Types of stoma and medical appliances

Ostomy is a surgical procedure of redirecting the intestine through an opening in the abdominal cavity (abdomen) in order to perform the excretion of stool or urine from the body. The opening is called a stoma, and the procedure is performed when you have a health condition that prevents you from emptying digested materials in a natural way. Here you can find out what the main types of stoma there are, as well as more about the types of ostomy systems and additional care products.

Main types of stoma

Some of the most common reasons for ostomy are Chron’s disease, ulcerative colitis, colorectal cancer and bladder cancer. The three main types of stoma are: colostomy, ileostomy and urostomy. Colostomy and ileostomy can be permanent and temporary, while urostomy is usually permanent.

Colostomy is an opening (usually) on the left lower side of the abdomen with a derived large intestine, the purpose of which is to allow the excretion of faeces. Surgical procedure removes the rectum or part of the intestine. In the case of colostomy, the stool that comes out of it is usually formed and regular.

Ileostomy is an opening with a small intestine on the right side of the abdominal cavity. In ileostomy, the diameter of the opening is usually slightly smaller than in colostomy. The content that goes through ileostomy is usually not regular and liquid.

Urostomy is an opening of the derived segment of the small or large intestine, most often performed on the front abdominal wall with the aim of extracting urine from the kidneys out of the body.

Ostomy systems

Ostomy appliances are divided into one-piece and two-piece systems. Since emptying trough the stoma is not within your control, both systems include a bag in which the stool or urine is emptied. A self-adhesive base plate with an opening in the centre, which is placed around the stoma, is also necessary for applying the ostomy bag.

In one-piece ostomy systems, the bag has an “integrated” self-adhesive base plate, and in two-piece systems the base plate comes separately.

The key difference is that one-piece systems are somewhat easier to use, while two-pieces allow changing the bag without removing the base plate. This makes a two-part system suitable for people who have to change the bag frequently. The base plate is changed once every 3-5 days.

Differences between ostomy bags

There are three main types of ostomy bags:

  • closed bags

  • bags with an outlet

  • bags with a drainage system.

Closed bags are replaced with a new one when they are about 1/3 to 1/2 are full. They are usually used if you have a colostomy.

Bags with an outlet are emptied through their opening when they are 1/3 to 1/2 are full. During emptying, they remain “connected” to the stoma, and you close them with a Velcro or some other mechanism. They are usually used by people with ileostomy.

Urostomy bags have a drainage system, which is opened when you need to release the accumulated urine from the bag. They are used exclusively by persons with a urostomy.

All three types of bags can be used as a one-piece or two-piece system.


For certain colostomies, one of the emptying options is also an irrigation system which rinses faeces with water directly from the stoma that is otherwise closed with a stoma zipper. In order to use the irrigation system, it is necessary to educate the user, consult a doctor or a stoma nurse, and establish an emptying routine.

Differences between base plates

The base plate is a hydrocolloid ostomy appliance. It has an opening in the centre, and it adheres to the skin around the stoma to hold the ostomy bag. In addition to standard base plates which are flat, there are also convex base plates intended for use on retracted stomas.

Another important division is between base plates with openings which were cut in advance (pre-cut) and the ones that can be cut right before use (cut-to-fit) using scissors to adapt the opening diameter and shape of the stoma. Cut-to-fit base plates are used in the weeks after the surgery when the stoma is gradually decreasing.

Ostomy accessories and additional care products

If you have a colostomy or ileostomy that are not overly active, you can also use a stoma zipper, which is suitable during intimate moments, sport activities or bathing.

In addition, the use of stoma systems often involves:

  • spray for easier removal of the base plate adhesive;

  • stoma barrier paste applied around the stoma to create a uniform surface for better base plate adhesion and to minimise the risk of leakage;

  • mouldable ring placed around the stoma if necessary (similarly to stoma barrier paste);

  • skin protection spray applied to peristomal skin (skin around the stoma) before using an ostomy pouching system;

  • stoma powder for peristomal skin care, absorbing moisture and reducing skin irritation;

  • elastic belt for additional fastening of two-piece ostomy systems, especially if you use a convex base plate.

How can you choose the most suitable appliance?

Given the differences between stoma types and their possible variations, you should choose the ostomy system according to your specific medical condition and needs. When making the choice, take into account your ostomy type, skin condition and lifestyle. Additional appliances and accessories for stoma care are also used according to your individual needs.



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