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Your Colostomy/Ileostomy
What Is a Colostomy/
Ileostomy?
An ostomy is a surgically created
opening in the abdomen for the
discharge of body waste.
After the ostomy is created,
you will expel or release
waste through a stoma.

f Ostomies that discharge

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stool are called ileostomies
or colostomies.

Your stoma is the end of the small

or large intestine that can be
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seen protruding or sticking out
of the abdominal wall. It is the
new site where stool will leave
the body and be collected in
the ostomy pouch. The size and
location of your stoma depend
on your specific operation and
the shape of your abdomen.
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Most stomas are similar and will:
f Stick out of the body,
usually an inch or less above the skin
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f Vary in size

f Be round or oval in shape

f Be red and moist (similar to the inside of your mouth)

f Have no feeling

f Be slightly swollen for the first weeks after the operation

and then shrink to their permanent size

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Who Needs an Ostomy?

Disease or injury such as cancer, trauma, inflammatory bowel
disease, or certain birth defects can block the flow and drainage
of stool. If the segment of the intestine cannot be repaired, then
your surgeon will perform an ostomy operation. The ostomy
will reroute the stool to a new opening on the abdomen.

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Your Colostomy/Ileostomy
Your Ileostomy/
Colostomy Operation
Understanding Your Digestive System
Food passes from your mouth through your esophagus
to your stomach. The stomach breaks down food into
small pieces that move into the small intestine.

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In the small intestine, enzymes break down food into a thick liquid.
The body absorbs nutrients, vitamins, and water. The material then
moves into the large intestine, also called the colon. In the colon, water
is absorbed from the stool. It becomes thicker as it moves through
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the parts of the colon. Your stool passes from the colon into the
rectum and is expelled through the anus. Your operation will bring
either the small or large intestine to the surface of the abdomen.
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Stomach
Large intestine/colon

Small intestine

Ileum
Sigmoid colon
Rectum
Anus

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Transverse

Descending
Ascending

Ileum
Sigmoid

Ileostomy
An ileostomy is the opening created by
the surgeon to bring the small intestine
(ileum) to the surface of the abdomen.
An ileostomy may be temporary or
permanent. Ileostomies are created
higher in the intestine, and less water
is absorbed from stool. The stool that
comes out of your stoma will be more
liquid. It will get thicker over time. Ileostomy

Colostomy
A colostomy is the opening created by
the surgeon to bring the colon (large
intestine) to the surface of the abdomen.
There are various kinds of colostomies,
each named for the location in the
colon where the ostomy is formed.
They are ascending, transverse,
descending, or sigmoid colostomy.
A colostomy may be temporary or
permanent. The stool draining from
a colostomy is more formed.
End
colostomy

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Your Colostomy/Ileostomy
About the Pouch
Your stool will exit from a new opening called a stoma and
will be collected in a pouch. You won’t be able to feel or
control your stool as it leaves your body through the stoma,
so you will need to wear an ostomy pouching system.

The pouching system sticks or adheres to the

skin around the stoma. The pouch:

ff Collects stool

ff Contains the odor

ff Protects the skin around the stoma

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Stool on the stoma will not cause any problems, but stool on the skin
surrounding the stoma can cause the skin to get red or irritated.

Ostomy pouching systems are lightweight and lie flat against the body.
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Pouching systems come in different sizes and styles. Your doctor or a
WOC nurse can help you choose which one is best for you. Most people
try several types of pouches before they choose one permanently.
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Pouching System/Types
Pouch systems are made up of the skin barrier that holds the
pouch to the skin and the pouch that collects the drainage.
They are available as a one-piece or a two-piece system.

ONE-PIECE SYSTEM
Skin
In a one-piece pouch, the pouch and skin barrier
barrier are attached together.

Pouch

T WO -PIECE SYSTEM
In a two-piece system, there is a skin barrier Skin
and a separate attachable pouch. The skin barrier
barrier adheres to the skin around the stoma
and protects the skin, giving you a place to
attach the pouch. The skin barrier usually
includes a flange or rim that is used to seal
the pouch to the skin barrier. Flange sizes are
made to fit exactly to a specific pouch. The
flange may make the system less flexible.
However, you may find it convenient to be able
to change your pouch more often without
having to remove the skin barrier each time. Pouch

DRAINABLE POUCH
A drainable or open pouch can be opened at
the bottom to expel waste. You do not need
to remove a drainable pouch to empty. The
pouch can remain in place for several days.
Drainable pouches are easy to empty and
are an option for people with ostomies that
need to be emptied several times a day.

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Your Colostomy/Ileostomy
CLOSED - END POUCH
A closed-end pouch has no opening and
can’t be emptied. When the pouch is full, you
throw it away. Since you could use several
pouches a day, you will need to carry extras.
You will also need plastic bags to place the
full pouch in before throwing it in the trash.
A closed-end pouch is generally not suitable
for patients with an ileostomy because of the
need to frequently empty the pouch. Closed-
end pouches are available in one-piece or two-piece systems.

A closed-end pouch is often used:

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f When the pouch does not have to be emptied often

f For convenience while traveling

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f During intimate moments, because it is
smaller and has no clips or closures

f While swimming
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Pouch Closure

I LEOS TO MY AN D CO LOS TO MY
A clip or roll-up-and-seal method is used to close a pouch for a colostomy
or ileostomy. The pouch is sealed by folding or rolling the opening,
usually three times in the same direction. Then, either press across
the opening or use Velcro® tabs that secure around the closure.

CLAMP METHOD
When using a clamp, be sure to wrap the end or tail piece around the
clamp, and tug on the clamp once while holding the bag to make
sure it doesn’t slip off. Clamps usually last a month or longer.

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Your Colostomy/Ileostomy
Pouch Colors
Some pouches are clear or transparent, and others are opaque
(you can’t see through them). While in the hospital, your
pouch will most likely be clear or transparent. When you get
home, you may prefer to switch to an opaque pouch.

Pouch Sizes
Pouches can be small or
large. The size you need
depends on the amount
of output that you

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produce as well as your
personal preference.
An ileostomy produces
watery output and PL
needs to be emptied
about 5 times a day,
so a larger pouch may
be needed. Colostomy
output is more formed. A person with a colostomy may often
produce 2 or 3 stools per day, so a shorter pouch may work. A
mini pouch is also available. It is smaller and less visible under
clothes. It has to be changed or emptied more often. The mini
pouch may be convenient during intimacy and exercise.
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Pouch with Filter
Some pouches have small vents, called Filter
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filters, that allow gas to escape. The vent

deodorizes gas as it filters out. Filters typically
do not work well once they get wet. So if you
bathe or swim, you may have to cover the
opening with a cover or waterproof tape.

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Pouch Belts and Wraps

Some people wear an ostomy belt or wrap
around their abdomen. The belt provides
extra support. Some pouch belts/wraps are
made specifically for water sports. If you
choose to wear an ostomy belt or wrap:

f Attach the belt so

that it lies evenly
against your abdomen
and lies level with
your stoma.

f The belt/wrap
should not be so
tight that it cuts into
or leaves a deep
groove in your skin.

f You should be able

to place one finger
between the belt
and your abdomen.

Pouch Covers
Pouch covers are lightweight, soft coverings that
go over the pouch. They come in a variety of
colors and prints. The coverings may decrease any
uneasiness associated with having someone view
the pouch. They may also reduce heat and moisture
caused by the pouch resting against your skin.

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