Opinions on Elective Colostomy Stoma Placement?

Hi, it's looking more and more like I will get an elective colostomy! Any opinions on placement of the stoma? 

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When I got mine, my ostomy nurse had me come in and made me move around, bend, stoop, etc., then she marked me on what she saw my body do. Which, for me, was just to the left of my belly button.

I ordered a sample bag and kind of need a starting point because I want to wear it around to get a feel for it. Thanks for the info.

I don't have a colo but my ileo experience says to keep it well away from your navel so the flange has a completely flat surface to adhere to and nowhere near any fold, such as the fold that appears at the abdomen when you bend over. After that, consider where the waistband sits on your pants.

The day before my colostomy, I had to see an ostomy nurse who made me move around and bend, then marked the spot for it. I didn't get a choice. Mine is also just left of my navel.

I had no say in the location of my stoma.

The nurse comes in, asks me to stand, asks where my belt is when I wear pants, and marks an X where it was going.

It is located to the right of the navel, 2 inches below the belt line. Wearing the appliance sideways helps with wearing a belt for pants. No issues at all.

I can tuck my shirt in and use a belt for pants, even suspenders.

You're welcome. For me, I'd hate to have mine any lower and have it mess with my waistline. Like Axl said, keep it far enough away from your belly button so whatever type of setup you use doesn't get hindered by your belly button. I'd also ask or reinforce to your surgeon that you want your stoma to stick out a bit and not be flush to your skin. Stomas fluctuate a lot in how far they protrude throughout the day. I'd hate to have it be flush at its highest point and then retract below skin level.

Personally... I'd like the location of my stoma... on someone else 🤦‍♂️😊.

I have a colostomy.

I had no choice. My surgeon did an excellent job placing it perfectly on me. I'm a small guy, so my Hollister bag is pretty long on me.

Mine is 3 inches to the left of my navel, and in line with the navel.

I have no problems with belts or bending over.

My stoma sticks out from 1 1/2 to 3 inches. Causes quite the bulge. I have a peristomal hernia, so I really have a bulge. My wife comments about it all the time. I sometimes wear a Nu-Hope support belt with a prolapse strap to rein in my wayward stoma. For a little while anyway.

Be sure and tell your surgeon not to cut your stoma length too close to your skin. Better a small bulge than the constant hassle of a stoma flush or below your skin.

I had emergency colon surgery on Christmas Day 2024, so I did not get to choose where my stoma would be. I also did not have a clue what was going on because of the pain and drugs. The surgeon placed my stoma 2 inches left of my belly button and right on my waistline. So I now only wear sweatpants and pants with elastic waistlines. So, don't put it there. Like everyone else says, 3 to 4 inches from your belly button and below or above your waistline. If you have it above your waistline, your pants will fit under the stoma. The bag might need to stay on the outside of your pants so the output will fall to the bottom of the bag. Note, there are waistline belts that the bag fits in that will hide the bag. If you have it below the waistline, your pants can fit over the stoma and bag. Just watch out for pancaking.

Hope this helps

Golf & Osto

Hi. Good reply. Welcome to the community. It sounds like you had a colonostomy on 12.25.23. Correct me if I am wrong.

Some tidings of comfort and joy, huh? 🤦‍♂️😩

There is no reason for your bag to be "hanging out" of your pants unless you want it to be. There are choices and options.

Being a newbie yourself, you will need to do some research on belts or wraps that hide the bag and support it too. Also, there are appliances enabling you to turn the bag sideways if that's more comfortable. Turning the bag sideways enables you to tuck in your shirt and use a belt for pants. Now do excuse me because I don't know if having a colonostomy you can do this or not. But someone will answer that question here.

Of course, location was the topic thread. Your body organs also dictate placement; that's why ileos are located on your right-hand side and colonostomy on the left. My 2 cents worth.

(7 yrs being an ileo. Kenn Buttor.)

You have a choice? Mine is to the left of my belly button. It has not been too bad. I have made it work with clothing, etc.

Yes, make sure it sticks out, not flush with the skin, away from the belly button, and watch for your skin folds. See an ostomy nurse.

I never had a choice. They came in. X-ed the spot. Boom. Done.

It's like trying to tie shoelaces on flip-flops.

I don't believe you have a say in location. A suggestion perhaps... then the nurse explains, "This is where it goes."

I know for me, a lot of people say my stoma is higher up than usual. That's because I'm in a wheelchair, apparently. I had a memory that before the operation, like right before the operation, the surgeon asked me if I was left-handed or right-handed. I'm right-handed, and I woke up with it on my right side. I also heard somewhere that the colostomy is usually on the left side and the ileostomy is usually on the right, so I don't know if there's any truth to that or not.

JVM, just curious if you are in a chair because of a spinal cord injury? I have a SCI but am not in a chair and am fairly active. I assume that before I get the operation, the stoma nurse or doctor will help me decide where to put the stoma. Thanks for the response.

No, born with neurological damage.

I'm right-handed, my colostomy is on the left side.

