The term “burping” isn’t something you’d expect to go hand in hand with ostomy care, but it is something that ileostomates and colostomates should familiarize themselves with.
Video
What Does it Mean to “Burp” an Ostomy Bag?
“Burping” means to manually remove gas from an ostomy pouch either through the outlet on the bottom or by a small gap between the flange on a two-piece appliance.
“But shouldn’t the filter on an ostomy pouch already do that?”
In an ideal world, yes. Unfortunately, we don’t live in an ideal world!
Most ostomates find that the filter on their appliance tends to either not work at all or clog up quickly and stops working soon after.
When this happens, gas builds up in the bag and that can cause “ballooning”, which can lead to lead to leaks and/or a very noticeable bulge under clothing.
Usually, an ostomate who has a ballooned pouch often has to visit the bathroom and empty their appliance, often times when it has no output in it.
This can be annoying and time-consuming, which is why burping your appliance can be a great little shortcut to use.
A Few Warnings
Like most shortcuts, burping an appliance isn’t without risks. I’ll highlight some important ones below.
- Smell. There’s no escaping this one, although some pouch deodorants can help. When you release gas from your ostomy pouch it’s pretty much like farting out in the open. There will be an odor, often times quite strong, so be mindful of where you do this. I recommend heading for a bathroom.
- Leaks. Burping your appliance may cause output to escape your bag. If done correctly, this should never happen.
- Messy coupling. You may not get a leak, but opening up the coupling of your two-piece appliance may cause stool to get between the plastic rings of both your bag and wafer. Sometimes this can lead to odors or even stain your clothes.
- Projectile poop! When the velocity of gas escaping your pouch meets with a soiled bag, you can sometimes get poop splatter. I’m being serious. If you plan to burp your appliance and it’s really full of gas, take toilet paper and place it right on top of where you’re opening the coupling to catch anything that flies out.
- Full pouch ejection! Some two-piece systems work better than others, and the ones that don’t work well with burping often cause this catastrophic failure. If your two-piece coupling uses stiff plastic (i.e Coloplast Sensura Click or Sensura Mio), then you won’t be able to easily open just a small crack for gas to escape. I would strongly recommend against burping if you’re using an appliance like that.
How to Burp an Ostomy Bag
There are two main techniques for burping an ostomy bag, which I will explain below:
Two-Piece with Mechanical Coupling
My preferred method of burping involves a two-piece system with a mechanical coupling. I find that the Hollister New Image two-piece is one of the best for this, but you can experiment with other brands to see which work best for you.
The idea is to just slightly open the top part of your two-piece coupling enough to allow gas to escape.
This works best while standing and you can also apply gentle pressure to your pouch to help move the gas along.
If you plan to do this while on your back, I would highly suggest making sure that no output has collected around your stoma or you’ll have a leak.
One-Piece Systems
While this technique is geared towards ostomates who don’t wear two-piece systems, it can also be used when the two-piece system isn’t ideal (i.e. adhesive coupling or stiff plastic coupling).
This technique involves opening the outlet at the bottom of your drainable bag to release gas.
The only easy way to do this is to lay on your back and lift the tail of your appliance up so that any stool will fall towards the top of your appliance (and away from the outlet).
When you are sure that no output is near the outlet, you can carefully open the outlet and allow gas to escape.
You may apply gentle pressure to your pouch to direct gas outwards, but use caution as this may cause stool to escape.
Once that’s done, you can close the outlet and stand back up.
Bonus: Osto EZ-Vent
If neither technique works for you, but you still want to burp your appliance, I would suggest looking into the Osto EZ-Vent.
The Osto EZ-Vent is a product that you can apply to just about any ostomy appliance and it allows you to vent gas easily.
I’ve reviewed the Osto EZ-Vent HERE, and you can order them on Amazon HERE (affiliate link).
Some people might like the convenience of using the Osto EZ-Vent over burping the usual way, but they do need to be installed on your ostomy pouch BEFORE you wear it.
