• The pouch does not fit well or a good seal was not made when the pouch was applied.
• The pouch is overfilled with stool, gas or urine.
• Your skin is sore and weeping.
• The pouch barrier is defective.

• Go over the procedure for pouch application to make sure you are following the steps correctly. Are you getting too close to the stoma or covering it with the barrier of the pouch? Look in a hand-held mirror for a closer look to see if your placement is correct.
• Check your skin. If it is sore or has weepy areas see your wound ostomy and continence nurse to look at the problem. It may be that your pouch does not fit right and leakage is occurring.
• Try a pouch from a different box of pouches.

• Eat meals slowly, and chew foods thoroughly.
• Check to make sure dentures fit well.
• Avoid chewing gum.
• Drink limited amounts of carbonated beverages.
• Check with your doctor for the possibility of "lactose intolerance" (sensitivity to dairy products).
• Try over the counter "anti-gas" products such as Gas-X® or Beano®. Your physician or wound ostomy and continence nurse may suggest other products.
• Adding a "gas filter" to your pouching system maybe helpful. Ask your wound ostomy and continence nurse about this kind of product.

• Put Stomahesive® or Premium® powder on your irritated skin.
• Brush off extra powder. Make sure your hands are dry.
• Change your pouch as you usually would.

• Clean and dry your affected skin.
• Spread an antifungal powder over the area and massage it all into your skin. You may buy an over-the-counter miconazole nitrate 2 percent (Mitrazol®) or get a prescription for nystatin (Mycostatin®) from your doctor.
• Brush off extra powder. Make sure your hands are dry.
• Change your pouch as you usually would.
• Use the powder for one or two pouch changes after your skin is healed.

• Sit on the toilet (if possible), or empty into a container.
• Hold the tail of the pouch up and push the stool away from the clip.
• Remove the clip and save it.
• Put your thumbs into the corners of the pouch end and turn back a 1 inch to 1 ½ inch cuff.
• Empty the contents of the pouch.
• Using toilet paper, clean the remaining stool from the cuff.
• "Uncuff" the tail of the pouch.
• Put on the clip.
• Empty the pouch when it is one-third to one-half full of stool or gas.
• Do not let the pouch overfill.

1. Assemble the equipment.
   • pouch
   • clip, if needed
   • paste
   • gauze, cotton balls, or a paper towel
   • electric shaver
   • warm water
2. Prepare the pouch
   • Remove the paper backing from the skin barrier.
   • Remove the paper backing from the adhesive tape (if present).
   • Apply a bead of paste to the opening edge, if needed.  Set it aside.
3. Change the pouch.
   • Empty the pouch and close the bottom.
   • Loosen the tape. Use one hand to gently push down on the skin while lifting up on the pouch.
   • Throw the pouch away. Save the clip (if present).
   • Control the stool from the stoma with gauze or a paper towel.
   • Shave your skin as needed.
   • Cleanse your skin with warm water using a gauze, cotton balls or paper towel. Dry your skin thoroughly.
   • Center the pouch opening over the stoma and press into place.
   • Close the bottom of the pouch.

1. Assemble the equipment.
   • pouch
   • clip (if present)
   • paste
   • scissors
   • pen
   • electric shaver
   • gauze, cotton balls, or a paper towel
   • warm water
2. Prepare the pouch.
   • Trace the pattern onto the cutting surface of the pouch.
   • Cut the pouch to the size of the pattern.
   • Remove the backing from the skin barrier.
   • Apply a bead of paste to the cut edge.
   • Remove the backing from the tape, if present.
   • Set it aside.
3. Change the pouch
   • Remove the pouch. Use one hand to gently push down on the skin while lifting up on the pouch.
   • Throw the pouch away. Save the clip (if present).
   • Control the stool from the stoma with a paper towel or tissue.
   • Shave your skin as needed.
   • Cleanse your skin with warm water using gauze, cotton balls or a paper towel. Dry your skin thoroughly.
   • Center the pouch opening over the stoma and press into place.

