Ostomy surgery is a relatively common medical intervention, diverting the digestive or urinary tract for millions worldwide. The resulting external appliance, often called a colostomy bag, is a life-saving device that allows individuals to continue living full, active lives after disease or injury has damaged a part of their intestinal system. The procedure is a standard surgical practice with a long history of improving patient outcomes. This article provides factual data regarding the number of people currently living with an ostomy and the underlying reasons for this procedure.
What is a Colostomy Bag?
A colostomy is a surgical procedure that creates a new opening, called a stoma, by bringing a portion of the large intestine, or colon, through the abdominal wall. The external colostomy bag, or pouching system, is then attached over this stoma to collect stool and gas that exit the body. This diversion is required when the lower part of the colon or the rectum needs to be bypassed or removed entirely due to illness or trauma.
The appliance typically consists of a skin barrier, or flange, that adheres to the body and a disposable or drainable pouch that collects the output. While a colostomy involves the large intestine, the broader category of ostomies also includes an ileostomy (which diverts the small intestine) and a urostomy (which reroutes the urinary tract). The procedure can be either temporary, allowing the lower bowel to rest and heal before a reversal surgery, or permanent when the damaged section cannot be restored.
Global and National Prevalence Statistics
Obtaining a precise, real-time count of people with an ostomy is challenging because no unified global registry exists, meaning most figures are estimates derived from surgical and product data. It is estimated that approximately 13.5 million people worldwide are living with some form of stoma. In the United States, the total number of individuals living with an ostomy—including colostomy, ileostomy, and urostomy—is estimated to be well over three-quarters of a million people.
Roughly 120,000 new ostomy surgeries are performed annually in the United States alone. Across Europe, the number of citizens living with a stoma is estimated to be as high as 700,000. Colostomies are the single most common type of intestinal or urinary stoma, generally accounting for about 48% to 55% of all ostomies performed. The majority of these procedures, approximately 56%, result in a permanent stoma, while the remaining 44% are temporary diversions intended for later reversal.
Key Medical Conditions Requiring Stoma Surgery
The creation of a stoma is a necessary intervention for a range of conditions that compromise the function of the lower digestive or urinary tracts. Colorectal cancer is consistently the leading cause of ostomy surgery, particularly colostomies, as it often requires the surgical removal of the rectum or a significant portion of the colon. This cancer-related surgery is a major driver of the high average age seen in the colostomy population.
Inflammatory Bowel Disease (IBD), which includes Crohn’s disease and Ulcerative Colitis, is a significant cause, particularly for ileostomies. These chronic inflammatory conditions can cause severe, widespread damage to the intestines, necessitating the diversion of waste to allow the diseased bowel to heal or to remove it entirely.
Complications from severe diverticulitis are another frequent reason for emergency or elective ostomy surgery. This condition involves the inflammation or infection of small pouches that form along the walls of the colon. Severe cases can lead to abscesses, perforations, or blockages requiring immediate surgical diversion. Less common but notable causes include congenital defects, such as Hirschsprung’s disease in infants, and trauma to the abdomen resulting from accidents or injuries.
Demographic Distribution of Ostomy Users
The demographic profile of the ostomy population reflects the prevalence of the underlying diseases that necessitate the surgery. The average age of individuals with an ostomy in the United States is approximately 68.3 years, with those specifically having a colostomy averaging around 70.6 years. The highest prevalence is observed in older adults, specifically those in their 70s and 80s, which is directly linked to the higher incidence of colorectal cancer and diverticulitis in this age group.
Conversely, ileostomies tend to be more common in younger populations, which is consistent with the typical age of diagnosis for Inflammatory Bowel Disease. A significant portion of IBD diagnoses occur in young adults, meaning the ileostomy population often skews younger than the colostomy population. Gender distribution varies slightly by region and study, but generally, men and women are represented in nearly equal numbers.