher. If you don’t aim right, or if the contents should splash out, you could spend the next hour cleaning yourself and the bathroom floor. But fear not, we have some great tips for reducing splattering:
To empty an ostomy bag while standing, stick to the following procedure:
- Position yourself in front of the toilet and pull up your shirt
- Pull out the drain opening
- Aim toward the center of the toilet
- Leaning slightly forward will enable you to better aim the target
- Open and empty the collection system
- Once emptied, you can rinse the ostomy bag or simply wipe the opening with toilet paper or wet wipes.
Emptying the pouch while standing is the second preferred method for people with an ostomy. About 29% of people surveyed, use this position to empty the pouch.
We recommend that you use this method especially if you are in public places, so that you do not have to come into contact with surfaces that are, probably, dirty.
3. Kneeling
Kneeling to empty the collection system might seem impractical. However, 17% of ostomates believe that this is the best way to do it. The use of this method also depends on the position of the ostomy and the height of the toilet.
When you get on your knees in front of the toilet, your bag will be level with the bowl, so you don’t have to worry about splashing.
In contrast, the disadvantage of emptying the ostomy bag on one’s knees is that it may not be feasible in public toilets because of sanitary problems. To counter this, an alternative would be squatting in front of the toilet. No splashing, no dirt, and a little exercise! 😉
If this is your preferred position for emptying the bag, you could use a small mat on which to rest your knees. This, would make the whole procedure much more comfortable and smooth. Alternatively, you could fold a towel and use it to rest your knees on.
4. Sitting on the toilet upside down
Sitting backward is a method used by about 7 percent of ostomates.
The idea is to sit upside down, with the toilet flush in front of you.
By adopting this position, you could place all the supplies, which you will need during this operation, on the drain box. However, most ostomates find this position a bit uncomfortable, but if it works for you, there is no reason why you shouldn’t do it.
5. Empty the bag into another container.
4% of ostomates surveyed, prefer to empty the pouch into another container before flushing the effluent down the toilet.
This method is especially useful for people with motor disabilities.
With this system, the chances of getting dirty are very low.
When it comes to choosing a location to empty the collection system, there is no golden rule for doing so. You have to try the different methods yourself and see which one suits you best.
Maybe use multiple methods, depending on where you are (e.g., at home or in a public place). The important thing is that you feel comfortable and at ease while emptying the bag.
If you are interested in finding out what the best tips are for emptying your ostomy bag in a public place, check out this article.
How to open and empty the ostomy bag?
Drainage collection systems have an opening toward the lower end. This opening is closed with Velcro tabs or a plastic clip.
After choosing one of the positions suggested above, follow these steps to empty your ostomy bag:
STEP 1
Pull out the drain opening of your presidium.
STEP 2:
Open the Velcro tabs or plastic clip and set it aside
STEP 3: Unroll the flush opening completely and aim the toilet bowl well
STEP 4:
Press the sides of the opening of your bag to let the effluent out
STEP 5:
Apply gentle pressure with fingers to completely empty the contents of the bag
STEP 6: Rinse your bag and/or use wipes to remove any residue
STEP 7:
Use some toilet paper to dry the opening of the bag
STEP 8:
Roll up slowlymind the discharge opening of the garrison and carefully fasten the Velcro tabs or reapply the plastic clip
STEP 9:
Put the drain opening back into the hidden pocket of the bag
STEP 10:
Finally, wash your hands with soap and water for at least 20 seconds.
How to empty a two-piece system
If you use a two-piece system, the process of emptying and cleaning the bag will be especially easy. Since the bag can be detached from the plate, offering greater flexibility.
Two-piece ostomy bags can also be drainable or undrainable (closed) types. Here’s how you can empty them:
Two-piece draining bag: you can empty this type of bag without detaching it from the plate, just as you would with a one-piece system (explained above).
Alternatively, you can detach the bag, empty it into the toilet, flush it, clean it, and then reattach it. This gives you more control over the bag and can make the process much easier.
Two-piece closed pouch: these pouches are disposable, so you will have to replace it once it is full. To do this, detach the bag from the plaque and empty the contents into the toilet.
Alternatively, in cases where you cannot empty the bag into a toilet, you can put the garrison in a sealed plastic bag or dog poop bag and dispose of it in the trash can. Finally, attach a new bag to the skin barrier and you are ready to go!
Tips for emptying your collection system
How to reduce splashing
Splashing is a major concern for ostomates when emptying their pouches. This problem is especially exacerbated when you visit someone and need to use their toilet.
One moment you are quietly emptying your bag, and the next you are cleaning poop off the floor of your friend’s bathroom (or worse, off the walls of his bathroom). What’s even worse is that you may find remnants even on your clothes. And this would not be a pleasant sight (or smell).
