Preparing for Your Ostomy
What is an Ostomy?
An ostomy is a surgical opening on the abdomen that creates a connection from an internal organ, such as the small or large intestine, to the skin surface. In many cases, the purpose is to allow the elimination of bodily waste products, such as feces or urine.
The abdominal opening of the ostomy on the skin is called a stoma. The stoma functions as an exit for waste (feces or urine) and requires people to wear a special bag to hold that waste.
What are the Different Types of Ostomies?
There are several different types of ostomies. The three most common ones are colostomy, ileostomy and urostomy.
Each ostomy procedure is done for different reasons. Although there are many similarities with these three ostomies, there are also important differences.
Colostomy
A colostomy is a surgical opening where the large intestine extends through the abdominal wall to the skin surface, creating a stoma. A stoma is the opening in the skin where a bag for collecting waste is attached. Colostomies can be temporary or permanent.
A temporary colostomy is often used to keep stool out of the colon so it can heal, and then the colon is reconnected during a later surgery. It can take weeks, months or years for the colon to heal and be rejoined. The timing depends on your medical condition and the type of surgical procedure you had.
When the colon becomes diseased, it may be necessary to perform a permanent colostomy. In some cases, the colon may have to be removed completely. A permanent colostomy may be needed for conditions such as:
- A blockage
- Injury, accident or birth defect
- Crohn’s disease
- Colorectal cancer
- Diverticulitis
- Inflammatory bowel disease (IBD)
- Ulcerative colitis
- Fecal incontinence or other anorectal conditions
- Severe decubitus wound (bed sores/pressure injury) at the buttocks area
Both temporary or long-term colostomies require a person to have a pouch attached to their abdomen where feces collect and then are disposed of. There sometimes can be drainage from the rectum.
Types of colostomies by section of large intestine:
Ascending colostomy
- Created out of the ascending colon on the right side of the belly
- Bowel movements are usually loose, pasty or watery
- Stoma is usually located on the right side of the abdomen
Descending colostomy
- Created out of the descending colon on the left side of the belly
- Most of the colon is intact, so stool will be formed and bowel movements are usually soft
- Stoma is usually located on the left side of the abdomen
Sigmoid colostomy
- Created out of the last part of the colon
- Similar to a descending colostomy, most of the colon is intact, and bowel movements can be soft or firm
- Stoma is usually located on the left side of the abdomen
Transverse colostomy
- Created out of the transverse part of the colon
- Bowel movements can be loose, pasty or watery
- Stoma can be located on the left or right side of the abdomen
Ileostomy
An ileostomy is similar to a colostomy, except that an ileostomy connects the last part of the small intestine (ileum) to the abdominal wall. This new opening allows waste to exit via the stoma.
- Created from the part of the small intestine called the ileum
- Bowel movements are mostly liquid and have more digestive enzymes that can cause skin irritation
- Stoma is usually located on the right lower side of the abdomen, but can also be on the left side in some cases
- Leakage from rectum is possible if colon is intact
- Can be temporary or permanent
Urostomy
A urostomy is a surgically created opening on the abdomen that discharges urine from the bladder. A urostomy is performed if the bladder is diseased, has been injured, or isn’t working as it should. The bladder is either bypassed or removed and urine is passed out of the body via the stoma.
- Created from the part of the small intestine called the ileum
- Urine drains into a special pouch that is worn on the abdomen
- Stoma is usually located on the right lower side of the abdomen
- Can be temporary or permanent
- The urine stream is surgically rerouted to drain into the urostomy so the urine can drain into the bag
Stoma Basics
A stoma is an opening in the abdomen that is connected to your digestive tract to allow waste to exit out of your body. A stoma is created by opening the intestine and stitching it to your skin to hold it in place.
There are three types of stomas:
- End stoma – end of the colon or ileum is brought to the surface of the skin
- Loop stoma – formed when a segment of the colon or ileum is brought to the skin surface, making an opening that is folded back and sewn down. In some cases, a rod is placed under the stoma temporarily
- Double-barrel stoma – formed when both ends of the separated/resected bowel are brought to the surface of the skin, creating two side-by-side stomas
What does a healthy stoma look like?
A healthy stoma should always look red or pinkish in color, circle or oval shaped, moist, and the skin around it should be dry and free from ulcers or rash. A stoma should protrude out above the level of the skin but may lie fairly flat. A stoma has no nerve endings, so you should feel no pain in that area. However, it is important that you protect it.
Should my stoma bleed?
Cleaning around your stoma is important and minor bleeding (a few drops on a washcloth) is normal. Contact your doctor if you notice more bleeding than normal when cleaning your stoma or changing your pouch.
Will my stoma change in size?
In the first six to eight weeks after surgery, you will notice some swelling, but that will decrease as your stoma heals. Stomas can also change in size depending on weight loss or gain. You should measure your stoma to ensure the correct fit for your pouch each time you change your pouch for the first six to eight weeks after your surgery.
Can my ostomy be reversed?
Your doctor should speak with your surgeon about your condition and whether you are able to have your ostomy reversed in the future. There are many factors to consider, including your underlying medical condition, and the reasons why your ostomy was created in the first place.
Learn more about caring for your ostomy at home
