A stoma bag collects waste from a stoma — an opening made surgically on the abdomen, connecting the bowel or bladder to the outside. It is worn where the normal route out of the body has been bypassed or removed, after bowel cancer surgery, inflammatory bowel disease, injury or obstruction.
What is Stoma Bag?
A stoma bag — also called an ostomy pouch or appliance — is a medical device, not a medicine, which is why it does not appear in the South African Medicine Price Registry.
A stoma is created when a surgeon brings the end or a loop of the bowel, or a section of intestine connected to the ureters, through the abdominal wall and stitches it to the skin. The opening is pink or red, moist, and looks a little like the inside of the mouth. It has no nerve endings, so it is not painful to touch, and no sphincter, which is why output cannot be controlled and a bag is needed.
The three main types:
| Type | From | Typical output |
|---|---|---|
| Colostomy | Large bowel (colon) | Firmer, more formed; less frequent |
| Ileostomy | Small bowel (ileum) | Looser, more liquid, continuous; higher fluid and salt loss |
| Urostomy | Urinary system | Urine, continuous |
Bags come as one-piece (bag and adhesive baseplate together) or two-piece (a baseplate that stays on for a few days with bags clipped on), and as closed bags that are removed and replaced, or drainable bags emptied through the bottom. Which suits you depends on the stoma type and output.
A stoma may be temporary or permanent. A temporary stoma allows the bowel below to rest and heal, and is reversed at a later operation. A permanent one is created where the bowel or rectum below cannot be used.
What is Stoma Bag commonly used for?
A stoma is created for:
- Bowel cancer surgery, where a section of bowel or the rectum is removed. This is the commonest reason.
- Inflammatory bowel disease — Crohn’s disease and ulcerative colitis — where the bowel is severely diseased or has to be removed.
- Diverticular disease with perforation or abscess.
- Bowel obstruction or perforation, often as an emergency.
- Trauma to the abdomen.
- Bladder cancer, where the bladder is removed and a urostomy is formed.
- Faecal incontinence or severe pelvic floor problems, in some cases.
- Congenital conditions, in children.
- Protecting a new join in the bowel while it heals — usually a temporary stoma.
A stoma is not an illness. It is a way of managing one, and for many people it resolves symptoms that were dominating their lives — the urgency, pain and incontinence of severe inflammatory bowel disease, for instance. People with stomas work, exercise, swim, travel, have relationships and have children. Modern appliances are discreet, odour-proof when intact, and worn under ordinary clothing without being visible.
Adjusting takes time, and that is normal. The practical skills come within weeks; the emotional adjustment often takes longer, and support helps considerably. A stoma therapist or stoma nurse is the single most useful contact you can have — they solve leaks, fit problems, skin problems and the questions nobody wants to ask a surgeon.
How Stoma Bag fits into this medicine category
| Item | Purpose |
|---|---|
| Stoma bags | Collect output |
| Baseplates and flanges | Adhere to skin and hold the bag |
| Barrier rings, seals and paste | Fill dips and creases; prevent leaks |
| Skin barrier films and wipes | Protect the surrounding skin |
| Adhesive removers | Take the appliance off without damaging skin |
| Deodorisers | Control odour when emptying |
| Support belts and wraps | Security and hernia support |
Medicines used alongside include loperamide to thicken high ileostomy output, bulking agents, and — for cramping — antispasmodics such as hyoscine (Hyospasmol) or anti-nausea medicines such as metoclopramide (Adco-Contromet), all on medical advice.
What to check before using Stoma Bag
- Measure the stoma and cut the opening to fit. This matters more than anything else. Too large exposes skin to output and causes soreness; too small constricts the stoma. The stoma shrinks over the first six to eight weeks after surgery, so remeasure regularly during that period.
- Empty a drainable bag when it is about one-third full — not when it is full, which causes the seal to pull away.
- Change the appliance at the recommended interval, and before it leaks rather than after.
- Care for the skin. It should look like the skin elsewhere on your abdomen. Clean with warm water, pat dry thoroughly, and avoid soaps, wipes with oils, and anything that leaves a residue preventing adhesion.
- Use accessories for an awkward site — a barrier ring or paste fills creases and prevents leaks around a stoma near a scar or in a fold.
- Drink enough, especially with an ileostomy, where fluid and salt losses are high.
- With an ileostomy, chew food well. High-fibre foods — nuts, popcorn, sweetcorn, mushrooms, celery, dried fruit — can cause blockage.
- Tell your pharmacist you have a stoma. Slow-release and enteric-coated tablets may pass through undigested, particularly with an ileostomy, and alternatives exist.
- Carry spare supplies whenever you leave home.
- Know your stoma nurse’s contact details.
Possible cautions and when to ask a pharmacist or doctor
Common problems, nearly all solvable: leaks, sore skin around the stoma, odour, wind and ballooning, and finding the right appliance. None of these should be endured — a stoma nurse fixes most of them quickly.
Get emergency help for:
- No output from an ileostomy or colostomy for several hours, with cramping abdominal pain, a swollen abdomen, nausea or vomiting — possible blockage. This is the emergency to recognise, and with an ileostomy it can develop quickly.
- The stoma turning dark purple, black or grey, which suggests its blood supply is compromised.
- Heavy bleeding from the stoma itself, as opposed to a small amount from the surface, which is common and harmless.
- Severe abdominal pain, fever, or feeling very unwell.
- Signs of dehydration with a high-output ileostomy — dizziness, very dark or reduced urine, extreme thirst, confusion. High-output stomas can dehydrate someone dangerously quickly.
- The stoma retracting inwards or protruding markedly, or a bulge developing around it.
Contact your stoma nurse or doctor if:
- Leaks are recurring — the fit is wrong and can be corrected.
- The skin around the stoma is sore, red, broken or itchy.
- Output changes markedly in volume, consistency or colour.
- You develop a bulge around the stoma — a parastomal hernia, which is common and manageable.
- You are struggling emotionally. That is extremely common, it is not a failure, and support exists — including stoma support groups and counselling.
Related medicine guides
Frequently asked questions
What is a stoma bag used for? Collecting waste from a stoma — a surgically created opening on the abdomen connecting the bowel or urinary system to the outside.
Why would someone need one? Bowel cancer surgery, inflammatory bowel disease, diverticular disease, obstruction, perforation, trauma or bladder removal.
Is it permanent? Sometimes. Temporary stomas allow the bowel below to heal and are reversed later; permanent ones are formed where the bowel or rectum below cannot be used.
Does the stoma hurt? No. The stoma itself has no nerve endings. Soreness comes from the surrounding skin, usually because of a poor fit or leaks — both fixable.
Can people see it? No. Modern appliances are flat and discreet under ordinary clothing.
Can I swim, exercise or travel? Yes, all of them. Appliances are waterproof, and support belts help with sport. Carry spare supplies when travelling.
What is the biggest emergency to watch for? Blockage — no output for several hours with cramping, a swollen abdomen and vomiting. With an ileostomy, also dehydration from high output.
Who do I ask when something goes wrong? Your stoma nurse or stoma therapist. They solve leaks, fit problems and skin problems quickly, and it is what they are there for.