Ileostomy, colostomy, urostomy: What’s the difference?

If you talk to 3 different people with an ostomy, they may all actually be living with something very different from the others. As we discussed in our first Ostomy 101 lesson, an ostomy is essentially a non-natural opening in your body by which a person releases waste, but there is more than one type. The type of ostomy is dependent on what part of the digestive tract is used to make the stoma.

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Ileostomy: This type of ostomy is made with a part of the small intestine (or ileum). It may be what-is-an-ileostomy-imageused when the entire colon has been removed (like mine) or it may be temporary following a resection or to allow the colon to heal before being reconnected. It is commonly used in patients with ulcerative colitis, Crohn’s disease, Familial Polyposis (FAP) and colon cancer. It is most often located at the lower right side of the stomach.

The poop is usually in liquid form and can be water or more of the consistency of applesauce. The individual does not have any control on the activity of the ostomy and must wear an ostomy bag, which needs to be emptied approximately 5-8 times a day.

what-is-a-colostomy-imageColostomy: This ostomy is formed with a part of the large intestine. It is used when only part of the colon is removed or when a section of the colon needs time to rest and heal and can also be either permanent or temporary. It is often used for patients who have diverticulitis, colon cancer, bowel obstruction, paralysis, injury or birth defects. There are 2 common types of colostomy that affects its placement: A transverse colostomy is on the upper part of the stomach and a descending/sigmoid colostomy on the lower left of the stomach.

The poop for the transverse colostomy is similar to the ileostomy, but somewhat more formed. The individual does not have control over the activity and must also wear an ostomy bag. For the descending colostomy, the poop is much closer to what is considered normal. The individual sometimes has control over the ostomy activity and may not need to wear an ostomy bag. In this scenario, they would wear a cap of some sort. They also have the option of “irrigating” their ostomy which is essentially an enema through the stoma.

what-is-an-urostomy-imageUrostomy: This type of ostomy is used for the urinary tract. It is actually a little more complicated than the other types of ostomies as it requires the removal of the bladder, as well as a section of the small intestine. The intestine is sewn back together, but the piece that was removed is then attached to the ureters that extend from the kidneys and is also used the create a stoma. It is only done as a permanent solution. A urostomy is most often needed due to bladder cancer, but also inflammation of the bladder or birth defects. It is usually placed on the right side of the stomach.

The pee empties into an attached urostomy bag. The individual has no control over its release. It needs to be emptied approximately every 2-4 hours.

what-is-a-j-pouch-imageJ-pouch: While not a type of ostomy, I feel the need to write a quick summary of a j-pouch. It is made after the removal of the colon when the small intestine can be reattached to the rectum and anus, forming an ileoanal reservoir. This surgery is usually done in 2 stages and involves the creation of a temporary ileostomy. It is often used in patients with ulcerative colitis (but not Crohn’s disease) and FAP.

In this scenario, the individual can still go to the bathroom in the normal fashion, however, the poop is less formed than what is considered normal.

So now you know: When someone is talking about ostomies, they will most often use “colostomy” as a blanket term, but that is likely to be an inaccurate description. Don’t be afraid to ask somebody you know about theirs. We appreciate not being lumped into a particular group, especially when each type affects individuals differently.

This is a very brief overview of the types of ostomies and there is a TON more that goes into each of these, but it’s a lot more detail than for my purposes here. UOAA has some guides with lots of good information. Images were stolen from here, here, here and here, respectively. 

What is an ostomy?

This coming Saturday is World Ostomy Day and in honor of that, I wanted to spread some knowledge of all things ostomy. So of course, that leads us to the big question: What is an ostomy? Well, here’s your first lesson…

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An ostomy is basically a non-natural opening in your body by which a person releases waste. Through this hole, the surgeon will pull the end of either your small/large intestine or ureter, thus creating a stoma. These terms are sometimes used interchangeably, however, most often when someone is speaking about their ostomy, they are referring to the entire thing, but a stoma refers to the actual piece of organ that is outside of the body.

An external pouching system is used to collect the waste. In more simple terms, an adhesive bag covers the stoma and catches the poop or pee as it exits the body. The bags can then be changed out or emptied into a toilet.

There are 3 main types of ostomies: ileostomy (stoma is made from small intestine), colostomy (made from large intestine) and urostomy (made from the ureter and part of the small intestine). I’ll go into each of these in a little more detail later this week.

It doesn’t seem like particularly accurate calculations are kept, but it is believed that approximately 1 million people in the U.S. alone have an ostomy of some sort, with another 300,000 having surgery every year.

Reasons for needing an ostomy:

  • Inflammatory bowel disease: Crohn’s disease & ulcerative colitis
  • Colon cancer
  • Diverticulitis
  • Bladder cancer
  • Familial adenomatous polyposis (FAP)
  • Bowel obstruction
  • Trauma, accident, birth defect, etc.

An ostomy can be temporary or permanent. A temporary ostomy may be used if the intestinal tract needs time to heal and can be reconnected in the future or it can also be used as the first step in a two-part surgery to form an internal pouch. A permanent ostomy is sometimes needed when the entire colon has been removed, or at the very least the rectum, or when a reconnection surgery is not possible.

I do not pretend to know all of the medical components of an ostomy, so some of this information was found online: UOAA, ASCRS, NIH

Walk a day in my shoes, I mean ostomy bag…

It really makes me happy to hear about new ostomy awareness events. And there is a really awesome one coming up in just a couple of weeks. The first WannaWearOne Ostomy AWEARness 5k is happening right here in North Carolina! It’ll be on October 4 to coincide with World Ostomy Day.

One very unique part of this race is that ostomy bags are going to be given away as part of the race swag. It’s also an optional part of the run for those who do not have an ostomy to wear the bag! What I find really funny is, to top it off, they will have things like applesauce and pudding to fill the pouches to get a little better feel for what it’s like to wear an ostomy bag.

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And while I am so excited that this event is happening, it absolutely breaks my heart that I will not be able to run in it. It happens to land on the same day as a family member’s wedding that is out-of-state and has been planned since before this race was announced. But I did the next best thing and I have signed up for the Virtual Race! Basically, for anyone who cannot make it to North Carolina on race day, you can sign up to be a part of it virtually and run your own 5K and raise awareness and funds on your own.

It’s really exciting to see the word getting out there and I hope that this is the start of many of these type of events in the future. And I can say this, I will make sure to go ahead and put next year’s race on my calendar and I will be one of the first ones getting involved!

But for all of you, now go sign up! Especially if you’re in the Raleigh-Durham area or can make it out here for the race. I think it’s going to be a really great event because I know some awesome people are heading it up. But otherwise, sign up for the virtual run and we’ll all “get together” for a 5K that morning. And in the meantime, spread the word online by using #WannaWearOne!