1. Assemble the equipment.
   • pattern
   • pouch
   • wafer
   • clip (if present)
   • paste
   • scissors
   • gauze, cotton balls, or a paper towel
   • pen
   • electric shaver
   • warm water
2. Prepare the pouch.
   • Remove the wafer from the individual wrapper.
   • Trace the pattern on the paper side of the wafer. Cut it out.
   • The pouch may be snapped onto the wafer to apply as one piece. Or, it may be applied separately.
   • Remove the backing from the wafer. Put a bead of paste to the cut edge.
   • Set the pouch aside.
3. Change the pouch.
   • Use one hand to gently push down on the skin while lifting up on the pouch.
   • Throw the pouch away. Save the clip (if present).
   • Control the stool from the stoma with a paper towel or tissue.
   • Shave your skin as needed.
   • Cleanse your skin with warm water using a paper towel or cotton balls/squares. Dry your skin thoroughly.
   • Center the wafer opening over the stoma. Snap the pouch to the wafer, making sure it is tight around all of the edges. Or, apply the pouch and wafer as one piece.

1. Assemble the equipment.
   • faceplate
   • pouch
   • adhesive gasket
   • paper tape
   • O-ring
   • water
   • skin prep
   • scissors
   • gauze, cotton balls or paper towel
   • dish soap
   • white vinegar
2. Prepare the pouch.
   • Attach the pouch to the ridge of the faceplate. Secure it by putting an O-ring between the collar and body of the pouch so it fits into the ridge.
   • Apply skin prep to the smooth side of the faceplate. Let it dry.
   • Peel the paper from one side of the adhesive gasket. Apply it to the faceplate. Smooth out the wrinkles. Remove the paper from the other side of the adhesive gasket.
   • Close the drainage spout at the bottom of the pouch.
   • Prepare wicks by rolling the gauze or paper towel like a cigar. Tape it closed.
3. Change the pouch
   • Empty the pouch.
   • Remove the pouch. Use one hand to gently push down on the skin while lifting up on the pouch. Set the pouch aside for cleaning.
   • Hold the wicks against the stoma to absorb the urine and keep your skin dry.
   • Clean your skin with water using gauze, cotton balls or paper towel. Rinse and dry thoroughly.
   • Apply a skin prep around the stoma, covering the area slightly larger than the faceplate. Let it dry completely.
   • Center the pouch opening over the stoma. Press into place.
   • Apply paper tape strips to the edge of the faceplate.
4. Clean the pouch.
   • Remove the O-ring.
   • Separate the pouch from the faceplate. Rinse thoroughly.
   • Soak the faceplate and pouch in dish soap and water for five minutes. Then soak in full-strength white vinegar for 10 minutes. Rinse and let air dry.

1. Assemble the equipment
   • pouch
   • gauze, cotton balls or paper towel
   • electric shaver
   • warm water
2. Prepare the pouch.
   • Remove the paper backing from the skin barrier.
   • Remove the paper backing from the adhesive tape (if present).
   • If you are changing a urinary pouch, prepare wicks by rolling the gauze or paper towel like a cigar and taping it.
   • Close the drainage spout at the bottom of the pouch. Set it aside.
3. Change the pouch.
   • Use one hand to gently push down on the skin while lifting up on the pouch.
   • Throw the pouch away.
   • Use wicks against the stoma to absorb urine and keep the skin dry.
   • Shave your skin as needed.
   • Cleanse your skin with warm water using a gauze, cotton ball or paper towel. Dry your skin thoroughly.
   • Center the pouch opening over the stoma and press into place.
   • Close the pouch spout.
4. Attach the pouch to straight drainage each night.
   • Connect the adapter to the pouch spout.
   • Connect the night drainage tubing to the adapter.
   • Turn the pouch valve to the "open" position so the pouch will drain during the night.
   • Make sure the pouch and tubing are not twisted. Twisting will keep the urine from draining well into the night reservoir.
   • Wear a leg strap if needed to keep the tubing from twisting.

