How to Overcome the Challenge of Pouching in Difficult Situations

November 26,2021 |
Man sitting on his couch looking frustrated.

Getting an ostomy is a major lifestyle change. It will take time to get used to changing your pouch, but eventually it’ll become second nature. However, as many people are quick to learn, there are plenty of instances that create challenges to your regular pouching routine. This doesn’t mean you have to suffer through any embarrassing incidents. There are tried and true ways to overcome the challenges of pouching in difficult situations, all of which depend on the circumstances at hand. In this article, we’ll go over everything you need to know about overcoming the challenge of pouching in difficult situations and provide you with a few examples of what to do.

General Guidelines on How to Change Your Ostomy Pouch

A lot of new ostomy patients feel overwhelmed when first changing their ostomy pouches, but over time it gets easier. Your ostomy nurse will walk you through everything you need to know before you go home and if you have any questions later on, don’t hesitate to call them and get clarification. There are different types of ostomies, all of which tend to require slightly different materials. With every ostomy, it’s a major lifestyle change and your doctor and ostomy nurse are there to help you through the transition. With practice, changing your ostomy pouch will become so routine that you don’t even think about it.

To get started, always make sure that you wash your hands. Have all of your equipment ready and have a towel or paper towels nearby in case of any spillage. You should also have clean washcloth if you’re not showering after and plastic bags for cleanup. To avoid any backsplash, put some toilet paper into the bowl beforehand. When your pouch is full, empty it into the toilet as usual. With many of the modern ostomy pouches, you shouldn’t need to rinse out your ostomy pouch, but always check with your ostomy nurse to be sure. You’ll then need to remove the pouching system from your body to change it for a new one. Discard the old pouch, wafer, and any waste into a plastic bag for added protection. Then, before putting on your new pouch, make sure that you properly clean your stoma and the surrounding skin with the washcloth and pat it dry. Clean, dry skin is essential for a strong seal. If you recently had surgery, you’ll want to measure your stoma and make sure that you record any changes. Otherwise, you can start applying the new skin barrier so that you can reattach a new, clean pouching system. This process is different for both a one-piece system and a two-piece system, so always go over the manufacturer’s instructions in detail to ensure a proper fit. For a more in-depth guide on how to change your ostomy pouch, check out this great resource.

How to Change Your Ostomy Pouch in a Public Bathroom

Changing your ostomy pouch is a very private process and many people get anxious when they need to do it in a public bathroom. However, as long as you have the proper supplies with you, you can overcome this challenge and change your pouch in any bathroom available. Create an ostomy travel bag and make sure you include extra supplies just in case. We also recommend always having an extra pair of clothes handy for worst-case scenarios. The primary difference in changing your ostomy pouch in a public bathroom vs. in the bathroom at your home is cleanliness and accessibility. If there is a hook in the bathroom stall, use it to hang up your pouch. If there’s no hook, you can either loop it around the stall door corner or put it on the floor. Only put your pouch on the floor if it’s a clean restroom or if you bring a towel to use as a barrier. Then, proceed to empty your pouch. Some people find it easier to sit down while others prefer to stand. It’s going to take some practice but do whatever is most comfortable. You’ll need to balance everything, so try practicing at home to get more comfortable with this process.

After you’ve drained your pouch, use some toilet paper to wipe the opening clean. You can then secure your pouch system, double check that it’s completely closed, and leave the bathroom stall to wash your hands. Using a closed end ostomy pouch is a little easier as you can simply discard the pouch without emptying it and reattach a new, clean one. Again, the main thing is practicing so that you’re comfortable. Don’t worry about other people in the bathroom—everyone does their business one way or another.

What to do if Your Ostomy Bag Won’t Stick

On occasion, people with ostomies experience the problem of their ostomy bag not sticking. If you notice loose corners, try using medical grade adhesive made for ostomates. We also recommend making sure that your stoma and the surrounding skin are as clean as possible to create a tight seal. If you’re changing your pouch in a public restroom where this could be more difficult, carry around unscented baby wipes to help ensure a thorough clean between pouch changes.

How to Pouch a Retracted Stoma

A retracted stoma is when the stoma sinks or dips inwards instead of protruding slightly above your abdominal wall. It can occur due to a number of reasons, but regardless of why it happens it makes pouching a little more challenging. If you notice a retracted stoma, talk to your ostomy nurse about switching to a convex insert. Convex inserts can help provide added protection and tighter seals. There are both reusable and single-use convex inserts available to help ease the challenge of pouching in difficult situations.

If you experience any stoma problems or feel that your stoma has become irregular, don’t hesitate to contact your doctor. Some changes to your stoma are natural after getting your initial surgery but can also indicate a problem or infection. To avoid any complications, it’s important to get your stoma examined by a medical professional to better understand what’s causing the changes.

Pouching with Skin Creases or Weight Changes

If you gain or lose a substantial amount of weight, your stoma is going to change. In some cases, you might experience a crease while in others your stoma may become retracted. For retracted stomas follow the advice above and if that doesn’t work, talk to your doctor about switching to a more flexible pouch to better accommodate your stoma changes. If you have creases in your abdomen, try using moldable adhesive strips to help create a tight fit and combat any creases.

Managing Ostomy Accidents

Even if you’ve been regularly changing your ostomy pouch and overcoming challenges for years, there is always the potential for an ostomy accident. By taking the steps and precautions above, you can help to prevent ostomy accidents, but it’s still important to have information at hand for the dreaded worst-case scenario.

Fixing or Preventing a Leak

Leaks are bound to happen at least once to everyone. It’s nothing to be ashamed of. With the right information you can reduce the likelihood of this happening and manage leaky stomas quickly if they do occur. If you’re experiencing regular leaks, it might be because of your ostomy pouching system. Consider talking to your ostomy nurse about switching to a new system or trying a new accessory. Always make sure to drain your pouch regularly to avoid a heavy bag. The heavier the bag, the more resistance at your stoma. When you’re leaving your home, have your ostomy travel bag packed and ready. If you notice a leak, grab a patch for a quick fix until you can solve the underlying problem.

Ostomy Odor

While you might think that ostomy odor is common, it’s actually not as bad as you’d think. There are plenty of great options for managing ostomy odor. Find something that works for you and include it in your ostomy pouching routine.

Pouch “Blowouts”

A blowout is easily the worst-case scenario for ostomates, but it doesn’t happen often so don’t worry too much. The main reason that a blowout occurs is due to faulty pouching systems, improperly changing your pouch, or excessive gas buildup. Take your time when switching your pouching system and contact your ostomy nurse if you think that your products might have a defect. During this time, talk to your nurse about switching to a pouch that offers a vent to release gas or learn about your options for filters.


Changing your ostomy pouch takes some time, but with practice it gets easier even in the most challenging situations. There are plenty of great products available to help you lead a normal life without any added complications. To get the most out of your ostomy, always opt for high-quality, medical grade ostomy supplies. You’ll need ostomy pouches, ostomy flanges, stoma powder, and skin prep essentials to get the most out of your ostomy skin care. At Byram Healthcare, we’re committed to helping improve the life of people living with an ostomy and offer a wide range of ostomy supplies, ostomy bags, and support systems. Byram is here to help save you time and hassle.