Adjusting to life with a colostomy, ileostomy or urostomy takes time, and worry about smell is one of the most common concerns new ostomates bring up. The good news is that modern pouches are built to contain odor. When you do notice a smell, there is usually a specific reason behind it, and once you know the reason, it is much easier to manage.
Where pouch odor actually comes from
Ostomy Canada puts it simply: you generally should not notice odor unless you are emptying or changing your pouch. The United Ostomy Associations of America describes the same idea from the other side: odor tends to come either from emptying or from leakage, and the first step is working out which one you are dealing with.
That gives you a useful rule of thumb:
- Smell while emptying or changing is normal and short-lived. Everyone’s output has an odor, ostomy or not.
- Smell between emptying usually means something is not sealing as it should. The skin barrier may be lifting at the edge, there may be a small leak, the outlet may not be fully clean, or a filter may be saturated.
- The type of ostomy matters too. Colostomy output usually smells stronger than ileostomy output because the colon holds more bacteria. With a urostomy, urine odor can change with diet and fluids, but a strong, foul smell can be a sign of infection and is worth a call to your provider.
Everyday habits that help
- Empty early. Many care teams suggest emptying when the pouch is about one-third full. A lighter pouch puts less strain on the seal, and emptying is quicker and cleaner.
- Keep the outlet clean. Wipe the inside of the pouch tail or outlet with toilet paper or a wipe before you close it. Residue left on the outlet is one of the most overlooked sources of lingering smell.
- Check the seal whenever you smell something between emptying. Look for edges that are lifting, output under the barrier, or skin that feels itchy or sore. Your stoma can change size, especially in the first weeks and months after surgery, so it is worth re-measuring it from time to time.
- Use products designed for ostomy pouches. Pouches with built-in charcoal filters let gas escape while reducing odor. Liquid or gel pouch deodorants are added to the pouch, and some double as a lubricant so output slides out more easily. Results vary from person to person, so it can take a little trial and error to find what works for you. Stick to products made for ostomy use, because household products can irritate the skin or damage pouch material.
- Notice food patterns without overhauling your diet.MedlinePlus lists onions, garlic, broccoli, asparagus, cabbage, fish, eggs, some cheeses, baked beans and alcohol among foods that may increase odor, and notes that parsley, yogurt and buttermilk may help reduce it. A simple food diary for a week or two can show which foods matter for you. Before cutting out whole food groups, talk to your care team or a dietitian, especially if you have an ileostomy and need to watch hydration and nutrition.
- Change the pouch on schedule. Stretching wear time beyond what is recommended for your system makes leaks and odor more likely.
- Ask before trying internal deodorants. Some people use tablets or capsules taken by mouth to reduce stool odor. They are not right for everyone and can change the color of stool, so check with your doctor or ostomy nurse first.
When odor is a sign to call your care team
Odor on its own is rarely an emergency, but it can point to a problem worth fixing. Reach out to your doctor or a wound, ostomy and continence (WOC) nurse if:
- you notice a smell between emptying even with a fresh pouch, which often means the fit needs adjusting;
- the skin under or around the barrier is red, broken or painful;
- you have a urostomy and your urine becomes cloudy or foul-smelling, or you have a fever;
- your output changes suddenly along with pain, swelling or nausea.
A WOC nurse can re-measure your stoma, suggest a different barrier or accessories, and help you find a routine that fits your day.
The bottom line
A brief smell while emptying is a normal part of life with an ostomy. A smell that lingers between emptying is a signal, and in most cases it points to the seal, the outlet or the timing of emptying. A few steady habits, the right products and a quick check-in with your care team when something changes go a long way toward feeling confident again.
For more on pouch deodorants and daily odor routines, see this guide from Safe n Simple.
This article is for general information and is not a substitute for advice from your doctor or ostomy nurse.