Follow these tips to reduce the risk of likely splashing when emptying the bag:
- Before emptying the bag, flush some toilet paper down the toilet to reduce the risk of splashing
- Try to aim for the inner side of the toilet bowl rather than the center
- If you have a chance try kneeling or sitting on the toilet
- When you sit on the toilet, spread your legs and try to leave enough room to empty the bag
Rinsing of ostomy bag
After emptying the bag (with good aim, hopefully), you can rinse the bag with water. Rinsing an ostomy bag during the emptying process is optional, but preferred by many ostomates:
About 44%* of people with an ostomy always flush the pouch after emptying it and 16%* from time to time. For this operation, you can use a cup of water, a perineal irrigation bottle, or a hand shower.
In contrast, 40 percent* never rinse the ostomy bag after emptying it, as it is not necessary for proper operation of the device.
*This survey was conducted in April 2021 and was completed by 233 people of different nationalities. The survey was posted in the following ostomy-specific Facebook group:
The rinsing process is certainly easier for those using a two-piece system. However, if you’re using a one-piece system or don’t feel like unplugging the bag to clean it, hold the drain opening open with one hand while you let a little water into it with the other, then gently shake it out and empty it.
To reduce the complexity, and avoid making a mess, we have listed the 5 best items to use for ostomy bag rinsing:
- A perineal irrigation bottle or spray bottle: small and easy to use and carry
- A cup of water
- Reuse plastic water bottles.
- An irrigation syringe: small and perfect to put in your purse.
- A bidet hand shower: this article is for you if you are serious about flushing and want to make it as easy as possible. Bidet hand showers are easy to find on the Internet, and you can buy one for a few euros
The rinsing of the ostomy bag is done primarily-in the case of pasty consistency evacuations-to facilitate drainage and to reduce odor.
Sometimes it is recommended not to rinse the pouch so as not to compromise the integrity of the plaque. However, if rinsed carefully, without letting too much water into the soma area, the water should not create problems for the adhesive barrier.
Device disposal (closed bags)
If you have a closed (disposable) ostomy bag, you will need to find a way to dispose of it properly.
The best way to do this is to use an airtight plastic bag. This ensures that the toilet remains clean and odorless at the end of the routine. For added privacy, get airtight sealed bags or opaque-colored trash.
In addition, having products to reduce odor can also make you feel better (as well as benefit others).
When to empty the ostomy bag?
The ideal time to empty the ostomy bag is when it is one-third to one-half full.
The longer you wait, the more likely you are to notice it under your clothes. In addition, a very full bag may give off a bad smell, a feeling unwelcome by you and the people around you.
Don’t wait too long before emptying or changing the bag; an overfilled bag could cause leaks that, in addition to being very annoying, are also particularly irritating to your peristomal skin.
So, as a rule of thumb: when one-third of the collection system is full, it is time to empty/change it.
How often should the ostomy bag be emptied?
The frequency of emptying the pouch usually depends on the type of ostomy you have:
- Frequency of colostomy bag emptying: with a colostomy, a bag tends to fill about 6-8 times a day. Colostomy bags require less frequent emptying than ileostomy bags. Because the stool of a person with a colostomy is more compact and less liquid.
- Frequency of ileostomy bag emptying: you can expect to empty your ileostomy bag 4 to 10 times a day, and sometimes more. Ileostomates need to empty their bag more frequently because evacuations tend to be very frequent and watery.
- Frequency of urostomy bag emptying: it may be necessary to empty a urostomy bag up to 10 times a day.
The number of times you empty your ostomy bag per day can also change depending on what you eat and how much fluid you ingest.
If you notice sudden changes in your bowel movements, don’t hesitate to inform your primary care physician.
Especially in the early days, living with an ostomy may present some challenges. Don’t be frustrated with yourself if you find emptying your ostomy pouch to be a very complex and slow operation. It is only a matter of time until you find out what technique is best for you to care for your ostomy and peristomal skin. This procedure can be made easier with the use of the cleanser Bioderm Stoma Plus, specifically for ostomy hygiene, which we recommend you carry with you at all times.
The important thing is to know that you are not alone. There are thousands of people like you, living comfortably with their ostomy. Take a look at this article if you are interested in how to connect with other people who are living with an ostomy, and with whom you might share advice and concerns.
Frequently asked questions
Still haven’t found the answer to your question? We have collected for you the most frequently asked questions related to emptying the collection system:
Do colostomy bags smell?
As long as they are properly sealed and well maintained, ostomy bags do not give off any bad odor. Remember to empty the pouch when it fills one-third to no more than half full. This will reduce the risk of bad odor escaping from the device. Also, clean the pouch properly and change it periodically.
How long does it take to empty a colostomy bag?
Emptying the ostomy bag should take about 1-2 minutes. Of course, in the beginning the time needed to empty the ostomy bag will be longer. If you include rinsing the bag in the process, it will take a few minutes longer. However, once you become familiar with the system, you will be much faster.