Ever have a conversation multiple times and think nothing of it, but then suddenly the significance of it becomes clear to you and you realize it’s a pattern and it’s time to address it?  My most recent experience surrounding this has to do with the word colostomy and what it really means.

I’ve had multiple conversations that go something like this:

Me: “I have an ostomy, are you familiar with what an ostomy is?”

Person: “Oh yea I know what a “colostomy” is”

It used to just kind of roll of my back, where sometimes I corrected them and other times I didn’t. Recently a couple conversations and particularly a meme(?!) for the Avengers movie Endgame made me realize this is actually a really big misconception and I feel it is worth addressing.

Before we address this, I won’t leave you hanging on the Endgame thing.  Here’s the meme:

Let me just point out really quick that aside from being incredibly ignorant to include that statement, it’s 100% inaccurate because having a colostomy bag will do nothing for you if you’ve got to pee.  Seeing this circulating the internet made me disappointed, it was an in-your-face reminder of how far we’ve got to go with our ostomy awareness education.

The word “colostomy” seems to be synonymous with “ostomy” for many people, but they are not the same thing.  There’s a huge difference between a colostomy and a urostomy, and even between a colostomy and an ileostomy, and I think it’s important that we strive to continue raising awareness about all types of ostomies and how they differ from each other.

Curious why colostomy seems to be so synonymous with ostomy? Well, back in the day, most ostomies were done as part of a cancer treatment, so colostomies were the most common type of ostomy around.  As healthcare and disease have evolved over the last 100+ years, other types of ostomies have become a little more prevalent. In the mid-1900s. Ostomies had kind of a bad reputation because the pouching systems were not as awesome as they are now, and people often smelled pretty foul as a result.  Thankfully, science and innovation have prevailed, we’ve got odor-proof pouches now and the stigma surrounding ostomies is being kicked out the door.

Enough blabbing, right? Let’s break down the different types of ostomies!

What is an ostomy?

An ostomy reroutes bodily waste via surgical procedure by pulling a section of an intestine out through the abdomen, creating an abdominal stoma.  There are multiple types of ostomies (the plural of ostomy), based on what type of bodily waste or section of the intestine is pulled out. An ostomy pouch (also referred to as an ostomy bag) is attached to the abdomen to collect this waste.

Colostomy:

Col = colon!  People who have a colostomy still have part of their colon, and their colon is used to create their stoma.  A colostomy diverts fecal waste (poop!) away from the rectum/anus. Poop from a colostomy tends to be more firm and less frequent, often mimicking the kind of poop and frequency people have when they’ve got a functioning rectum and anus.  The more colon left in the body before the stoma protrudes, the more time the poop has to sit in the colon and have the water absorbed and all fun stuff your colon does. If a person has very little colon left, their poop and frequency will be more similar to that of an ileostomy (which is what we’re talking about next!).  Colostomies are usually located on the left side of the abdomen, but the location is somewhat dependent on how much of the colon is being removed.

The most common reasons for a colostomy are rectal cancer, colon cancer, inflammatory bowel disease and familial adenomatous polyposis (FAP), but there are a TON of other reasons that people find themselves with a colostomy as well.

Ileostomy:

Ileo = ileum! The ileum is the very end of the small intestine, right before it connects to the colon. The term ileostomy tends to be used synonymously for any stoma created by small intestine, though the small intestine does have different sections and sometimes the ileum is diseased so a different part of the small intestine gets used to create the stoma.  In the same way that having less colon leads to less firm poop, the consistency of poop from an ileostomy often varies based on how much small intestine a person has left (and what they’re eating). Ileostomies tend to release poop varying from straight liquid to a thick smoothie.

The most common reasons for an ileostomy are colon cancer, inflammatory bowel disease and familial adenomatous polyposis (FAP), but there are a TON of other reasons that people find themselves with an ileostomy as well.  Both colostomies and ileostomies can also be generally referred to as fecal ostomies and seem to be more common than urostomies.

Urostomy:

Ur = urine! The urostomy diverts urine from the kidneys.  Urostomies are most commonly made by using a small portion of the very end of the small intestine (ileal conduit) or the beginning of the colon (colonic conduit) as a conduit to form the stoma and connect to the kidneys.  The most common reasons for an urostomy are bladder cancer, spinal cord injuries, and other bladder defects.

Here are some things that are the same about all three types of ostomies:

• Body waste empties into a pouch.
• The person has undergone major abdominal surgery and now has a stoma protruding from their abdomen.
• The stoma is incontinent (you can’t control when waste comes out, that’s one of the reasons the pouch is so handy).
• The person can now multitask, by releasing bodily waste while completing any number of other activities at the same time (though they do eventually have to go empty the pouch into the toilet just like a regularly functioning bowel or urinary system would).
• The psychosocial struggles that may come with having ostomy surgery can affect all of us and should be monitored by medical professionals (If you’re struggling, please talk to someone! You’re not in this alone!)
• All three types are welcome at the big United Ostomy Association of America conference every other year.  2015 was in St. Louis, 2017 was in Irivine, 2019 is in Philadelphia (and if you’re reading this before August 2019, there’s still time to register to attend! I highly recommend it)
• The ostomy community we belong to is one big family.

I hope that little crash course on types of ostomies was interesting and informational for you! It just barely scratched the surface, but I think it’s important to have that basic knowledge.  I try to include more information that’s specific to the different types of ostomies throughout this website as it’s relevant. So when you’re reading topics on all the Behind the Scenes ostomy stuff, it should be relatively clear what information is relevant for your specific type of ostomy.

Also, if you have an ostomy, please do your best to remember which kind you have. This is your body, you’re your own biggest advocate, and it’s beneficial to be able to tell someone your medical history in case you find yourself in a situation where your medical records are not immediately accessible.

Now that you’re equipped with this knowledge, I hope you’ll use it next time you get the opportunity to spread some ostomy awareness.