How to Use a Pouching System

Ostomy supplies

A pouching system collects output from an ileostomy or a colostomy. It also protects the peristomal skin and provides security by keeping the pouch sealed to the skin. The pouching system should be emptied when its about one-third full, and changed every three to four days.

How do I choose a pouching system?

The ostomy nurses at the University of Chicago Medicine will help you choose an appropriate pouching system. Factors to consider when selecting a pouching system include the type of stoma, your body shape, stoma construction, issues with concealment, activities of daily living and your preference. 

A pouching system should provide you with security—  no leakage between the time you place on the pouching system and when you remove the pouching system as well as protection of the peristomal (around the stoma) skin.  You should achieve a consistent wear time that should be approximately three to four days.  If you are unable to achieve a consistent wear time you should check with the ostomy nurses for an evaluation of your pouching system.

How often should I empty my pouch?

You should empty the pouch when it is one-third full.  If you allow it to get too full, the weight of the stool may pull the pouch away from the skin. A person with an ileostomy will need to empty the pouch about five or six times in a 24-hour period. If you have a colostomy, you will need to empty the pouch two or three times in a 24-hour period.  

 How often should I change my pouching system?

The standard wear time of a pouching system is three or four days. Under normal conditions, you will change a pouch about twice a week. A change should be made immediately if a leak is detected. If you are unable to achieve a consistent wear time, you should check with the ostomy nurses for an evaluation of your pouching system.

Where should I purchase a pouching system?

Your health insurance usually determines where to purchase a pouching system. When discharged from the University of Chicago Medicine, you will have adequate supplies to use for the first two weeks at home. If you have home care nursing following your hospital discharge, he/she may provide you with the necessary supplies. 

Nurses at the University of Chicago Medicine will provide a list of local and online ostomy suppliers that you can use. We recommend that you contact your insurance to see if they have a preferred provider for supplies.

It is important that you always have an adequate amount of ostomy products on hand in case of an emergency. Expect a delay between the time you order your ostomy supplies and when they arrive at your home. 

Are pouching systems covered by health insurance?

Many private health insurance policies pay a percentage of the pouching system supplies, but this varies. Ask your insurance provider which of your expenses are covered.

Medicare pays 80 percent of allowable monthly expenses for pouching systems. The remaining 20 percent balance may be covered by supplemental insurance.

If your insurance requires that a health care provider sign for your ostomy supplies, provide them with the name of your ostomy nurse. In some instances, sending the approval to the surgeon may delay the delivery of supplies.

How do I conceal a pouching system?

There are undergarments, wraps and accessories that cover the entire pouching system and keep it flat by distributing contents evenly throughout the pouch.  If you cannot pull the undergarments over the pouching system, consider wearing a snug undershirt or camisole that has some stretch to flatten the pouch.