Closing Thoughts
Burping your ostomy appliance can be a convenient way to relieve your pouch of ballooning.
While you can burp just about any appliance using various techniques, you’ll still want to be mindful of the smell it can produce and the risks of leaks (or worse).
Thabks for making a video on this! One of my nurses in the hospital showed me how to burb it from the drain end but I had not thought about the way to do it with a two piece.
I have had those mishaps – mainly when I’ve been too tired to get out of bed and oops! That wasn’t just air in there…Had to get up anyway then…
Also, if you hear a “pop!” Sound after attempting to burp your bag’s drain end and happen to not move it correctly in that direction, you might want to immediately run some warm water through the appliance to see if you blew a seal…yup…live and learn. I’m MUCH more careful now ;-)
Hi ,great comments , I am four weeks new to my stoma. (I called him James after my youngest brother) ..
I am just learning about burping and yes at night it is a panic a bit ! I have been just emptying the bag as I knew of no other safe way.
Maybe an odd question,but why is the smell so different from before,(chronic ulcerative colitis all of my colon was removed after no response to Iv steriods) I mean it offends me ! I would think others would run in terror! , as I say I am still learning but ,I definitely would not burp a bag in a place where it could be traced back to me 😉 again in time things have been getting easyer . I went from flex sig to bag in 7 days. Vancouver Canada
Hi Sleepy:
Welcome to the group. I agree with you on the smell it is totally different from when it is expelled through the normal bowel. My trick to eliminate the odour is twofold, when I empty my pouch I always rinse it with water, before I close the pouch I put 1 ml (or one bottle cap) of hydrogen peroxide in my pouch and then close it up. It does a terrific job on neutralizing the door. It is very inexpensive if you purchase it at Walmart or your local dollar store. Hope this helps. BTW I live in Ontario, Canada.
Hi Sleepy,
Yes, the smell is different when you don’t have a colon. I noticed that bile, which looks dark green, is the most offensive as far as output smells are concerned. Odors will change as your body gets used to your new setup, and depending on what you eat, you may notice that your output smells a little like the food you’ve eaten.
Using a pouch deodorant can help, but you may have to experiment to find one that works for you. More info here: https://www.veganostomy.ca/ostomy-odor-tips/
I tried the Hollister with a two piece accordian flange but in Australia their bag product range is very small and the that one is far too long for my body, also their flange is too narrow for me to get my fingers under to push. I think but not sure, that it was Hoiiister that told me that all their bags are floating flange! As i said previously — very confusing. BTW- with many surplus one piece bags I found a charity that will send them to Ethiopia.
I wrote the article below for the December edition of Ostomy Australia magazine so could not mention brand names. I was using the two piece Dansac convex with a wonderful accordion/FF but since a recent op my stoma shape has changed and I can now wear the new flat two piece Eakin Dot – which I give a four and a half out of five!
No more floating — !
I have an ileostomy and had been searching for a solution to my ballooning problem for many frustrating months. Leaks or the threat of one in the middle of the night had been so distressing. I’d tried every brand of pouch available here in Australia and none of the inbuilt filters had worked for me, even though they claim to ‘minimize’ ballooning!’ My main ballooning problem was at night, in bed —- it’d usually be two or three am when I’d wake to find my pouch about to burst or horror of horrors, leaking! So off I’d trot to the toilet to release the air from the opening end but on returning to bed I was often so wide awake that I could not go back to sleep. And of course as we all know, lack of sleep does not make for a good day the next day.
Finally, wonderful indescribable relief! I found the answer on Facebook with a suggestion from someone in the Australian and New Zealand Ostomy Support Group. They said ‘try a floating flange.’
Never having heard of a FF I rang around the stoma product supply companies but some of them did not understand what I was taking about. Then one company said “Ah, an accordion flange.” They sent me samples and then I understood what a FF is! More phone calls and I found a few other stoma supply companies who also sent me samples. And that’s when the magic happened!
