Colostomy vs Ileostomy: Key Differences Explained

January 5, 2026

Colostomy vs ileostomy differences showing stoma location

Understanding the difference between Colostomy and Ileostomy is important for effective ostomy care, proper pouch selection, and skin protection.

Although both procedures involve creating a stoma to divert bowel output, they differ mainly in which part of the intestine is used, how the output behaves, and what daily care requires.

What's the Main Difference?

The key difference between Colostomy and Ileostomy lies in which section of the digestive system forms the stoma.

Colostomy

A colostomy is created from the large intestine (colon). Because the colon absorbs most water during digestion, output is usually thicker and more formed.

Ileostomy

An ileostomy is created from the small intestine (ileum). Since this bypasses the colon, output is more liquid and frequent.This difference directly affects pouch choice, skin protection, and daily management.

Location and How They Look

Where the stoma is placed on your belly usually tells you which type it is:

Colostomy: Usually sits on the left side of your abdomen. The stoma often looks a bit larger.

Ileostomy: Usually sits on the lower right side. Since the small intestine is narrower, this stoma is usually smaller.

Adult abdomen with an ostomy stoma and skin barrier wafer in place, hands on hips.

Understanding the Output

The type of waste (poo) determines which colostomy bag or Ileostomy bag you need to use.

Feature	Colostomy	Ileostomy
Output Type	Thick, formed, or semi-solid.	Liquid or paste-like.
Frequency	Less frequent; can be predictable.	More frequent and constant.
Enzymes	Lower levels.	High levels (can be harsh on skin).

Choosing the Right Bag

Picking the right pouching system is key to feeling comfortable and confident.

Colostomy bag: Designed for thicker output. Some people prefer closed bags that are changed once or twice daily, while others use drainable bags depending on output consistency. A well-fitted bag helps support a stable, comfortable wear experience.

Ileostomy bag: Typically drainable, as liquid output needs frequent emptying. A secure skin barrier helps protect the surrounding skin and reduce leakage risk caused by frequent output.

Quick Tips for Daily Care

1. Skin First: Always keep the skin around the stoma clean and dry. This helps protect against irritation.

2. Stay Hydrated: If you have an Ileostomy, your body doesn't soak up water as well as it used to. Drink plenty of fluids!

3. Check the Seal: A snug fit for your colostomy bag or Ileostomy bag is the best way to reduce leakage risk.

4. Eat Mindfully: For those with an Ileostomy, chewing food really well helps the small stoma work smoothly and supports a healing environment.

Takeaway

Living with Colostomy and Ileostomy might feel like a big change at first, but with the right colostomy bag or Ileostomy bag, most people get back to their favorite activities quickly.

If you ever notice skin redness or have trouble with leaks, don't hesitate to talk to your stoma nurse—they can help you find the perfect fit to help protect your skin and keep you feeling your best!