Hello and glad to have you here. What hospital are you going to be at? I think the placement may be based on why you're having it done, yours being neurological. Do you know if it's going to be a "loop colostomy"? If so, it will be on the left just above your button. But call all the manufacturers and get all the free samples you can. And start looking at the support belts. Stealth is the best but pricey. And you will end up with a peristomal hernia within a year, just be ready.

Besides the placement of the ostomy, how much the stoma sticks out is important. A stoma is a shape-changing little beast. It will grow longer, shorter, fatter, and thinner. It's constantly in motion due to peristalsis.

If your stoma is too close to your skin, output will get on your skin near the wafer seal area, causing irritation and leaks. You'll have to use convex wafers.

Mention to your surgeon that you want the stoma to stick out enough to prevent it from declining to skin level.

Mine sticks out from 1 inch to 2.

My ileo is on the right side. I guess there's truth to ileos on the right and colos on the left.

Like your cat!

His cat is possessed.

Welcome. I see you're new here.

This is a great place to find what you are looking for and have peace of mind.

Your comment above about stoma placement is accurate but not always true. There are some folks with colostomies on the right-hand side. I was schooled on this myself, thinking as you did, but I was wrong. It's not always the case that colostomies are on the left...nope. When it's on the right-hand side, it's due to surgical or mechanical reasons depending on where the diseased area is. Someone will explain in depth here.

Funny fact, a person kept saying she had an ileostomy. As her story unfolded, she indicated it was on the left. I questioned her about it being an ileo on the left as it's rare. Guess what? She herself was unaware it was, in fact, a colostomy. She really had no idea what she had, thinking it was an ileo, questioned her surgeon to find out.

I'm a male who has had an ileo for 10 years. Two days after surgery, which went well, I was rushed back into the OR and literally ripped back open. I had a severe septic leak from two prior bowel resections. I was placed in an induced coma for eight days on full life support, fighting for my life. I was 59 years old, and recovery wasn't pretty. All this to say that my tummy looks like the Grand Canyon, and my navel is hardly distinguishable. I've had a lot of practice experimenting with different techniques to avoid leaks. I'm so jealous of everyone's pretty little cherry and smooth belly. Here's my input/advice for some things I've read on these threads.

1) I agree there was no choice as to placement. The trained ostomy nurse marked the optimum spot with a Sharpie a week before surgery (right side).

2) I wear a high output bag which is longer. There is no way I could wear my bag vertically. Sitting at work with a belt and bending slightly caused leaks to pop. I've sprung a leak while driving just reaching over to adjust the radio. So I permanently changed to wearing my bag horizontally above the belt line and my shirttail out to cover the bulge. I also try to wear

3) Then there was the problem of supporting the horizontal bag.

Do you think your surgeon messed you up here? How in the world did you bust open after 2 days post-op? This is a nightmare.

If your tummy area looks like the Grand Canyon, no wonder you can have leaks, even if you sneeze.

Man, you have my sympathy, but it sounds like a surgical error from the get-go. Sadly.

Sorry, fat finger posted before I was ready.

3) cont'd: I initially bought pregnancy stretch belly bands. That proved expensive for multiples with my leaks and heavy sweating (don't get white!). Then I found the OstomySecrets website and bought the band with a hidden pocket to support the load. Over time, they would roll up and slide; also expensive for multiples. Then I thought I'd jumped over the moon when I discovered through my product supplier a StomaSafe Classic Ostomy Support Garment. They are bands made from gauzy, cottony, stretchy material with an inside pocket. They are supposed to be short-lived and insurance allows this product. (Medicare allows three every ninety days).

4) My stoma is often wet or has skin irritation at the base, making it difficult for the wax ring to stick. Instead, I attach it to the sticky side of my barrier and roll the center through the hole, making a neck up against the stoma. This helps a lot.

5) You might benefit as I do from using a product called Sure Seal Rings (Active Lifestyle Products). I also source this from my product supplier and insurance covers it. It's an ultra-thin 6”x6” square of clear, waterproof plastic wrap with a hole cut out that further protects the skin.

My point in describing the backstory is to say that circumstances or preferences may dictate experimenting around and/or taking advice from others rather than staying with a process that a nurse, etc., may have told you. Only you know what works and won't work. Go with your gut (pardon the pun) and try anything and everything to make it work for you.

Of course, one's first thought is surgical error. I don't think that's the case. I was diagnosed with Crohn's at age 14 and was 59 when I had surgery. At the initial diagnosis, I lost 10 inches of large and small bowel. Then I had two additional bowel resections over the years. That's like a pipe with three plumbing repairs. There was a lot of scar tissue to deal with. I beat the odds, but I have to deal with the consequences. Paraphrasing an old song lyric, "If you can't keep the one you love, then love the one you now have." Some days are much easier than others!

Hello,

My cat says thank you. She's a weasel. Lately, she has become obsessed with light beams. I have track lights on the side wall in my spare bedroom. Using my eyeglasses, I can create a light beam on the carpet. Charcoal chases the beam all over, even up the wall. It's so funny when I make the beam disappear. She looks so astonished, quickly looking around... wondering "What the heck?"

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Sit down when you mark the ideal spot to make sure it is not placed in a fold of your tummy. Good luck.

Oh... just looking for trouble, that one. (The cat photo)

Good tune. Interesting take on the words used.