What Is an Ostomy?
This procedure redirects waste out of your body through an opening in your abdomen.
Medically reviewed by Kashif J. Piracha, MD
An ostomy is a procedure in which a surgeon creates an opening, or stoma, from the inside of your body to the outside. This opening lets content bypass an area of the body that's injured or diseased. Surgeons can perform an ostomy as an emergency procedure or as a scheduled surgery.
An ostomy can be a life-saving procedure for people with a disease of the bladder, colon, small intestine (ileum), rectum, or trachea. Read on to learn what an ostomy is, what to expect, and possible complications.
Related: What Is Hiatal Hernia Surgery?
Types of Ostomies
There are different types of ostomy, which vary by location. The type you receive depends on what health condition you have.
A surgeon may create a temporary stoma when a part of your gut is diseased or injured. The opening allows the diseased area time to heal. In contrast, a surgeon might create a permanent stoma, which allows waste to leave your body if part of your gut has been removed.
Colostomy
A surgeon creates a stoma in the abdomen, usually if a disease or injury affects the colon. The stoma can be anywhere on your abdomen, depending on where the problem occurs. A colostomy brings the large intestine, which is the end of the colon, to the opening. As a result, stool passes from the colon, through the stoma, and then into a bag that attaches to the skin.
A colostomy may be temporary or permanent. You might need a temporary colostomy to allow part of your colon to heal after surgery or due to disease. A surgeon will later reattach parts of your colon after it heals. In contrast, a surgeon usually performs a permanent colostomy to treat severe diseases, such as cancer.
Ileostomy
In an ileostomy, a surgeon creates a stoma, typically on the right side of the abdomen, if there's a problem with the small intestine. They will bring the lower part of the small intestine to the opening, which allows stool to pass.
You might require an ileostomy if you have a disease that severely affects the colon or small intestine, such as:
A birth defect
An injury to your intestines
Colorectal cancer
Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis
Polyps, or growths, on the lining of the colon or rectum
A surgeon may remove the colon and rectum so that stool no longer passes through the rectum. Instead, digestive content will come out of the body through the stoma. Digestive content is mostly fluid in consistency when it reaches the stoma. You'll typically see liquid or paste-like material in the bag, which you must change five to eight times per day.
Urostomy
A surgeon will create a stoma in the abdomen that helps divert urine away from the bladder. Instead, urine will pass through the opening in your abdomen and into a bag that attaches to the opening. You might require an urostomy if you have chronic inflammation or damage to the bladder. Some people with bladder cancer may need an urostomy.
Caring for an urostomy is essential. Infections from the bag can spread into urine and then into your kidneys. Moisture may also cause skin damage if the bag does not fit properly. Taking care of hygiene and properly practicing how to fit the urostomy pouch can help prevent skin damage.
Tracheostomy
A surgeon can create a stoma in the front of your neck if you have trouble breathing. The stoma is usually in the trachea, or the windpipe. The surgeon will insert a tube through the opening to provide an airway.
A tracheostomy may be an emergency procedure for people who have sudden airway obstruction. Others might have a planned surgery to treat severe health conditions, such as head and neck cancers.
A tracheostomy may be temporary or permanent. A temporary tracheostomy treats a blockage or an injury to the trachea. A healthcare provider will remove the tube after some time, which usually leaves a small scar. A surgeon will typically close the stoma to help it heal fast. You may require a permanent tracheostomy if you have had part of your trachea removed, such as to treat cancer.
What To Expect After Ostomy Surgery
A healthcare provider will teach you how to change the bag and when you need to empty it. They will educate you on any changes and complications that may develop at the site of the stoma.
Changes and side effects that may occur after an ostomy include:
Constipation, diarrhea, and gas
Less water and nutrients that your gut absorbs
Mucus that leaks or passes from the anus
"Phantom rectum," or the need for a bowel movement after the rectum is removed
Stool that's liquid or paste-like in consistency
After the surgery, a healthcare provider will likely advise resting and avoiding certain activities. Recovery varies from person to person, but many people eventually continue normally with their daily activities.
You might encounter issues with body image, sexual activity, social life, travel, and dependency on others. Those issues can affect a person's life emotionally, mentally, and physically. Talking to a healthcare provider and loved ones may help.
What Is an Ostomy Bag?
An ostomy bag is a pouch that attaches to the stoma on the outside of your body and helps collect waste from your body. The bag is made up of an odor-free hard plastic material that does not allow waste to leak if you wear it properly.
You'll need to empty the bag when it gets one-third full to avoid leaking. A healthcare provider will likely advise you to change the bag every two to four days. They can recommend what best suits you based on your health condition and diet.
After emptying the bag, wash your hands with soap and water, making sure to clean between your fingers and underneath your fingernails. You'll then follow these instructions to change an ostomy bag:
Gently press on your skin near the stoma: This removes the seal if you have a two-piece bag.
Throw the old bag away: Wrap the bag in a newspaper or place it in a plastic bag before throwing it away.
Cleanse your skin with soap and water: Your skin might be pink or red and bleed slightly. Gently pat it dry and let it air dry for one to two minutes. Wipe the stoma with a skin wipe.
Measure the stoma: Use a measuring card to match the circle size to the stoma. Trace the circle onto the back of the seal and cut out the area.
Attach the new bag: Apply a skin protectant or paste to the area. Attach the bag to the seal and then peel the paper off. Place the seal around the stoma, pressing the pouch firmly onto your skin.
Complications of Ostomy Surgery
An ostomy can be life-saving for many people with disease or injury to the bladder, colon, small intestine, rectum, or trachea. Still, some complications might arise during and after the surgery. About 10% to 70% of people who receive an ostomy develop complications later.
Complications include:
High output stoma: The body creates an excess output of the waste, which is difficult to manage.
Narrowing and obstruction: Food can obstruct the stoma if it becomes too narrow, which may result in nausea and vomiting.
Ostomy prolapse: The stoma that's created further protrudes from the abdominal wall.
Skin irritation: Leakage from the bag may cause skin redness. You might develop a skin infection if there are any breaks in your skin.
Stoma necrosis: The cells in the stoma start to die, leading to tissue death if something compromises the blood supply to the stoma.
Related: What Is an Endoscopy?
A Quick Review
An ostomy is a procedure in which a surgeon creates a stoma, or opening, on your abdomen to allow waste to exit your body. One type of ostomy, a tracheostomy, makes an opening in your trachea to help you breathe. After the surgery, an ostomy bag attaches to your skin to collect waste. You will regularly need to empty and change the bag to help avoid skin irritation and maintain hygiene.
An ostomy can significantly improve the quality of life in people with diseases or injuries to the bladder, gut, or trachea. Still, complications, including narrowing, prolapse, and necrosis, may occur. Talk to a healthcare provider if you have concerns about your ostomy or stoma.
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