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.
Ileostomy: This type of ostomy is made with a part of the small intestine (or ileum). It may be used 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.
Colostomy: 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 in a transverse colostomy is similar to the ileostomy, but may be somewhat more formed. The individual does not have control over the activity and must also wear an ostomy bag. For some who have a colostomy formed out of the descending colon, the poop may be closer to what is considered “normal”. In some cases, the individual may have an option of “irrigating” their ostomy (essentially an enema through the stoma) which may give a degree of control over the ostomy activity and some may even have the option to wear a plug over the stoma, rather than a bag.
Urostomy: 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.
J-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.