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How Does a Colostomy Bag Work? (Temporary or Permanent)

A colostomy bag or pouch is the most important piece of equipment for a person who has gone through colostomy surgery. They have made life easier for ostomates. Thanks to the advancement in medical technology an ostomate can happily embrace colostomy. No doubt, living with colostomy brings significant changes in your life; therefore, an individual must understand how does colostomy bag works.

In this article, we will delve into the basic details of colostomy bags along with their functionality and types. So without further ado, let’s begin.

What is a colostomy bag?

due to certain medical conditions such as Crohn’s Disease, colorectal cancer, Inflammatory bowel disease, or diverticulitis, the colon is not supposed to be used, either the injured part of the colon is removed or the colon has been given time to heal.

In such situations, the surgeon brings the part of your colon through an opening in the abdomen. This opening is called a stoma. Instead of defecating stool from the rectum or anus, it excretes from the stoma created in the abdomen. Remember, a stoma does not have any nerve endings, like anus, so your bowel movements are out of your control. Stool may come out from the stoma at any time, so to meet such situations, colostomy bags are invented.

Colostomy bags are medical devices that are attached to the stoma in your abdomen. These bags are the life savers for ostomates as they collect and hold the poop from the stoma. Depending on your medical conditions these bags can be used for temporary time or they can be permanent.

Related: Why would someone need a colostomy bag?


The colostomy pouching system consists of two things:

A flange that may be called a skin barrier or wafer is part of a colostomy bag that is attached to the skin around the stoma.

A pouch is a plastic bag that is attached to the flange to collect the stool as it passes through the stoma.

Read more: Why watery discharge from anus?


Based on components of colostomy bags, there are two basic types which are:

One-piece pouching system:

One-piece pouches have both a pouch and skin barrier attached in the same unit. One-piece pouches are like a team where the pouch and the skin barrier work together in the same unit. When you need to change the pouch, the barrier also comes off with it, making the process more straightforward

Two-piece pouching system:

It consists of a skin barrier and a pouch when you remove the pouch, the barrier hangs around, staying right where it is. It’s like having two friends who can be apart for a while but still have each other’s back when needed.

Based on their functionality, there are two types of colostomy bags:

Drainable pouching system:

As the name implies, these are the pouches whose content can be easily drainable. They are also known as reusable pouching systems. They have openings at the bottom of the bag with some type of closure system such as a seal, Velcro, or clamp. Drainable pouches need to be empty when they are one-half or one-third full. They are best for liquid output.

Read More: ileostomy bag vs colostomy bag

Closed pouching system:

The closed-ended pouching system is known as the disposable pouching system. They are designed for one-time use only, so they must be disposed of once they are full. They have special liners inside that can be flushed off easily. They are best for firm output.


A hole is made into the skin barrier of the pouching system which is supposed to be the same size and shape as your stoma. This means if your stoma is round, the hole in the skin barrier should be round, and the same goes if your stoma is oval in shape. In short, your skin barrier and stoma should be of the same size and shape otherwise it wouldn’t fit properly on the stoma.

When you stick the skin barrier on, it should snugly fit around the junction of your skin and stoma; otherwise, it may lead to inflammation of the skin around the stoma. As the waste comes out of your stoma, it flows over the skin barrier and into the ostomy bag, where it stays until you empty it.


Your ostomy nurse will help you choose a perfect custom pouching system keeping in mind your stoma type and shape, your body shape, and your activities and preferences. Remember, not every pouching system works well for everyone.

Ideally, an ostomy pouching system should have the following features:

  • It should be odor resistant
  • The bag should be user-friendly, which means easy to apply and take off.
  • It should provide a leak proof seal.
  • The adhesive barrier of the pouching system should not damage the skin around the stoma while taking off.
  • The bag should achieve a consistent wear time.

Related: What stage of colon cancer requires a colostomy bag


Taking good care of your colostomy is important, like giving it regular check-ups and emptying it when it’s needed. How often you need to empty the bag depends on the person – some do it a few times a day. When it’s time to empty the bag, you open the bag, empty the contents of the bag in the toilet bowl, and make sure it’s tightly closed again.

If you need to change the whole bag, that’s a bit more involved process and we have discussed it in detail in our previous articles.

The highlights are: You take off the old bag, clean the area around your stoma, and then put on a fresh bag. It’s like giving your colostomy the care it needs to stay clean and comfortable.

Remember to wash your hands properly with warm water and soap before and after the procedure.

Hygiene and Skin Care:

Keeping things clean around your stoma is super important to avoid skin irritation and infections. You should regularly clean both the stoma and the skin around it, and it’s best to use gentle, fragrance-free products for this. There are a lot of colostomy products available in the market that will help you to live a stress-free live with colostomy.

Adapting to Life with a Colostomy:

Adjusting to life with a colostomy means dealing with changes not just in your body but also in how you feel. It’s both a physical and emotional journey. Getting support is key, and that support can come from healthcare professionals, educational resources that provide useful information, and being part of support groups where you can connect with others going through similar experiences.


In conclusion, understanding how a colostomy bag works is fundamental for individuals who have undergone colostomy surgery. The advancements in medical technology have indeed made life easier for ostomates, allowing them to embrace the changes with confidence. a large number of colostomies is temporary which means they will be reversed back to normal condition after a time. However, permanent colostomy is also there. With the support of healthcare professionals, educational resources, and fellow ostomates, you can navigate the physical and emotional aspects of living with a colostomy.

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