Understanding Colostomy vs Ileostomy - Differences, Control, and Irrigation

I see a lot of people talking about a colostomy and irrigation and being able to go without a bag for a while. I am somewhat confused between the two. Is an ileostomy when you lose all or most of your colon and a colostomy when you still have part of your colon working? When you have an ileostomy, you can't go without a bag or wear a plug, but do people have control when they have a colostomy? What exactly is irrigation and can it be done with ileostomies? I've done some reading but it isn't totally clear. Is the position of an ileostomy different than a colostomy, higher or lower or on the opposite side of the body? Thanking you all ahead of time. I will just listen.

Hello freedancer.

Technically a 'colostomy' is when the outlet/stoma is situated near the lower colon and an 'ileostomy' is when it is situated near the ileum. Basically, it is as you say : more of the colon is left with a colostomy, which allows an amount of water to be flushed through to irrigate. The ileostomy does not have this extra colon so there is not enough left to allow for this flushing exercise to take place effectively. Also, but perhaps less relevant, is the fact that the extra colon with a colostomy allows the feaces to become firmer because the digestive processes extract the moisture from the stools. This makes the flushing/irrigation more effective. The output from an ileostomy tends to be much more liquid which, in some ways is flushing itself more quickly and more often. There seems little point in artificial flushing when the ileostomy system is doing this for itself. 

A colostomy is normally on the left (as viewed by the patient) and an ileostomy would normally be on the right where the ileum is located. The height of both is often decided by choice, convenience and common sense rather than necessity. 

I hope my explanation is correct and helps yu better understand the differences.  There are some very good illustrations on body parts on the WWW which show the locations of the organs and the reasons for the stoma locations.

Best wishes

Bill

Bill hit the nail on the head with all the correct information. Ileostomies and urostomies are usually on the right and colostomies on the left (but not a hard and fast rule, just depends on where the surgeon would think it best be placed, and some patients need them shifted to either side and even in the middle).

Many people with ileostomies have no large bowel at all (like me) so I don't believe it is necessary to irrigate if at all possible.

I found this YouTube video that explains the differences in an easy-to-understand way (better than I can anyway!)

My colostomy does what it wants when it wants. Some people, through diet and monitoring, do regulate their output. This is more scheduling and not control. With irrigation, you set a time to do it (AM or PM) and you get relief from output sometimes until your next irrigation. I do not irrigate, so I am reporting just what I have heard or read.

Bill explained it all better than I ever could. All I would say is you never irrigate an ileostomy as your small intestine is weaker and at high risk of perforating.....I now have a Jejunostomy but when I had an ileostomy, my output was very solid and not liquid like most people have.

My Ostomy Journey: April | Hollister

The short answer is irrigation can only be done with a colostomy.

Not an ileostomy.

With an ileostomy too much "internal plumbing" has been removed.

God bless the person who came up with the irrigation process way back when.

It is something anyone facing an AP resection operation should be told about.

It is also something I am doing as I type this!

Cheers.

Rock on "new" meetanostomate site.

V.J.

Not sure about ileostomies. I have a colostomy and do irrigate, which means you still have most of your colon. It works great for me, and I am in my second year after APR surgery in 2017 due to rectal cancer. I irrigate once a day and have no output at all during the day, which is very comforting to me as I work full time and it makes me feel much better. I only wear a big bandaid over my stoma. Irrigation to me is my routine now and takes about 15-30 minutes every night.

In order to irrigate, you have to have the majority of your colon. You wouldn't want to irrigate the small bowel because that is where the body takes the nutrients from the digested food. The colon only absorbs water. I irrigate every 3rd day, by irrigating I am capable of wearing a stoma cap or a stoma patch. Unless I eat a huge amount of fiber, I get 48 hours free from output after irrigation. This gives me something resembling control of my life that the colostomy took from me. I also use fewer supplies. If I am using a wafer with a two-piece system, I get up to 9 days from the appliance, and I can get 3 days from a single stoma cap. For some reason.

I had both an ostomy and ileostomy. I did not irrigate the ostomy, and it was not possible with an ileostomy. Fortunately, they both have been reversed. The colostomy was 6 years ago, and the ileostomy was 5 years ago. I am bag-free. One thing I must emphasize to anyone with an ileostomy: You must drink plenty of water! Without a colon, absorption of water is restricted. You will get dehydrated quickly with an ostomy. If you chronically remain dehydrated, you will lose kidney function. That's what happened to me, and it took only 3-4 months. My doctors didn't tell me, and by the time I discovered it, it was too late. Fortunately, the damage was not terrible, and I am doing very well. I've been stable kidney-wise for years.

Good evening Suzanne,
Me too, I irrigate every day and I put a cleansing pad and a film Tegaderm. I have a picture if you want to see on my profile. You said you wear Band-Aid .... do you have a picture to show me? I'm always looking for the best solution to this damn handicap.
Thank you!

Danielle from Quebec
PS Google translation ... lollllll

Good evening Medic 361,
I do irrigation every day and I would like to have the opportunity to do it only every 2 days and even 3 days like you. Do you have a special diet that gives you very little residue? Can you help me by giving me some ideas on diet and what to do next? I greatly appreciate your help.
Thank you
Danielle from Quebec, Canada
PS Google translation... lollllll

Hi Danielle, I eat a ketogenic diet and when I cycle to more carbs, I eat a paleo diet. I eat minimal fiber. I drink a minimum of 3 liters of water daily also. Sometimes I will get a very small amount of solid output 24 hours in, then I get more time without output. Everybody's body works differently also, so I can't guarantee the same results.