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Ileostomy vs Colostomy Stoma: What's The Difference?

Medically reviewed by Regina Victoria Boyles, MD · Pediatrics

Written by Honey Buenaventura · Updated Dec 23, 2022

    Ileostomy vs Colostomy Stoma: What's The Difference?

    What’s the difference between an ileostomy vs colostomy stoma? A colostomy and an ileostomy are both surgical procedures in which a doctor creates an opening in the skin as a way for waste products to leave the human body. While ileostomies and colostomies seem similar at first look, they are really rather different.  

    There are several medical circumstances where a person may need to undertake ileostomy or colostomy such as bowel infections, bowel inflammation, bowel cancer, or even serious injury to the bowel, among a few others.

    Ileostomy vs colostomy stoma

    An ileostomy is an opening made with part of the small intenstine (or ileum). It is used either when the entire colon has been removed or if it needs to heal before being reconnected. Very little water is taken in the small bowel, so the inside of the stoma bag tends to have a liquid-like consistency. And because the enzymes contained in small bowel contents can cause skin irritation, the bowel has a spout sticking out from the abdominal wall. This allows fecal matter to drain without touching the skin.

    A colostomy is an opening formed with a part of the large intestine (or colon). It is used when only part of the colon is removed or only part needs to rest. Colostomies are positioned close to the skin because the enzymes present in large bowel contents have less alkali and, thereforeless irritating to the skin.

    The opening formed by an ileostomy or by a colostomy is called a stoma. A stoma is where the end of the bowel is brought to the outer surface of the abdomen to release body waste into a stoma pouch.

    The different cases for ileostomy vs colostomy stoma

    Doctors generally perform colostomies and ileostomies for conditions that affect the digestive tract. In particular, doctors perform ileostomies and colostomies to take care of injuries and diseases that affect the large and small intestines.

    An ileostomy or colostomy can be just temporary or sometimes permanent. The doctor may decide to do a temporary colostomy or ileostomy to allow the intestine to have a rest and to heal after surgery. However, it will be permanent if the anal sphincter and the lower part of the rectum are removed.

    A colostomy and an ileostomy are two different procedures and thus each require different treatment. With a colostomy, you often have fully formed stools. With an ileostomy, you have liquid-like stools, meaning you have to empty the bag all throughout the day.

    Both medical procedures have their differences and advantages. But first and foremost, before undergoing any of these types of operations, you will need to thoroughly discuss certain issues with your doctors such as your medical history, any medications you may be currently taking, and possible risks and complications of the operation.

    Risks and complications

    Both an ileostony and colostomy procedure are not without possible complications. Some of the possible complications may include:

    • excessive bleeding (hemorrhage)
    • infection
    • allergic reaction to surgical medication, such as anesthesia
    • a portion of bowel protruding through the stoma (incisional hernia)
    • diarrhea
    • dehydration
    • narrowing of the stoma
    • difficulties in passing feces through the stoma and into the bag
    • skin complaints caused by contact with feces around the stoma
    • kidney stones,
    • gallstones

    If the stoma is only temporary, a subsequent operation will be needed to reattach the bowel so feces can once again be passed through the anus.

    If permanent, the stoma is checked again approximately three weeks later (or when the swelling has already subsided) to make sure it is of appropriate diameter. The person has no voluntary control over the movement of their feces, which is also likely to be thin and watery.

    Many people appreciate the much-needed understanding and support presented by support groups such as stoma associations. These specific support groups can advise on important issues such as clothing concerns, body image, and sexuality.

    Key Takeaways

    Which of the two procedures is better for the patient? An ileostomy medically has a number of advantages over a colostomy. However, there are patients with a greater risk of dehydration or compromised kidney function.  

    Both ileostomy and colostomies can save lives, and, in many cases, it can improve the quality of life in other circumstances. For more information about ileostomy and colostomies, consult your doctor. 

    Learn more about other Surgeries and Medical Procedures here


    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Medically reviewed by

    Regina Victoria Boyles, MD


    Written by Honey Buenaventura · Updated Dec 23, 2022

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