Emptying and changing the ileostomy pouching system

How to empty the pouch

Empty the ileostomy 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 clip on the end or tail of the pouch.
  • 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.

When to change the pouching system

Different pouching systems are made to last different lengths of time. Some are changed every day, some every 3 days or so, and some just once a week. It depends on the type of pouch you use.

There may be less bowel activity at certain times in the day. It’s 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’ll be better able to find the best time for changing your system.

Caring for an Ileostomy has more information on pouching systems and keeping them in place.

Sterility

You don’t have to use sterile supplies. For instance, facial tissue, toilet paper, or paper towels can be used to clean around the stoma instead of sterile gauze pads.

Factors that affect the pouching system seal

The pouching system must stick to your skin. It’s important to change it before it loosens or leaks. 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.

Here are some other things that may affect how long a pouch sticks:

  • Sweating 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 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 are more likely to break a seal than a thicker discharge.
  • Physical activities may affect wearing time. Swimming, very strenuous sports, or anything that makes you sweat may shorten wear time.

In its original form this document was written by the United Ostomy Association, Inc. (1962-2005) and reviewed by Jan Clark, RNET, CWOCN and Peg Grover, RNET. It has since been modified and updated by:

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: December 2, 2014 Last Revised: December 2, 2014

American Cancer Society medical information is copyrighted material. For reprint requests, please contact permissionrequest@cancer.org.