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Colostomy, ileostomy and urostomy: how the three stomas differ | CION Cancer Clinics
A colostomy comes from the large bowel, an ileostomy from the small bowel, and a urostomy carries urine after the bladder is removed. That difference decides what comes out, which bag you wear and what to watch for at home. This page compares the three side by side, explains how the surgeon chooses, and says what it cannot tell you about your own operation. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What is the difference between a colostomy, an ileostomy and a urostomy?
- How does each type of stoma work?
- Which bag and which watch-outs go with each?
- How does the surgeon decide which stoma you need?
- What do the words on the surgery notes mean?
- What do people get wrong about the three types?
- What can this page not tell you about your own stoma?
- Common questions about the types of stoma
The short answer
What is the difference between a colostomy, an ileostomy and a urostomy?
The difference is which part of the body the stoma comes from. A colostomy is made from the large bowel, an ileostomy from the small bowel, and a urostomy carries urine after the bladder has been removed or bypassed.
Why the source matters to you
Where the stoma comes from decides what comes out of it. Stool from the large bowel has had time to lose water, so it is thicker. Stool from the small bowel has not, so it is loose and comes more often. Urine flows almost all the time. That one fact shapes the bag you wear, how often you empty it, and what you need to watch for at home.
Why the name on your discharge sheet matters
The name of your stoma goes on your discharge summary and your supply prescription. If you ever go to a different hospital or chemist, saying "I have an ileostomy" gets you the right bag and the right advice far faster than "I have a bag". Ask your nurse to write the exact name down for you before you go home.
One by one
How does each type of stoma work?
All three look similar on the belly. What comes out of them is very different.
Colostomy
Made from the colon, the large bowel. It usually sits on the lower left side of the belly. It is often made after surgery for cancer in the lower bowel or back passage.
Output is usually
- Soft to formed stool
- Once or a few times a day
Ileostomy
Made from the ileum, the last part of the small bowel. It usually sits on the lower right side. It is often made to rest a new bowel join while it heals.
Output is usually
- Loose, like thick porridge
- Several times through the day
Urostomy
Made after bladder removal. The tubes from the kidneys are joined to a short piece of bowel, which opens on the belly, usually on the right.
Output is usually
- Urine, flowing most of the time
- Some mucus, which is normal
Not sure whether this applies to you?
Ask an oncologistSide by side
Which bag and which watch-outs go with each?
Stoma type
What it usually means for you
Colostomy
Often a closed bag, changed when full. Watch for hard stool and blockage.
Ileostomy
A drainable bag, emptied through the day. Watch for dehydration and sore skin.
Urostomy
A bag with a small tap, joined to a night bag. Watch for urine infection.
The decision
How does the surgeon decide which stoma you need?
The operation decides it, not a preference. The surgeon looks at where the cancer is, which part of the bowel or bladder has to be removed, and whether the remaining ends can be safely joined straight away.
Temporary or permanent
A temporary stoma protects a new join lower down while it heals. A loop ileostomy is the most common example, and it may be closed in a later operation. A permanent stoma is made when there is no lower bowel or bladder left to reconnect, or when joining it would not be safe.
Plans can change in theatre
Sometimes the surgeon only knows once the operation is under way. A join may look unsafe, or the cancer may be more extensive than the scans showed. That is why you may be marked for a stoma "just in case" and wake up without one, or the other way round. Ask before surgery how likely each outcome is for you.
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On your notes
What do the words on the surgery notes mean?
- End stoma
- One open end of bowel is brought out through the belly. Often, though not always, permanent.
- Loop stoma
- A loop of bowel is brought out and opened, so it has two openings side by side. Usually temporary.
- Ileal conduit
- The short piece of small bowel used to carry urine out in a urostomy.
- Reversal
- A later operation that closes a temporary stoma and reconnects the bowel.
- Spout
- The small raised lip of an ileostomy or urostomy, which keeps output away from the skin.
Commonly believed
What do people get wrong about the three types?
