An ileostomy and a colostomy are both forms of ostomy surgery. Although they are similar, ileostomies and colostomies involve different parts of the bowel.
Ostomy surgery, or bowel diversion, is a procedure that reroutes the removal of the intestinal contents from the bowel. Surgeons perform this procedure when disease or damage necessitates the removal of part of the bowel. The bowel is another term for a person’s small and large intestines.
During ostomy surgery, a surgeon will bring part of the intestine through the walls of the abdomen. As a result, the waste exits via the abdominal walls rather than through the anus.
The surgeon will also create a stoma during the procedure by bringing the end of the intestine through the opening in the abdomen and attaching it to the skin. Doing this creates an opening to which a person can attach an external collection pouch, or ostomy pouch, to collect the waste.
This article will cover the differences between ileostomies and colostomies and explain why a person might need one of these procedures.
Ileostomies and colostomies are both types of ostomy surgery. Ostomy surgeries can be temporary or permanent.
Ileostomies involve a surgeon rerouting part of a person’s ileum to come out of an opening in their abdomen. This new opening allows waste to exit via the new stoma rather than through the anus.
The ileum is the last part of the small intestine, and it helps digest food, as well as absorbing nutrients and water.
Ileostomies can be temporary or permanent depending on the reason for their requirement. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), ileostomies are the most common type of temporary bowel diversion.
A colostomy is similar to an ileostomy. However, a surgeon will reroute part of a person’s large intestine, which is also known as the colon.
The colon, which is the last part of the gastrointestinal tract, absorbs any remaining water and nutrients from the food passing through it. This final absorption helps form stool.
During a colostomy, a surgeon attaches part of the colon to an opening in a person’s abdomen. This diversion of the colon allows waste to pass out via a stoma on the abdomen.
As with ileostomies, colostomies can be temporary or permanent.
The type of ostomy surgery that a person requires depends on the medical condition that they are experiencing.
Problems with the small intestine may require a person to undergo an ileostomy. Ileostomies reroute waste products away from damaged or removed areas of a person’s ileum.
Depending on the cause of a person’s small intestine issues, an ileostomy can be temporary or permanent. A person may need an ileostomy for just 3–6 months to allow that part of the colon to rest and heal. In other cases, an ileostomy may be permanent.
People with various health conditions may need to have an ileostomy.
Reasons for a temporary ileostomy
If a person has surgery on an area of the bowel that is lower than the ileum, an ileostomy may be required to allow the site to heal. Some surgeries that may require an ileostomy include:
- colorectal cancer surgery
- surgery for diverticulitis, a type of inflammatory bowel disease (IBD)
- j-pouch surgery, in which an internal pouch replaces the rectum
Reasons for a permanent ileostomy
A person may require a permanent ileostomy if a surgeon has removed or bypassed their colon, rectum, and anus.
Conditions that may require a person to have a permanent ileostomy include:
- Crohn’s disease
- some cancers
- colonic dysmotility, which is where the muscles or nerves of the colon do not work properly
- ulcerative colitis, which is inflammation of the colon or rectum
- familial polyposis, an inherited condition that causes abnormal growths in the colon and rectum
Certain diseases or injuries can cause damage to a person’s colon. Colostomies divert stool away from the colon and through a stoma on a person’s abdomen.
Temporary reasons for a colostomy
A person may need a temporary colostomy if the colon needs time to heal. Reasons for a person to have a temporary colostomy include:
- blockage in the bowel
Permanent reasons for a colostomy
If a surgeon needs to remove or permanently bypass part of the colon or rectum, a person may require a permanent colostomy. Conditions such as cancer can sometimes make a permanent colostomy necessary.
The procedures for ileostomies and colostomies are similar, but they involve different sections of the bowel. Surgeons may also use different techniques when performing these surgeries.
Before performing an ileostomy, a surgeon will mark out the future location of the stoma. Ileostomy stomas are usually on the lower right side of a person’s abdomen. The surgeon will then remove a circle of skin between
After forming this hole, the surgeon will cut through the abdominal tissue to get to the ileum. There are then two main methods for forming the stoma — loop ileostomies or end ileostomies.
Temporary ileostomies are usually loop ileostomies. These involve the surgeon pulling a loop of intestine through a person’s abdomen and cutting it open, forming two stomata that they sew into the person’s belly.
Permanent ileostomies are usually end ileostomies. An end ileostomy occurs when the surgeon permanently detaches the ileum from the colon. They then attach the end of the ileum to an opening in the abdomen to form a stoma.
Surgeons perform colostomies in a very similar way to ileostomies. Surgeons can form stomas using either loop or end techniques during a colostomy.
Colostomies may have different names depending on the affected part of the colon. The type of colostomy will determine the location of a person’s stoma.
The types of colostomies include:
- transverse colostomy
- sigmoid colostomy
- ascending colostomy
- descending colostomy
After a person has ostomy surgery, they may tire quickly once out of the hospital. It is important that they rest until they have recovered from the surgery.
The Bladder & Bowel Community notes that a person’s ileostomy stoma should be functional a few days after surgery. A person may have to stay in the hospital for 1–2 weeks following ileostomy surgery.
Following colostomy surgery, healthcare professionals will feed the person through their veins, or intravenously, for a few days. A person may have to stay in the hospital for 3–10 days following a colostomy.
A person may also feel as though they have an urge to pass stool following surgery. There may sometimes be discharge from the anus, which will be a mix of blood, mucus, and leftover stool.
According to the NIDDK, a person should be able to return to work 6–8 weeks after surgery. They should avoid driving or heavy lifting for 2–3 weeks after the procedure.
People should also avoid extreme physical exercise or sports for 3 months. However, walking, swimming, and biking are suitable forms of exercise, as long as they are not strenuous.
It is also important to note that an ostomy should not affect a person’s ability to maintain a physical relationship. People can resume sexual activity providing their healthcare team says that it is safe to do so.
Once a person has had ostomy surgery, they may have to wear an ostomy bag — either temporarily or permanently. Ostomy bags attach to a person’s stoma and contain diverted waste from the bowels.
As a result of ostomy surgery, a person will have no control of their bowel movements. A person’s ostomy bag will fill with waste as the body digests food. A person will then have to empty it manually five to eight times a day.
Bowel movements following an ileostomy may be liquid or pasty in form as they contain more water.
Depending on where in the colon the colostomy occurred, a person may have liquid or more solid stools.
For 6–8 weeks after surgery, a person’s healthcare team may recommend that they consume a low fiber diet, as this will give the bowel more time to heal.
Over time, a person should be able to resume their normal diet. However, the following foods may affect the gastrointestinal tract and cause more gas and odor:
After surgery, a person may need to adapt their dietary habits by:
- avoiding large amounts of liquids alongside meals
- ensuring that they eat regularly
- drinking plenty of liquids between mealtimes
- avoiding high fiber foods
- chewing food thoroughly
The table below shows the key differences between the two types of procedures.
|Location||Surgeons perform them on the ileum.||Surgeons perform them on the colon.|
|Stoma location||The stomata are usually on the right side of the abdomen.||The stomata can be in various locations on the abdomen.|
|Stool type||These procedures create liquid or pasty stool.||These procedures create liquid or semi-solid stool.|
|Recovery time||A person will need to stay in the hospital for 1–2 weeks.||A person will need to stay in the hospital for 3–10 days.|
Ileostomies and colostomies are both forms of ostomy surgery. Each procedure involves different parts of a person’s bowel.
Ileostomies and colostomies can both be lifesaving surgeries. If a person has any concerning bowel symptoms, they should talk with a doctor.