A colostomy bag, also known as a stoma bag, is a small waterproof pouch worn over a surgically created opening on the abdomen called a stoma. It collects stool directly from the large intestine when the colon or rectum cannot function normally.
Colostomy bags are commonly used for:
Colorectal cancer
Inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
Diverticulitis
Bowel obstruction or injury
Birth defects
A colostomy can be temporary (to let the bowel heal) or permanent, depending on the medical condition.
How Does a Colostomy Bag Work?
Right after surgery, your stoma begins to pass stool through your abdomen. A skin barrier (wafer/baseplate) attaches to the skin to keep it protected and prevent leaks. The pouch then collects stool naturally throughout the day—no muscle control is required.
There are different pouching options:
Drainable vs. Closed-End Pouches
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Drainable pouches: Open at the bottom; ideal for soft or frequent output.
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Closed-end pouches: Thrown away when full; often used with formed stool.
One-Piece vs. Two-Piece Systems
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One-piece systems: The barrier and pouch are attached together; low profile under clothing.
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Two-piece systems: Pouch can be changed without removing the barrier; convenient for active lifestyles.
What Is Colostomy Surgery?
Colostomy surgery creates a stoma by bringing part of the colon through an opening on the belly. Stool then leaves the body through this opening instead of the anus.
A colostomy may be:
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Temporary, allowing the colon time to heal
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Permanent, when reconnection is not possible or safe
Preparing for a Colostomy
1. Talking with Your Care Team
Your surgeon and ostomy nurse will explain why the procedure is necessary and help you understand daily care, pouch options, and lifestyle changes.
2. Health Checks & Stoma Site Marking
Before surgery, you may have:
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Blood tests
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EKG
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Chest X-ray or abdominal imaging
An ostomy nurse will mark the best location for your stoma based on your body shape and how your clothes fit.
3. Day of Surgery
You may need to:
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Stop eating 6 hours before
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Drink only clear liquids
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Do a bowel cleanse
You’ll then receive anesthesia and be asleep during the procedure.
Recovery After Surgery
Most people stay in the hospital 3–7 days. Recovery includes:
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Gradually returning to normal food
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Gentle walking to reduce clot risk
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Learning how to change and empty your pouch
Types of Colostomy Surgery
Understanding the type of colostomy you have helps you plan your care.
1. Loop Colostomy
A loop of the colon is brought out to create one stoma with two openings (stool + mucus).
Often temporary, used when the bowel needs rest or in emergency cases.
2. End Colostomy
The cut end of the colon is brought out as the stoma.
May be temporary or permanent, especially after cancer surgery.
Location-Based Colostomies
These types depend on where the stoma is placed on the colon.
| Type | Location | Stool Consistency | Common Use | Notes |
|---|---|---|---|---|
| Ascending | Right abdomen | Liquid or pasty | Rare, usually temporary | Requires drainable pouch; protect skin carefully |
| Transverse | Upper-middle abdomen | Soft or paste-like | Often temporary | Odor & gas control important |
| Descending | Left abdomen | Semi-formed or solid | Often permanent | Output predictable; irrigation possible |
| Sigmoid | Lower-left abdomen | Solid, formed | Most common | Easier to manage; may use irrigation |
What’s Next: Living Well with a Colostomy
Understanding what a colostomy bag is and how it works is the first step. But daily life with a colostomy involves much more—what to eat, how to dress comfortably, staying active, traveling with confidence, and choosing the right pouching system for your lifestyle.
In Part 2, we’ll explore practical, real-life guidance to help you feel confident and prepared, including day-to-day care tips, lifestyle adjustments, and how to choose a colostomy bag that truly fits your needs.
👉 Continue to Part 2: Living with a Colostomy Bag—Daily Care, Lifestyle Tips, and Choosing the Right Pouch.