"All stoma bags are the same."
They are not. A closed colostomy bag used on an ileostomy fills and leaks quickly. A urostomy needs a tap and a non-return valve. Using the wrong kind causes leaks and sore skin, so always buy by the name your nurse gave you.
"An ileostomy is just a colostomy on the other side."
The side is only a clue. An ileostomy loses much more water and salt, so the person needs to drink more and watch for dizziness, dark urine and cramps, especially in hot weather.
"Mucus in the urostomy bag means infection."
The piece of bowel used to make a urostomy keeps making mucus, so white threads in the urine are expected. Fever, back pain, or cloudy and strong-smelling urine are what need a call to your team.
"A temporary stoma will definitely be reversed."
Most are planned for reversal, but it is not a promise. Healing, further treatment and general health all affect whether and when it happens. Ask what would need to be true first.
Being straight with you
What can this page not tell you about your own stoma?
It cannot tell you which stoma you will have. Only your surgeon can, and sometimes only after the operation. It also cannot tell you whether your stoma will be reversed, because that depends on how you heal.
Questions worth taking to the surgeon
Ask which type is planned and why. Ask whether it is meant to be temporary, and what the plan is if the operation changes. Ask who will mark the site before surgery, and who will teach you and your family to look after it. Bring the family member who will help at home.
Where to go next
Once you know your type, the rest of this guide gets more useful: what a healthy stoma looks like, how to change the first bag and which appliance suits you.
Questions we are asked
Common questions about the types of stoma
How do I know which type of stoma I have?
Check your discharge summary or operation note, where it is written by name. Position gives a hint: a colostomy usually sits on the left and an ileostomy or urostomy on the right. Output is the clearest sign. If you are still unsure, ask your surgical team rather than guessing, because it changes the bag you need.
Which type is easiest to live with?
There is no easiest type in general. Each has its own routine. A colostomy often needs fewer bag changes. An ileostomy needs more attention to fluids. A urostomy needs a night bag. The type is decided by your operation, and your nurse will teach the routine that goes with yours.
Can one type of stoma be changed into another later?
Occasionally, in a planned operation, but it is not common and it is not a choice made for convenience. It depends on how much bowel is left, the reason for the original stoma and your general health. If you have problems with your stoma, raise them with your surgeon, who can explain what is possible.
Why is the ileostomy output so watery?
The large bowel is where most water is taken back from stool. An ileostomy stops before the large bowel, so the stool comes out loose. Output often thickens a little as the body adapts over the weeks. Starchy foods such as rice, curd rice, banana and idli can help, but ask your team first.
Can I pass stool from my back passage with a stoma?
If the back passage and lower bowel are still in place, you may pass some mucus or old stool from it now and then. This is normal, especially with a loop stoma. If the back passage was removed, this will not happen. Tell your team about any bleeding or pain from below.
Does a urostomy mean I will have kidney problems?
Not necessarily. Your kidneys keep working as before, and the urostomy simply gives urine a new way out. Regular blood tests and scans are part of follow-up to check the kidneys. Drink plenty of water and report fever, back pain or a sudden drop in urine straight away.
Is a colostomy the same as a "colostomy bag"?
People use the words loosely. The colostomy is the opening on the belly. The bag is the appliance worn over it to collect stool. When you shop for supplies, you need both the stoma type and the product name, since each maker sells several bags for each type.
Does the type of stoma say how serious the cancer is?
No. The type reflects which organ was operated on and how it could be reconnected. It tells you nothing on its own about stage or outlook. Those come from your pathology report and your oncologist, who will explain them at your follow-up visit after surgery.
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Sources
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Living With a Stoma: The Complete GuideDaily life after surgery, for any type of stomaDehydration With a High-Output StomaThe main watch-out with an ileostomyOne-Piece vs Two-Piece AppliancesChoosing the bag system that suits your stomaStoma Reversal: What to ExpectIf your stoma is planned to be temporary
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