Any medical procedure that ends in the suffix -ostomy typically involves the creation of a new hole or orifice within an organ or part of the body. Ileostomy and colostomy procedures are two common examples of this, and they both involve the creation of a stoma, or hole, in the skin to allow for waste products to be removed from the intestines.

However, even though the colostomy and ileostomy procedures have similar functionalities and purposes, they aren’t the same thing. There are some quite big differences between them, and in this guide, we’ll look at definitions of ileostomy and colostomy procedures, as well as examining the key differences between these procedures.

What Is an Ileostomy?

Let’s begin with a closer look at ileostomies. What is an ileostomy? In simple terms, an ileostomy is a medical procedure that involves diverting the small intestine, or small bowel, via an opening, or stoma, in the abdomen. It is a relatively common procedure in many parts of the world.

The process of an ileostomy involves a surgeon forming an opening in the abdomen and then redirecting part of the ileum (part of the small intestine) so that it leads out of that opening. The ileum is the final part of the small intestine and is very important for digestion and absorption of nutrients.

Once the stoma has been formed, a bag can be placed over it. This bag will serve as a receptacle for waste products from the intestine. Rather than continuing on into the large intestine and leaving the body via the rectum and anus, the waste products will instead be redirected into the bag, which can be removed and replaced as needed.

It’s also worth noting that there are two different varieties of ileostomy procedures: 

• Loop – A loop ileostomy involves a loop of the small intestine actually being pulled out of the abdomen and then opened and stitched to the skin, forming the stoma. 
• End – An end ileostomy involves separating the ileum from the colon, before bringing it out via an opening in the abdomen to form the stoma.

End ileostomies are usually permanent, while loop ileostomies are more temporary and may be reversed or undone later on. These kinds of procedures are typically carried out in patients who may have had colon or intestinal surgery, bowel cancer, Crohn’s disease, or other conditions.

What Is a Colostomy?

Next, we’ll look at a brief overview of a colostomy. So, what is a colostomy? Well, this is a medical procedure that involves the colon, which is part of the bowel or large intestine. It’s actually the biggest part of the large intestine and is a crucial component of the overall digestive system.

The colostomy process involves diverting or rerouting the end of the colon through an opening or stoma in the abdomen. The surgeon may make a long incision in the abdomen to access the colon, or they might make use of keyhole surgery instead, which involves multiple small incisions and a small camera to guide their movements.

Usually, keyhole surgery is the preferred option as it has a reduced risk of complications and has faster healing times, too. But, regardless of which method is used, the end result is similar, involving the formation of a stoma. A bag can be placed over the stoma to collect stools and waste that pass through it.

Just like with an ileostomy, there are two main forms of colostomy procedures:

• Loop – A loop colostomy involves pulling a loop of the colon out through a cut in the skin and then stitching it in position to form the stoma. 
• End – An end colostomy is when the end of the colon is pulled out through an incision and stitched to the skin to form the stoma.

An end colostomy is usually a permanent procedure, but can be temporary, and loop colostomies may also be temporary and can usually be reversed later on. These procedures are carried out on patients who may be unable to pass stools normally via the anus, which can be related to injuries or illnesses like bowel cancer, Crohn’s disease, anal cancer, or Hirschsprung’s disease.

Ileostomy vs Colostomy: Key Differences

While there are plenty of similarities between colostomy and ileostomy procedures, these procedures are still very different in many ways.

Organ

One of the main differences between ileostomy and colostomy procedures is the organ that they actually involve surgery on. As the names suggest, an ileostomy involves surgery on the ileum, which is part of the small intestine, which a colostomy is focused on the colon, which is a large part of the large intestine.

Procedure

Another big difference between ileostomy and colostomy procedures is how the procedure actually takes place. Even though the procedures are quite similar, and both can take the form of loop or end surgeries, they do vary in terms of the actual process. 

With a colostomy, it’s quite common for keyhole surgery to be used to access the colon and make the necessary alterations. Keyhole surgery is not used for ileostomy procedures. Instead, a large incision is usually made in the abdomen to access the ileum and pull it out to form the stoma.

Duration

It’s also worth noting that the duration of an ileostomy can vary compared to the duration of a typical colostomy procedure. An ileostomy procedure will usually take around two hours in total. Meanwhile, patients undergoing a colostomy operation may be in surgery for anywhere from two to four hours, on average.

Intention

Another big difference in terms of colostomy vs ileostomy is the purpose or intention of the procedure, as they can be used to treat slightly different conditions. 

