The skin around one’s stoma should look similar to the skin anywhere else on the abdomen, but ostomy output can make that skin tender or sore. There are many ways to keep that skin healthy.
One involves using the proper size pouch and barrier opening. Too small of an opening can hurt the stoma and make it swell; too large of one may irritate it. If this is happening, it’s important to replace it with the right fitting. Pouching systems should be changed regularly, so schedule changes before you experience problems like itching or burning. Unless there is a problem, one should not remove their pouching system more than once a day, and they should always be careful when pulling the system from the skin. Simply push the skin away from the skin barrier rather than pulling it. Always clean the skin around the stoma with water, and dry it thoroughly before putting on a skin barrier or a pouch.
There can be sensitivities and allergies to the many components having to do with stomas. Whether that be a reaction to the adhesive, barrier, paste, tape, or pouch, these responses can occur after weeks, months, or even years. In some cases, it can be as simple as trying out different pouch covers or brands of pouches. Ask your stoma nurse for ideas. Be sure to test many different products to watch how your skin reacts, and know that you can also make your own pouch.
Some with stomas practice colostomy irrigation, which involves putting water into the colon through the stoma to normalize bowel movements. The practice has been used for a number of years, but less so now thanks to the improvement in pouch systems.

Talk to a doctor before deciding to try irrigation. The choice to irrigate depends on factors such as lifelong bowel habits, activity level, skill and comfort level with irrigation, and personal feelings about the colostomy.
If you do decide to irrigate, here are some tips. Use the time of day during which you had bowel movements most often before the colostomy. Watch for a squirt of gas to know that the irrigation process is complete and know that it won’t often take longer than an hour. If it does, bring it up with your doctor or nurse.
One must change the pouching system at regular intervals. Depending on the pouch, you may want to change yours out every day, three days, or once a week. It may help to change the pouch out during periods of low bowel activity.
It’s important that the pouching system stick to the skin and that it’s changed before loosening or leaking. The stickiness of a pouch depends on many things such as the weather, skin condition, scars, weight changes, diet, activity, and body shape.

Stomas are not harmed by water and soap, but soap can interfere with the skin barrier. Due to unwanted fecal output, removing the pouch for a bath or shower is not recommended.
It may sound odd, but spots of blood on the stoma are not a cause for alarm. Cleaning around the stoma during pouch changes can cause slight bleeding.