1. Assemble the equipment.
   • pattern
   • pouch
   • scissors
   • straight drainage adapter
   • electric shaver
   • pen
   • gauze, cotton balls, or a paper towel
   • warm water
2. Prepare the pouch.
   • Trace the pattern onto the cutting surface of the pouch.
   • Cut the pouch to the size of the pattern.
   • Remove the backing from the skin barrier.
   • Remove the backing from the adhesive tape, if present.
   • Close the drainage spout on the bottom of the pouch. Set it aside.
   • Prepare wicks by rolling gauze or a paper towel like a cigar and tape the edge.
3. Change the pouch.
   • Remove the pouch. Use one hand to gently push down on the skin while lifting up on the pouch.
   • Throw the pouch away.
   • Use wicks against the stoma to absorb the urine and keep the skin dry.
   • Shave the skin around your stoma as needed.
   • Cleanse your skin with warm water using a paper towel or cotton balls/squares. Dry your skin thoroughly.
   • Center the pouch opening over the stoma and press into place.
   • Close the spout.
4. Attach the pouch to straight drainage each night.
   • Connect the adapter to the pouch spout.
   • Connect the night drainage tubing to the adapter.
   • Turn the pouch valve to the "open" position so the pouch will drain during the night.
   • Make sure the pouch and tubing are not twisted. Twisting will keep the urine from draining well into the night reservoir.
   • Wear a leg strap to keep the tubing secure during the night, if needed.

Assemble the equipment.
• pattern
• pouch
• wafer
• scissors
• gauze, cotton balls, or a paper towel
• pen
• electric shaver
• warm water
1. Prepare the pouch.
   • Remove the wafer from the individual wrapper.
   • Trace the pattern on the paper side of the wafer. Cut it out.
   • The pouch may be snapped onto the wafer to apply as one piece. Or, it may be applied separately.
   • Remove the backing from the wafer.
   • Prepare wicks by rolling gauze or a paper towel like a cigar and taping it.
   • Close the drainage spout at the bottom of the pouch. Set it aside.
2. Change the pouch.
   • Use one hand to gently push down on the skin while lifting up on the pouch.
   • Throw the pouch away.
   • Use wicks against the stoma to absorb urine and keep the skin dry.
   • Shave your skin as needed.
   • Cleanse your skin with warm water using gauze, cotton balls or a paper towel. Dry your skin thoroughly.
   • Center the wafer opening over the stoma. Snap the pouch to the wafer, making sure it is tight around all of the edges. Or, apply the pouch and wafer as one piece.
3. Attach the pouch to straight drainage each night.
   • Connect the adapter to the pouch spout.
   • Connect the night drainage tubing to the adapter.
   • Turn the pouch valve to the "open" position so the pouch will drain during the night.
   • Make sure the pouch and tubing are not twisted. Twisting will keep the urine from draining well into the night reservoir.
   • Wear a leg strap to keep the tubing secure during the night, if needed.

• Handi Medical Supply
  2505 University Avenue West, St. Paul, MN 55114
  651-644-9770
  1-800-514-9979
• Better Care Medical
  8546 Excelsior Avenue, Hopkins, MN 55343
  612-933-1126
• Merwin Home Medical
  4082 Lakeland Avenue North, Robbinsdale, MN 55422
  763-535-5335
• Edgepark Surgical
  1-800-321-0591
• Mercy Surgical Group
  1-877-796-8637
• Midwest Medical Services
  8400 Coral Sea Street NE, Suite 200, Blaine, MN 55449
  763-780-0100
  1-800-233-4522
• Dahl Home Medical
  1200 Nicollet Mall, Minneapolis, MN 55403
  612-333-4205
• Byram Healthcare
  1-877-902-9726
• AARP
  1-800-249-1531
  (Accepts assignment only on Hollister™, Bard® and Coloplast® items.)
• Duke Medical Supply
  1-888-678-6692
  (Accepts assignment only on Hollister™, ConvaTec® and Cymed® ostomy products.)

If you buy supplies from any of these retailers that do not accept Medicare assignment, you will need to pay for the supplies and submit your own insurance claims. If you need help filling out the forms, ask your insurance provider.

• AOS (American Ostomy Supply)
  1-800-858-5858
• Bruce Medical Supply
  1-800-225-8446
• Goodrich Pharmacy
  100 Monroe Street, Anoka, MN 55303
  763-421-5540
• Health Care Pharmacy - Mercy Health Care
  3960 Coon Rapids Boulevard, Suite 102, Coon Rapids, MN 55433
  763-236-7111
• Parthenon
  1-800-453-8898
• Total Medical Supply
  323 Osborne Road NE, Fridley, MN 55432
  763-784-6140
  1-866-784-6140
• Express Medical Supply, Inc.
  1-800-633-2139
• Liberty Medical
  1-888-844-2651 (ostomy supplies only)