Usually, a colostomy will be chosen as a treatment method for conditions including bowel cancer, anal cancer, cervical cancer, Crohn’s disease, diverticulitis, and Hirschsprung’s disease. It’s used when patients are struggling to pass stools via the anus

Ileostomies are different. They can also be used to treat conditions like bowel cancer and Crohn’s disease, but are also selected when patients are about to have surgery on a lower part of the digestive system, like the rectum or colon.

Risks and Side Effects

With any surgical procedure, there’s always a risk of side effects and complications. The potential side effects and complications that you might experience will vary depending on whether you’re undergoing an ileostomy or a colostomy.

Some of the most common side effects of ilostomy procedures include rectal discharge, headaches, loss of appetite, pouchitis, phantom rectum, diarrhea, stomach cramps, and dehydration, and there’s a high risk of obstruction.

With a colostomy, some of the common side effects that patients may experience include things like nausea, vomiting, cramps, diarrhea, skin problems, rectal discharge, stomal stricture, stomal leakage, stomal prolapse, and hernia.

Side Effects of an Ileostomy versus a Colostomy

Just like with any other kind of surgery, there is a risk of side effects and complications occurring when it comes to ileostomy and colostomy procedures. Here’s how the two procedures may vary in terms of their side effects:

• Ileostomy – Some of the possible side effects of an ileostomy include dehydration, rectal discharge, tiredness, feeling faint, headaches, tinnitus, and loss of appetite. Patients may also struggle with conditions like phantom rectum, pouchitis (the inflammation of an internal ileo-anal pouch), diarrhea, cramps, and stoma problems.
• Colostomy – Some of the side effects of a colostomy procedure may include stoma blockages, diarrhea, stomach cramps, nausea, and vomiting. It’s also possible that patients may experience a range of other side effects like skin problems, stoma prolapses, stomal stricture, leakage around the stoma, and stoma ischaemia.

Potential Risks of an Ileostomy versus a Colostomy

There are also some risks associated with ileostomy and colostomy procedures. Below, we’ll look at some of the main risks of each one:

• Ileostomy – One of the main risks with an ileostomy is obstruction. After surgery, the ileostomy may not work as intended, which can lead to cramps and nausea, and the patient may have to avoid solid foods to deal with this. There’s also a risk of dehydration for ileostomy patients, and they may also start to suffer from vitamin B12 deficiencies and related symptoms.
• Colostomy – One of the main complications or risks associated with a colostomy is rectal discharge. Some patients notice mucus discharge from the anus after undergoing this procedure, and it can recur every few weeks. Another risk is parastomal hernia, which is when the intestine actually pushes into the skin around the stoma area.

Life Expectancy of Ileostomy versus Colostomy Patients?

One of the questions that many people have before undergoing a colostomy or ileostomy is how it might affect their life expectancy. In general, a colostomy or ileostomy should not affect your life expectancy in a negative way. In fact, it can be a crucial treatment method for patients with various conditions, like Crohn’s disease and bowel cancer. 

Studies into the matter have suggested that there is no real impact or difference between life expectancies in colostomy or ileostomy patients. So this is not usually something that patients will need to worry about. Life expectancy will instead be influenced more by the health condition you have and how effective the treatment is at dealing with it.

FAQ

Why Might a Patient Need an Ileostomy or Colostomy?

There are many different reasons why a patient might require either an ileostomy or a colostomy. Usually, these procedures are carried out if the patient has some sort of digestive disorder, injury, or illness that makes it difficult to digest or excrete food normally. 

A colostomy may be used as a treatment method for the likes of bowel cancer, Crohn’s disease, diverticulitis, anal cancer, vaginal cancer, and Hirschsprung’s disease, among other conditions. It can be used for patients who are unable to pass stools through the anus.

An ileostomy, meanwhile, may also be used to treat conditions like Crohn’s disease, as well as different types of cancer. It can also be used for people with ulcerative colitis, or used for patients who are about to undergo surgery on the anus or rectum.

How Long Does an Ileostomy Operation Take?

Typically, an ileostomy procedure should take around two hours, on average. It may be completed sooner or could take longer, depending on various factors like the condition and age of the patient.

How Long Does a Colostomy Operation Take?

Typically, a colostomy procedure can take anywhere from two to four hours to complete. Complications that arise during surgery could cause the procedure to take longer.

Can You Have Both Colostomy and Ileostomy Surgery?

It is possible that a patient may need to have a colostomy and ileostomy at the same time, or undergo both procedures at different stages of their lives, depending on various factors like their health conditions and general digestive health.