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Thread: elective colostomy vs ileostomy

  1. #1

    elective colostomy vs ileostomy

    I am considering getting a sigmoid colostomy to bypass my problematic rectum. I had a consult with a CR-Surgeon who recommended an ileostomy instead because she said some of her patients complain that a colostomy didnt help with their constipation troubles, and an ileostomy doesnt produce gas and "less messy"

    I think I would rather have the option of irrigation so i am going with a colostomy, but i am also wondering if an ileostomy would be better because I have decreased motility due to all the medications i take. I would still have to take miralax i assume.

    Based on my research, an ileostomy seems like a challenge because the bag has to be emptied more and the output is acidic.
    C3/4 Incomplete. Ependymoma tumor, syrinx from C to T.

  2. #2
    I just had an elective colostomy in January (LOVE IT). I can't advise from a medical stand point on which one you should get to bypass your issue but, most of the people I know with Ileo's hate how often they have to empty their bag. They also find intamacy a little more difficult as the output is a little less predictable during those times. I was very constipated pre colostomy but am finding that things are much smoother now. I haven't had to take anything to help me go since I became and ostomate. I take Devrom pills which has almost eliminated any gas and the smell of stool. I take 2 per day and never worry about expelling gas at an inappropriate time. I love the Devrom pills and don't know how people make it without them. Good luck to you.
    DFW TEXAS- T-10 since March 20th, 1994

  3. #3
    Thank you, i have looked through the archives on this forum and know there is a lot of info. But what you said about "unexpected" output has me sold more or less! I thought there were filters for the odors and gas?
    C3/4 Incomplete. Ependymoma tumor, syrinx from C to T.

  4. #4
    Had my colostomy done in April. Love it also. Should have done it 10 years ago. You will have so much more freedom. I change the bag once a day and done. From what I read the Ileo is much more watery, un predictably and more prone for leaks.

  5. #5
    Quote Originally Posted by seawalker View Post
    Thank you, i have looked through the archives on this forum and know there is a lot of info. But what you said about "unexpected" output has me sold more or less! I thought there were filters for the odors and gas?

    I use Convatec moldable wafers and attachable bag with filter. The filters do not last for very long and you end of having to burp your bag. I seriously have not burped my bag since I started using Devrom pills. NOT EVEN 1 TIME. When I change my bag or anything that has to do with my stoma it does not smell at all. If I eat a lot of eggs or fish then I will take 2 extra pills. No one who enters the restroom after me would ever know what I just did in there....LOL. I hope you love yours as much as I love mine. It is one of the greatest decisions I've ever made. Mine started out as a temp colostomy so that I could heal from flap surgery. I decided to keep it because it is so much easier and gives me so much peace of mind. The first 6 weeks or so were the worst (before I learned of Devrom). Terrible smell, terrible gas, and terrible stool. Visit the UOAA website for more information. It is one of the best forums with the greatest group of people ever.

    https://www.ostomy.org/forum/index.php
    DFW TEXAS- T-10 since March 20th, 1994

  6. #6
    I'm wondering if this would improve my quality of life.
    I've had major surgery with a bladder augment and Mithronoff.
    If I could rid a bowel routine from my life....oh....the freedom!!
    I guess I'm concerned about having a bag?
    I wore a foley for years.

    Does it get in the way of swimming, sex etc?
    Get involved in politics as if your life depended on it, because it does. -- Justin Dart

    I shall not tolerate ignorance or hate speech on this site.

  7. #7
    Quote Originally Posted by Liz321 View Post
    I'm wondering if this would improve my quality of life.
    I've had major surgery with a bladder augment and Mithronoff.
    If I could rid a bowel routine from my life....oh....the freedom!!
    I guess I'm concerned about having a bag?
    I wore a foley for years.

    Does it get in the way of swimming, sex etc?


    Hi Liz,
    Mine does not get in the way of swimming or sex. When I swim I just use water proof tape and put a picture frame around the wafer with tape. Sex is not a problem either. Just plan ahead as much as possible so that you don't eat a big meal right before. Go to the bathroom and make sure your bag is empty right before. I wear these really cute and sexy waist type lingerie that cover it nicely. They have special Ostomy lingerie websites that make bands for around the waist or crotchless panties. My husband is not bothered by my ostomy at all. He says that what's on my belly is the last thing on his mind during that time. I just plan ahead, just like we do with everything else in the life of a SCI. Planning meals around certain activities has been my only annoyance. I know others have had a harder time with getting a good fit with their appliance and sometimes get leaks. I've had mine since January and have been very blessed not to have that problem. I got a sample from my surgeon and tried it on a few days before the surgery and wore it around before I did it. You get used to it and don't even knows its there.
    DFW TEXAS- T-10 since March 20th, 1994

  8. #8
    Senior Member
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    @Seawalker - I have an illieostomy, and it was done because of bowel issues immediately post-sci. The stool is soft/liquid, and I have to empty the bag 2-3 times a day. Output is more frequent after eating, but I have to assume that there could be some pretty much 24/7.

    I seldom have any problems with leaking or odor. I use the same supplies OffroadersWife uses, and they work the best of others I have tried. I find using odor drops in the bags controls the odor just fine for me. But it does produce gas occasionally, and I certainly wouldn't consider a liquid/semi formed output "less messy", just different. You have to empty the bag either way unless you irrigate.

    (by the way, any output and "mess" is in the bag of course)

    I would think a colostomy would be far more appropriate if this is elective (I had no choice due to where the damage was).

    There is also the issue of less of the nutrients getting absorbed into your body, as everything leaves the body earlier.

    This isn't saying that an illieostomy is a bad thing, I would do it again in a heartbeat. Just that I think a colostomy would be better.

    @Liz - I second everything OffroadersWife said. In fact I was just discussing this with the nurse-practitioner at my doctors office today. The ONLY con I can see is the body image one. At my age, I am long past that, but I could see that it might be a problem for a teen or young adult.

    It is simpler, far less prone to accidents (and certainly easier to clean up if they do happen), and I don't think that anyone would notice that I had one if I didn't tell them (well, as long as my clothes are on, lol).
    T7-8 since Feb 2005

  9. #9
    anyone willing to post a pic?
    "We must become the change we want to see in the world." Gandhi

  10. #10
    Senior Member
    Join Date
    Mar 2006
    Location
    connecticut
    Posts
    8,272
    Hollister has some videos on their site, on how to use their products.

    http://www.hollister.com/us/ostomy/learning/theatre.asp

    It shows what the stoma looks like, and the bag.
    T7-8 since Feb 2005

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