An ostomy is a surgically created opening on the abdomen that allows waste to exit the body. This procedure becomes necessary when the digestive or urinary system cannot function as intended due to various medical conditions. This article describes what an ostomy and its components look like, offering a visual guide.
Understanding the Stoma
The stoma is the portion of the intestine or urinary tract brought through the abdominal wall to create the opening. It appears as a moist, pinkish-red bud, similar in color and texture to the inside of the mouth or gums. As a mucous membrane, it naturally produces mucus, giving it a wet and shiny appearance. The stoma has no nerve endings, so it is not painful to touch or when waste passes through.
Stomas vary in shape and size, often appearing round or oval, and may protrude slightly from the abdomen, sometimes described as rosebud-shaped. While initial swelling after surgery is common, the stoma typically stabilizes in size within six to eight weeks. It often measures approximately one to one and a half inches in diameter. A healthy stoma is highly vascular, which can sometimes lead to slight bleeding if rubbed, similar to how gums might bleed when brushed.
The Ostomy Pouching System
Since the stoma does not have a sphincter muscle to control the release of waste, an external pouching system is used to collect output. This system consists of two primary components: a skin barrier and a collection pouch. The skin barrier is an adhesive component that adheres to the skin around the stoma, protecting it from irritation caused by waste output. These barriers are available in various sizes, with openings that can be pre-cut or customized to fit the stoma’s shape.
The pouch attaches securely to the skin barrier to collect the output. Pouching systems come in one-piece or two-piece configurations. A one-piece system has the skin barrier and pouch permanently joined as a single unit, offering a lower profile that lies flatter against the body. In contrast, a two-piece system allows the pouch to be detached from the skin barrier, which remains on the skin for several days, offering flexibility in changing the pouch. Pouches are typically made from odor-proof plastic and are available in different styles, such as drainable pouches that can be emptied, or closed pouches that are discarded after use.
Types of Ostomies and Their Visual Differences
While the general appearance of a stoma is consistent, visual differences exist based on the ostomy type. The three main types are colostomy, ileostomy, and urostomy, each created from a different part of the digestive or urinary tract. Colostomies, which involve the large intestine, are often located on the left side of the abdomen. Their stomas can be flush with the skin or slightly protruding, and the output is typically more formed.
Ileostomies, formed from the small intestine, are commonly placed on the lower right side of the abdomen. These stomas often protrude more, forming a “spout,” which helps direct the usually liquid output away from the skin, protecting it from digestive enzymes. Urostomies, which divert urine, are also frequently located on the right side of the abdomen and typically feature a spout-like stoma to prevent urine from irritating the surrounding skin. The type of output also influences pouch design; ileostomy pouches may be larger to accommodate more liquid output, and urostomy pouches feature a tap for draining urine.
Managing Ostomy Appearance in Daily Life
A common concern for individuals with an ostomy is its visibility under clothing. Modern ostomy pouching systems are designed to be discreet and generally go unnoticed beneath most everyday attire. Pouches are often compact, lie flat against the body, and are made with materials that minimize noise and odor. Clothing choices can further enhance discretion; loose-fitting clothes, patterned fabrics, and layering can effectively conceal the pouch. High-waisted trousers or specialized ostomy support wear can also help keep the pouch securely in place and minimize any bulge.
Concerns about leakage or odor, while not visual, relate to an ostomy’s appearance. Modern pouches are engineered with advanced filters and odor-proof barriers to mitigate these issues. While specialized clothing designed for ostomy wearers is available, it is often not a necessity, as many individuals find their regular wardrobe sufficient. Design advancements in ostomy products allow people to manage their ostomy with confidence, enabling them to participate in a wide range of daily activities without concern for its appearance.