Ileostomy vs. Colostomy: Similarities and Differences (2024)

An ileostomy and a colostomy are surgical procedures that reroute part of the intestines to an opening in the abdominal wall. Ileostomies involve the small intestine, while colostomies involve the large intestine.

There are several similarities between an ileostomy and a colostomy.

An ileostomy is a surgical procedure that attaches part of the small intestine to an opening in the abdominal wall so waste can exit. A colostomy is a surgical procedure that reroutes the large intestine to an external opening.

Both an ileostomy and a colostomy can be done on a temporary or permanent basis, depending on why the procedure is necessary.

Although there are similarities, these procedures may be needed for different conditions and have slightly different recovery timelines.

This article takes a closer look at both an ileostomy and a colostomy, and the key differences between them.

An ileostomy is a surgical procedure that attaches the lower third section of the small intestine, called the ileum, to an external opening in the abdominal wall. That opening is called a stoma.

A collection bag goes over the stoma to collect the digestive waste that would normally pass into the large intestine (colon) and then out through the anus.

There are two types of ileostomy:

  • End ileostomy: During an end ileostomy, the small intestine is separated from the colon and brought through the abdominal incision to create the stoma.
  • Loop ileostomy: In a loop ileostomy, a loop of the intestine is pulled through the incision to form the stoma.

When is an ileostomy needed?

An ileostomy redirects how your body processes digestive waste. The health issues that may require an ileostomy include:

  • inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis
  • colorectal cancer
  • familial adenomatous polyposis
  • congenital intestinal irregularities
  • preparation for surgery on the colon or rectum
  • healing after surgery to the digestive tract

When is it temporary and when is it permanent?

An ileostomy is sometimes a temporary procedure, like when the colon needs time to recover and rest. For instance, you might have a temporary ileostomy if your body is healing from colon surgery or needs relief from inflammation.

Temporary ileostomies are typically kept in place for up to 6 months, but it’s possible to have one in place for years before removal.

In some cases, ileostomies are permanent. This is done when the small intestine or colon is badly damaged, or when cancer has spread throughout the intestine. When this happens, a permanent ileostomy that cannot be reversed may be necessary.

What is recovery like?

An ileostomy is typically an inpatient surgical procedure. You usually need to stay in the hospital for several days after surgery to ensure your stoma is functioning correctly.

While you’re in the hospital, your healthcare team will teach you how to care for your stoma and use your collection bags.

A colostomy is similar to an ileostomy, but it involves the large intestine (colon), not the small intestine. With this procedure, a surgeon creates an opening in the abdominal area and attaches the large intestine to it.

Like the stoma created in an ileostomy, the stoma created with a colostomy is used to redirect digestive waste so it doesn’t move through the colon to the rectum.

Instead, the digestive waste exits through the stoma. A small bag is attached to the stoma to collect the waste. Once it’s full, you remove it.

When is a colostomy needed?

The conditions that may require a colostomy include:

  • colorectal cancer
  • a blockage in the colon
  • an anal fistula
  • diverticulitis
  • Crohn’s disease
  • an injury to the colon or rectum
  • fecal incontinence
  • Hirschsprung’s disease, a rare congenital condition that can prevent stool from moving through the colon

When is it temporary and when is it permanent?

A colostomy can be temporary or permanent. Temporary colostomies may be done to help the colon, rectum, or anus recover from surgery, inflammation, or an injury. For instance, you might have a temporary colostomy as part of your treatment for an anal fistula.

Permanent colostomies are often done when there’s damage or disease to the colon, rectum, or anus that’s not expected to heal. For instance, a permanent colostomy may be necessary due to colon cancer or if a large part of the colon is removed.

What is recovery like?

A colostomy is an inpatient procedure. You’ll stay in the hospital for several days after surgery. During your stay, your healthcare team will ensure your stoma is functioning correctly. They’ll teach you how to care for it too.

You might need to make a few lifestyle changes after surgery. For instance, people who have had a colostomy can get dehydrated more quickly, so it will be important to drink more water.

Additionally, since your body will be digesting everything differently, your doctor may need to adjust your current medications.

Whether you have an ileostomy or a colostomy, living with a stoma can be an adjustment. Here are a few things to keep in mind as you recover:

  • Care for your stoma: Keeping your stoma clean is important. The waste collected in your bag can irritate your skin, so gently clean the area with soap and water daily. Also, watch out for any redness, burning, and itching, and report those symptoms to your doctor.
  • Stay hydrated: Your colon reabsorbs water and minerals back into your body. This means that after a colostomy, it can be harder to stay hydrated. Make an effort to drink more fluids than before your surgery.
  • Monitor your diet: Your doctor will likely recommend a low fiber diet for the first several weeks after surgery. As you recover, you can gradually reintroduce foods back into your diet.
  • Adjust medications: You might need to take different forms or different dosages of medications. Many medications are designed to process the entire way through your digestive system. They may not be as effective if you have a stoma. Tell all your doctors about your ileostomy or colostomy so they can make adjustments to your medications if necessary.
  • Stay active: Once you’ve recovered from surgery, you can get back to your usual activities. However, for some activities, such as sports, it might be a good idea to wear a stomach guard or other protective gear. Ask your doctor if you’re not sure.

An ileostomy and a colostomy are similar procedures that reroute parts of the digestive tract to an opening in the abdominal wall called a stoma. This allows digestive waste to pass through this opening and into collection bags outside your body. Both procedures can be done on a temporary or permanent basis.

The key difference between them is that an ileostomy redirects part of the small intestine to a stoma, while a colostomy redirects the large intestine (colon) to this abdominal opening.

With both procedures, digestive waste will move through the stoma instead of passing out through the anus.

Both procedures may require changes to your diet, medications, and fluid intake. Your healthcare team can help you understand the types of adjustments that may be required.

Ileostomy vs. Colostomy: Similarities and Differences (2024)
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