How often should I change my pouching system?

Wear time, or the number of days between changes (removing the pouching system and applying a new one), is a hot topic.

The maximum number of days between changes recommended by manufacturers is seven days. After seven days the products can break down and no longer provide the protection they are designed to offer.

The average number of days between changes is four. This means some people change daily, some people change once a week, and lots of people are anywhere in between.

Some people want to change as infrequently as possible. Some people want to change more often to help them feel “clean”. Almost everyone wants to change before they have a leak. Here are important considerations in deciding how often to change your pouching system:

The consistency of your stool

Liquid output is harder to contain that more formed output. Liquid output will increase the likelihood of leakage.

The condition of your skin

If you have had leakage, or you have a rash, your skin will be weepy and moist. This moisture breaks down your seal more quickly. Getting a good seal is like building a house. You want to build on a solid foundation. See this page for more information on changing for healing your skin.

The height of your stoma

A stoma that sticks out makes it easier to get stool or urine into the pouch than one that opens at skin level.

The “mobility” of your stoma

A stoma that sticks out and then becomes flat or pulls below the level of the skin while moving makes it harder to ensure your urine or stool goes into the pouch instead of under the flange.

The shape and movement of your abdomen

If your abdomen changes shape a lot when you’re moving around, it may affect your wear time. Deep creases and other “challenging topography” will also affect your wear time. Getting the best flange for your abdomen will help with this.

Once you find a pouching system that works for you:

  • Start low: change after 2 or 3 days. Check the back of your flange to see if there is stool behind the flange, or on your skin.
  • Increase you wear time by one day. Check the back of the flange and your skin. If it is clear, increase the number of days between changes by another day.
  • Repeat this process until you get leakage (stool or urine on your skin or the back of the flange). Subtract one day. This is your wear time. (Example: pouch removed on day 6 has stool behind it. Wear time is 5 days.)

st_changes

This is a photo of leakage. It may make some people uncomfortable. We are including them so that people can see what to look for when they remove their pouch.

st_changes

This photo shows that, even though stool was on the skin, no leakage is visible from the outside.

A reasonable goal is to change twice a week, or every four days.

Some people will never get four days, because of a variety of factors. Working with your ET nurse can help you identify factors that are limiting your wear time, and strategies to manage them.

The big exception: one-piece disposable pouches for colostomy

People with a colostomy may use a one-piece disposable pouching system. These pouches are designed to be changed at least once a day.