Different Types of Stoma: Colostomy, Ileostomy, and Urostomy

Stoma surgery is a vital medical procedure that many people undergo for various health reasons. It involves creating an opening in the abdomen to divert bodily waste. The word “stoma” is used as an umbrella term, but it actually covers three main types of stoma — colostomy, ileostomy, and urostomy.

Whether you’re an ostomate (someone with a stoma), are about to undergo surgery, or have friends or family who have a stoma, it’s important to gain a better understanding of the different types of stomas. In this overview of stomas, we explain when they’re used, how they work, and how they can impact someone’s life. 

What is a stoma?

A stoma is an opening that’s created on the surface of the body through surgery. It allows waste to exit the body and be collected in a special bag that’s attached to the opening on the outside of the body, on the abdomen. Stomas are usually needed when a person’s usual ways of passing waste aren’t functioning properly, due to disease, injury, or other health conditions. Stomas may be required if they have Crohn’s, Colitis, incontinence, inflammatory bowel disease, cancer, or birth defects. They can be temporary or permanent.

There are three main types of stomas, each serving a specific purpose: colostomy, ileostomy, and urostomy. For a colostomy or ileostomy, the stoma is attached to the intestine. For a urostomy, the stoma is attached to the urinary tract. The waste, either faecal or urinal, passes through the stoma opening and into a bag, which can be removed and cleaned when needed. 

The three types of stomas

Below, we go into more detail about the main types of stoma. 

What is a colostomy?

A colostomy is a type of stoma where an opening is created in the abdomen to the large intestine, also known as the colon or the large bowel. A small part of the colon is then stitched to the skin, where a stoma bag can be attached to collect waste that passes through the colon. Colostomies are common in neuropathic conditions like spina bifida, as well as people with bowel cancer.

Appearance

Colostomy stomas are typically round, moist, and reddish in colour, similar to the inside of your mouth. It protrudes slightly from the abdomen, usually on the left, making it easily visible.

Function

A colostomy diverts stool away from the anus. It’s designed to mimic a functioning anus, but the waste passes through the stoma instead of the rectum, exiting into a colostomy bag attached to the abdomen.

Temporary vs. permanent 

A temporary colostomy is often used to allow the bowel to heal after surgery or injury. Once it’s healed, surgery is performed to reverse the colostomy, reconnecting the bowel so waste can exit through the rectum again.

A permanent colostomy is when the rectum or lower colon must be removed due to severe disease, such as cancer. This means the stoma will remain for the rest of the person’s life and they’ll permanently use a colostomy bag.

What is an ileostomy?

An ileostomy stoma creates an opening in the small intestine, also known as the ileum. The ileum is turned inside out in a process called everting, forming a spout that’s attached to the skin. 

Ileostomies are more common for people with Crohn’s Disease, Colitis, or irritable bowel disease. 

Appearance

An ileostomy stoma looks similar to a colostomy stoma — moist and reddish — but is usually smaller, with a more pronounced protrusion. 

Function

The ileostomy diverts digestive waste directly from the small intestine. This type of stoma is necessary when the colon is unable to process waste. The waste is typically more liquid compared to a colostomy because it hasn’t passed through the entire digestive system. The digestive enzymes in this waste make it highly corrosive, so protecting the skin around the stoma is very important.

Temporary vs. permanent 

A temporary ileostomy is often used to give the colon time to heal after surgery. Like a colostomy, it can be reversed, restoring normal waste passage through the colon and rectum.

Permanent ileostomies occur where the entire colon needs to be removed. This may be the result of an extensive disease, where the patient will need to use an ileostomy bag for life.

What is a urostomy?

A urostomy stoma diverts the ureters — two small tubes that connect the kidneys to the bladder — to the abdomen. Due to their small size, they’re sometimes moved into a small piece of the bowel to form the stoma. 

This procedure is necessary when the bladder isn’t working or has been removed due to conditions like bladder cancer or severe trauma.

There are different types of urostomy, including the ileal conduit and the colonic conduit. The most common is the ileal conduit, which involves removing some of the ileum to create a pipe for urine to leave the body. Colonic conduits are less common, using the large intestine — or colon — rather than the ileum. 

Appearance

Like other stomas, urostomy stomas are red and moist, though it’s usually smaller and less protrusive. 

Function

Urostomy stomas allow urine to bypass the bladder, leaving the body through the opening into a urostomy bag. These stomas have a consistent flow of urine.

Temporary vs. permanent 

Unlike colostomies and ileostomies, urostomies are always permanent. They’re only performed when the bladder is removed or permanently nonfunctional, so the procedure can’t be reversed. 

Learn more about the types of stomas

If you’d like to read more info about stomas, check out more of our resources — such as tips around living with a stoma or treating peristomal dermatitis — on the Medicareplus blog.