Colostomy vs ileostomy

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A stoma is an outcome of the medical procedure
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Comparing colostomy vs ileostomy: similar yet different procedures

When an individual has to have a colostomy or an ileostomy this is often due to the fact that he has lost function of the rectum or of the colon because of cancer, Crohn’s disease or ulcerative colitis.

Both procedures allow the removal of waste from the body once the digestive process is reached. Ostomy refers to the surgically created hole in the body from which body waste is discharged.


In both surgeries, a cut is made in the patient’s abdomen and the damaged part of the rectum or intestine is removed.

A hole is made in the inner abdominal wall and it is made level with what remains of the intestine. The hole that is created is called a stoma which is Greek for “mouth.” The intestine that remains is attached to the stoma and the stoma is covered with either a bag or an ostomy pouch.

A colostomy and an ileostomy can be permanent or temporary depending on the circumstances. Sometimes a temporary procedure is done to give the digestive tract time to recover after a trauma. The procedure can be reversed in some cases.


When a colostomy is done, the opening is from the colon. The waste that comes from the colon is formed so it will not be liquid. The opening can be on the right or left side of the colon, depending on what part of the colon was diseased. However, when the stoma is made on the left side, a pad is the only thing needed to cover the opening but when the stoma is on the right said, a bag is required.

When an ileostomy is performed the last part of the small intestine or the ileum is brought through the wall of the abdomen. When the body waste reaches the ileum it is liquid. The bag is placed over the hole (stoma) in the abdomen to collect the stool which is liquid.

Sometimes an internal pouch made from skin can be created on the inside of the abdomen and a bag is not required.

This procedure is usually not permanent unless the entire rectum or colon has to be removed and then it would be. When an ileostomy is no longer needed, it is removed.

During the closure, an inch or two inch incision is made in the lower right quadrant around the stoma (hole) and the bowel that is protruding is amputated. The lower end which has been disconnected is brought up and reconnected to the small intestine. The connection is then replaced into the abdomen and the muscle is closed. Recovery and healing time is required.


There are now alternative ileostomy procedures that are being used around the world. The Ileoanal Reservoir or J-pouch is not really an ostomy because there isn’t a stoma. When this type of procedure is done the colon and much of the rectum is removed and an internal pouch is created out of the terminal part of the ileum.

This pouch is the reservoir for waste. It performs the duties of the rectum that was removed. The pouch is made from two to four inches of large intestine (colon) and it is attached to what remains of the rectum or to the anal muscle if all the rectum is gone.

An opening at the bottom of the pouch is attached to the anus in a way that the anal sphincter muscles that exist can be used for continence.

This type of procedure is used on those who have familial polposis and have their sphincters intact and for those with colitis.


There are other ostomy techniques including the S pouch and the W pouch. Names for these methods include pull-thru, ileal pouch, ileoanal anastomosis, ileal pouch anal anastomosis (IPAA), endorectal pull through and pelvic pouch.

When the Kock Pouch or continent ileostomy method is used a reservoir pouch is made inside the abdomen using a part of the terminal ileum. A valve is created within the pouch and a stoma is brought through the wall of the abdomen. A tube is inserted in the pouch by the patient several times of day, which drains feces from the reservoir.

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