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Changing the pouching system

There may be less bowel activity at certain times in the day. It is easiest to change the pouching system during these times. You may find that early morning before you eat or drink is best. Or allow at least 1 hour after a meal, when digestive movement has slowed down. Right after surgery, ileostomy output may be thin and watery. As the output gets thicker, you will be better able to find the best time for changing your system.


You don't have to use sterile supplies. For instance, facial tissue or toilet paper can be used in place of gauze pads. The stoma and nearby skin are clean but not sterile.

Factors that affect the pouching system seal

The length of time a pouch will stay sealed to the skin depends on many things, such as the weather, skin condition, scars, weight changes, diet, activity, body shape near the stoma, and the nature of the ileostomy output.

  • Sweating during the summer months in warm humid climates will shorten the number of days you can wear the pouching system. Body heat, added to outside temperature, will cause skin barriers to loosen more quickly than usual.
  • Moist, oily skin may reduce wearing time.
  • Weight changes will also affect how long you can wear a pouch. Weight gained or lost after ileostomy surgery can change the shape of your abdomen. You may need an entirely different system.
  • Diet may affect your seal. Foods that cause watery output may prevent a long-lasting seal.
  • Physical activities may affect wearing time. Swimming, very strenuous sports, or anything that makes you sweat may shorten wearing time.

Emptying the pouch

Empty the pouch when it is about 1/3 full to keep it from bulging and leaking. Follow these steps:

  • Sit as far back on the toilet as you can or on a chair facing the toilet.
  • Place a small strip of toilet paper in the toilet to decrease splashing.
  • Hold the bottom of the pouch up and open the pouch at the tail.
  • Slowly unroll the tail over the toilet.
  • Gently empty the contents.
  • Clean the outside and inside of the pouch tail with toilet paper.
  • Roll up the end of the pouch and clip.

Last Medical Review: 03/17/2011
Last Revised: 03/17/2011