Ostomy Types for Cystic Fibrosis

People with cystic fibrosis (CF) may experience intestinal blockages and intestinal dysmotility at any stage in their life. Dysmotility is when the intestines do not function correctly to move bowel movements through the intestinal tract.¹

Blockages and dysmotility are sometimes treated with surgery. A common surgery for these intestinal issues is called an ostomy. There are many different types of ostomies. Some of these are specific to adults. Some are specific to infants and children.¹

Types of ostomies

Ileostomy

An ileostomy is a surgery where the surgeon brings a piece of the ileum (part of the small intestine) to a stoma (a hole made in the skin through the abdomen). The stoma is part of your intestine. A pouch is inserted into the stoma to collect waste (stool). The stool from an ileostomy is usually liquid.^1,2

This surgery may be temporary (only for a short time) or permanent. Temporary ileostomies are usually done to give other parts of the intestines time to heal. Once your intestines are healed, your doctor can close the stoma and reattach your intestines. Permanent ileostomies are usually done when you have your colon removed.¹

Colostomy

A colostomy is a surgery where a surgeon brings a piece of the colon (a part of the large intestine) to a stoma (a hole made in the skin through the abdomen). The stoma is part of your colon. A pouch is inserted in the stoma to collect waste (stool). The stool from a colostomy is usually pink or red and wet.^2,3

A colostomy may be temporary (for a short time) or permanent. Temporary colostomies are sometimes done to give your colon or rectum time to heal. After you are done healing, your doctor can close the stoma and reattach your colon. Permanent colostomies are usually done when your lower colon and/or rectum has been removed.³

Types of ostomies in adults

There are 3 main types of permanent ileostomies for adults.⁴

Brooke or standard ileostomy

This is the most common type of ileostomy. It is usually placed in the lower right side of the abdomen (belly). You will always have to wear a collection pouch to collect waste. The collection pouch is worn outside of the body. This waste will contain digestive enzymes. These enzymes can cause skin irritation. You will need to use skin protection.⁴

Continent ileostomy

This may also be known as an abdominal pouch. The surgeon creates a pouch or pocket inside of the abdomen (belly) using a loop of intestine. There is still a stoma, but it is covered with a stoma cover. You do not wear a collection pouch outside the body. You would insert a tube called a catheter into the stoma to drain the pouch. This is done a few times a day.⁴

Ileo-anal reservoir

This may also be known as a J-Pouch or Pelvic Pouch. This is where a pouch is made inside the body from a loop of intestine. This loop is then attached to the anus. There is no need for a collection pouch outside the body. You would go to the bathroom normally, though the stool may be softer in texture. This ileostomy usually takes at least 2 surgeries to complete.⁴

Colostomies in adults

There are 3 main types of colostomies in adults.⁵

Transverse colostomy

There are a few types of transverse colostomies. Sometimes the colon (large intestine) is separated completely. Sometimes it is split open. There can be 1 or 2 stomas in a transverse colostomy. If there is 1 stoma, there are usually still 2 openings.

One opening, or stoma, will be pouched and produce stool. The other opening, or stoma, will produce mucus. You will have to wear a pouch at all times to collect the waste. The stool will be paste-like in texture. It will contain digestive enzymes which can cause skin irritation. You will need to use skin protection.⁵

Ascending colostomy

This is a fairly rare colostomy. It is placed close to where the colon (large intestine) starts. It requires you to wear a pouch all the time. The waste in an ascending colostomy is usually liquid. Most doctors prefer an ileostomy to an ascending colostomy.⁵

Descending and sigmoid colostomy

These are fairly common colostomies. They are usually placed on the lower-left side of the abdomen (belly). The sigmoid colostomy is usually a few inches lower than the sigmoid colostomy. You have to wear a pouch all the time with these colostomies. The waste tends to be firm because it has gone through most of the colon.⁵

Types of ostomies in infants and children

Infants and children may need ostomies because of a condition called meconium ileus. This is a bowel obstruction in newborns. About 80 to 90 percent of infants with meconium ileus have cystic fibrosis.⁶

Some infants and children may need ostomies because of a sudden intestinal blockage.⁶

Children may have the same colostomies as adults. If being treated for meconium ileus, there are 2 common types of ileostomies:⁷

• Bishop Koop
• T Tube

Both of these are temporary ileostomies. Infants with T Tube ileostomies may have spontaneous healing of their stomas. This means they may not need surgery to close their stoma. Bishop Koop ileostomies usually require surgery to close them.⁷

You should ask your healthcare team if you have questions about what type of ostomy you or your child has. Your healthcare team can tell you if your ostomy is temporary or permanent. If it is temporary, they can estimate how long you will need to have your ostomy. Your healthcare team can also help you learn how to care for your or your child’s ostomy type.

While ostomies may seem scary, many people have them. You may also want to join a support group for people with ostomies or parents of children with ostomies. This can help you better understand you or your child’s ostomy.