What is the difference between a colostomy and an ileostomy?

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On a first glance, both colostomies and ileostomies sound fairly similar. As the name suggests, they’re both ostomies that involve surgery to bring a part of your bowel through to the surface of your abdomen so stool can leave your body. Both ostomies are done for conditions that affect your digestive tract like illnesses or injuries. They can either be permanent or temporary, however, this is fully dependent on your individual circumstances. For example, your ostomy can be temporary if it’s done to give a part of your bowel a rest to heal and it’ll be permanent if parts or all of your bowels have to be removed.

So, where exactly is the difference?

Even though there are many similarities between the two, there are equally as many differences. First of all, they have to do with two different parts of your bowels. An ileostomy concerns your small intestine, also called ileum, and a colostomy concerns your large intestine, also called your colon.

With an ileostomy, your surgeon will bring a part of your small intestine to the surface of your abdomen. This is a procedure often used for people who suffer from bowel cancer, ulcerative colitis, Crohn’s disease, or Familial Polyposis or FAP for short. It’s usually done when your entire colon has to be removed or needs to rest and heal before being reconnected to your small intestine. An ileostomy will usually sit on the lower right side of your stomach, and the stools leaving your body are anywhere from liquid to paste-like. This means stools will constantly leave your body, and you’ll have to wear an ileostomy bag to collect the waste. You will also have to empty your bag multiple times during the day. Usually, that’ll be anywhere between 5 to 8 times every day but it’s completely individual and might be more or less for you.

A colostomy, on the other hand, means that part of your large intestine will be brought to the surface of your abdomen. This type of surgery is generally used when only part of your large intestine needs to be removed or only a part of it needs to rest. For example, this can happen when you suffer from colon cancer, diverticulitis, bowel obstruction, or any injuries to your intestines. The output of your colostomy will generally also be more solid than the output of an ileostomy and your output will likely much more predictable and not constant. However, you’ll still have to wear a colostomy bag to collect your stools.