Stoma classifications

There are three basic types of eliminating stomas:

Ileostomy: opening into the ileum (small intestine)

Colostomy: opening into the colon (large bowel)

Urostomy: opening into the urinary tract.

A fourth, but less common, eliminating stoma is that of a jejunostomy – an opening into the jejunum.

Different stoma types

1. Ileostomy: constructed mainly from terminal ileum. Usually sited in the right iliac fossa (RIF). Output is variable (loose/watery) but mostly a thick porridge consistency. Daily output is approximately 600–800 ml. An ileostomy is spouted, protruding 6–25 mm from the abdominal wall surface (Figure 18). A drainable bag is required. The bag is emptied 3–7 times in 24 hours. A low-fibre diet is recommended.

2. Colostomy: constructed from ascending, transverse, descending or sigmoid colon. Usually situated in the left iliac fossa. Output is thicker/more formed/contains less fluid. A colostomy is flush with the abdominal wall surface (Figure 18). A closed bag is required. The bag is changed 1–3 times in 24 hours. A high fibre, high fluid intake is usually recommended.

3. Urostomy/ileal conduit: constructed from 10–15 cm of ileum (implantation of the ureters into ileum). Usually situated in the RIF. With a fluid intake of 2–2.5 litres a day, 1.5–2 litre output is expected. A Urostomy is spouted (6–25 mm). The mucosal lining produces mucus on a daily basis. A bag with a tap outlet is required. The bag is emptied 3–7 times in 24 hours. (Night drainage system is also used.) A high fluid intake is advised (to reduce the risk of infection).