Andy Fletcher shares his tips on changing an ostomy bag

Andy Fletcher shares his tips on changing an ostomy bag

Which is best, a one piece or a two piece appliance? What is the best way to remove a bag? How do you dispose of a used bag?

These are some of the questions I have had to answer over the years. Nowadays the internet is full of suggestions, so I have here attempted to “merge” the more useful ones into this single blog, representing my personal views. I have also included a link to a YouTube video that I made a few years ago which show the changing process of a one piece bag, however viewer discretion is advised.

What is best – one piece or two piece?

Some people only change their appliance once a week, others (like me) change daily. It would be impossible to keep a bag on for much longer than a week, human skin replaces itself completely every 27 days, but the surface layer (epidermis) every two to four weeks. This means the longer the appliance is attached, the more prone you will be to suffer from leaks.

There are two main types of Stoma bags available, a one piece and a two piece.

I have tried both types from a variety of manufacturers. I personally prefer a two piece, but have suffered too many leaks whilst at work (I sit and stand all day), so I now use a one piece.

Both have advantages and disadvantages over each other. Here is what I have found over the years. My advice though for the first time ostomist is give your postman a hernia and send away for as many samples from different manufacturers as possible, bags differ greatly in colour, shape and feel.

  • Two piece – With a two piece, the base plate stays attached to the skin for a couple of days (possibly longer) and the actual stoma bag can be unclipped and replaced “on demand”. The main advantage with this is that you can change and “freshen up” really quickly. The main disadvantage is that you double the chances of a leak (although unless your name is Andy, these are rare!).
  • One piece – A one piece bag can be changed as often as you want, apart from the filter and the exit point, this means fewer places exist for a leak. The advantage for me is that I always feel clean after changing, but the disadvantage is the damage to the skin that can happen with frequent changing. A YouTube video of me changing a one piece is located at There are variations in styles, shapes and colours between manufacturers. My previous one piece bag had sharp bottom corners which tended to stab into the most unfortunate place for a male. I have since changed to one with curves rather than edges. The material on the outside of the bags may feel rough on some and smooth on others. There is no right or wrong bag, it’s all a matter of preference. This is why you should experiment with samples to find the one you are comfortable with.

Removing a bag from the skin

Lesson one, do not pull the bag off, they stick very well indeed, and pulling it off will result in a loss of blood, along with some removed skin!

When I first had mini-me created, my stoma nurse advised me to use warm soapy water to gently peel the bag away from the skin. This does work, but takes time. These days, I use purpose designed medical adhesive remover which is available on prescription in the UK. They come in two types – spray and wipe.

Some people are advised to change their bags whilst leaning over a toilet to catch any output. I tend to use a “puppy training mat” and stand on that. Nine times out of ten this works well, except for the odd one time it tends to “spit out” at Olympic style distances which results in me washing walls down afterwards!

Have some tissues within arm’s reach, spray gently in a quick burst at the top of the flange, the adhesive remover works so well that the bag will immediately start to disconnect from the skin. Once it’s off, I use a non-woven tissue to clear any “excess” away before using a remover wipe around the skin where the flange was. This dissolves the glue completely. A quick wash afterwards and you are ready to reapply. Removed bags can then be placed inside a secondary poly bag. All home delivery companies in the UK supply these as complimentary items, but are only pennies to buy.

Word of warning … poo is horrible at the best of times, only us ostomists and people with babies get this much down and dirty with it, so wash your hands thoroughly afterwards.

Disposal of used bags

Stoma bags can be placed in with normal household rubbish and thus passed to the bin-men. My local council though offer a clinical waste collection which I use. All my stoma bags go in there and is collected once a week. My downside to this is that the collection bag is bright yellow with “hazardous waste” written in the world’s largest letters. Probably scares the life out of the van driver! The alternative is to use your dust bin for disposal. Not good for the environment, and certainly no good for your nose after a week contained inside a bin under the hot sun.

So, in conclusion, Google or look on my blog for stoma companies, all of which will supply samples of not just bags but adhesive sprays and deodorisers. Take your time changing, be patient and do not pull. A thorough clean will make the entire task easier.

One thing you can do is “go commando” in the shower. Having fresh water on the stoma itself makes me feel very clean, but make sure you cover it well when drying yourself, any “waste” that appears will simply be washed down the plug hole.

Lastly, be gentle with your stoma, it has no nerves within it, so in theory you could bash it with a brick and not feel it. It will bleed though, mine bleeds a lot by sometimes simply touching it. My nail slid over it once when cleaning and it bled for a good half hour.

Next time, I’ll discuss clothing. What’s best to wear, and what’s best to avoid. I’ll also discuss the various clothing that is available to ostomates, either on prescription, or to purchase.

As always, if you would like to contribute, have a suggestion for a future blog or just want to comment, let me know below.