An ostomy is a surgically created opening, called a stoma, on the abdomen that allows bodily waste to exit through a new pathway. The type of ostomy, its location, and the characteristics of the diverted intestine influence its function and management. This article clarifies the distinctions between an ileostomy and a colostomy.
What is an Ileostomy?
An ileostomy involves bringing a portion of the small intestine (ileum) through the abdominal wall to create a stoma. This diverts digestive contents before they reach the large intestine. The stoma usually appears on the right side of the abdomen and often protrudes slightly.
The output is consistently liquid to pasty. This continuous flow reflects the early stage of digestion and the small intestine’s primary role in nutrient absorption. Because the output comes directly from the small intestine, it contains digestive enzymes and bile, making it highly acidic. Ileostomies are created for conditions such as Crohn’s disease, ulcerative colitis, or familial adenomatous polyposis.
What is a Colostomy?
A colostomy involves bringing a section of the large intestine (colon) through the abdominal wall to form a stoma. Its location on the abdomen depends on which part of the colon is used. Colostomy stomas can be on either the left or right side and may lie flatter against the skin compared to an ileostomy stoma.
The output varies significantly based on the section of the large intestine involved. If the colostomy is closer to the beginning of the colon, the output may be liquid. A colostomy further along the colon produces more formed stool because the large intestine’s primary role is to absorb water, solidifying waste. Colostomies are created for conditions such as colorectal cancer, diverticulitis, or severe abdominal trauma.
Key Differences and Practical Implications
The primary difference between an ileostomy and a colostomy lies in the segment of the intestine involved. This anatomical distinction leads to various practical implications.
Stoma appearance and location also differ. Ileostomy stomas usually protrude more and are on the right side of the abdomen. Colostomy stomas can be on either side, depending on the colon segment used, and often present a flatter profile. These variations influence clothing choices and the fit of ostomy appliances.
The consistency and frequency of output are another distinction. Ileostomy output is liquid to pasty and continuous, necessitating frequent pouch emptying. Colostomy output, particularly from the descending or sigmoid colon, can be more formed and occur less frequently, sometimes allowing for more predictable bowel movements. This directly impacts daily management.
Ileostomy output contains digestive enzymes and bile, making it highly acidic and potentially irritating to the surrounding skin. Meticulous skin care and specialized skin barriers are important to prevent irritation and breakdown. Colostomy output generally has lower enzymatic activity and is less irritating to the skin, though proper care remains important.
A significant practical difference is the potential for irrigation. Certain colostomies, specifically those involving the descending or sigmoid colon, can be managed with irrigation to achieve scheduled bowel movements, sometimes eliminating the need for a pouch for periods. This technique is generally not suitable for ileostomies due to their continuous, liquid output.