A floating flange is the specially designed base plate of a two piece stoma pouch system. It allows fingers to be placed under the flange to help minimize pressure on the abdomen when attaching a pouch and is especially helpful for arthritic fingers like mine. I’d tried the two piece system before but was unable to manage the connection between the base plate and the top pouch as I was also pressing down on soft and pliant tummy tissue.
I think the word accordion better describes the shape and function of this base plate. Also, floating flange is a name used by one company to describe all their base plates, which is a confusing interpretation.
The top part, the specially designed pouch, has a small tab for a hernia belt each side of the underside opening and also another tab near the top which is used for lifting and reattaching it to the FF/accordion base plate.
Now, if I wake and find myself about to float to the ceiling (and having taken the precaution of no food or drink after seven pm) I just reach down, eyes still closed, feel around for that little tab, gently and very carefully pull it open a smidgen, release the air and then close it. It closes with an audible snap which is very comforting. It’s taken some getting used to and the trial of several brands of pouches and FF/accordion bases but these past few weeks I’ve managed six or seven hours of sleep each night —- magic indeed!
Thanks Emby 36 for the info on a floating flange. I will check our suppliers out here in Ontario, Canada.
Merry Christmas to you and yours.
Thank you – I didn’t see this little reply button till later – woops!
Happy to hear that a solution was found. Yes a FF/accordian Flange helps a lot as you don’t have to press hard against your Stoma area to attach a pouch, especially if you just had surgery.. Cheers from Canada
The floating flange is another reason why the Hollister systems seem to work better – they come with one built-in :)
I use the Sensura mio two piece click and always burp my bag from the bottom. I find it the safest way to ensure that the gas is expelled without any mess occurring.
I also use 1 ml of hydrogen peroxide in my pouch every time I empty it and rinse it. I have been doing this for months and find that there is hardly any odour on emptying.
I have usually a very liquid output as I only have my small bowel, but do notice that when I have fibre at a meal or snack that I have a tendency to pancake. I’m wondering if the pancaking is occurring Because my stoma sits almost flush with the protective ring and doesn’t have enough length to it to push the output into the pouch.
Y
Interesting, I forgot to mention that I use a closed small pouch with no filter, which is why I can put air in, basically creating an air barrier between my protruding Stoma and the pouch liner. Hence no pancaking which in the past has caused my wafer to blow open. Everyone is different and through trial and error we come up with fixes that work for us. Merry Christmas..
Thanks for your response, wish I could do the same. Merry Christmas to you and yours
Like I mentioned to you before, I have been “burping” my pouch as I use a 2 piece system, with a filterless pouch as I intentionally put air in my pouch with an small air pump purchased at Canadian Tire. The benefit to this is I am now stress and anxiety free from not having to worry about pancaking. No more issues.
When I do have an excess of gas buildup, is when I burp.
Hollister is the best product out there due to quality. I have experimented with most of the products out there and Hollister has a soft plastic which makes it easy to do.
Convatec has a hard rigid plastic which when trying to burp, usually comes apart and is hard to put on. With that hard plastic I use soft soft as a lubricant.
I also smear a dab of soft soap to the inside of my pouch as to make sure stool slides down.
Ever since doing this I have not encountered any problems.
My Hollister 2 piece system with floating flange works extremely well with my Stealth Belt, as the belt fabric sits behind the flange, as opposed to a Convatec 2 piece system.
I wish Convatec would switch to a softer plastic and have a floating flange, but I guess copyright laws prevent that.
Again, very happy with my Hollister 2 piece product.
I like the soft soap idea as a lubricant and I’m glad that’s been working!
Convatec is very difficult to snap together, let alone burp! It’s one of the most difficult in my opinion, so I’d advise that nobody attempt it on that system.
Meant to say, I find if my pouch is full of gas its holding back the rest of the gas I need to pass plus output. so it helps in many ways
Hi Eric, Burping is a very useful tip/trick, I have experienced all of the above problems in doing it over the years. but so many times with a full pouch and no bathroom in sight it have given me the extra time/space to get to one.
Glad it’s helped you, John! Sometimes the risk of “burping” outweigh the risks of not being able to.