Types of Stomas and adjuncts 

1. Types of Stomas 

A. Based on organ/diverted output 

Colostomy – diversion of the colon (large intestine) 
Purpose: Usually for faecal diversion in colorectal cancer, trauma, inflammatory bowel disease (IBD), or obstruction. 

Common types: 

End colostomy: One end of the colon brought to the surface; distal portion may be removed or closed. 
Loop colostomy: A loop of colon is brought out; temporary diversion. 
Double-barrel colostomy: Two separate stomas (proximal for faeces, distal for mucus). 
Ileostomy – diversion of the ileum (small intestine) 

Purpose: Often for ulcerative colitis, Crohn’s disease, or familial adenomatous polyposis. 

Types: 

End ileostomy 
Loop ileostomy 
Continent ileostomy (e.g., Kock pouch): Internal pouch with valve; patient drains via catheter. 
Urostomy – diversion of urine (usually after bladder removal) 

Common forms: 

Ileal conduit: Segment of ileum used to channel urine to the skin. 
Continent urostomy (e.g., Indiana pouch): Internal reservoir emptied with catheter. 
Cutaneous ureterostomy: Ureters directly to skin; less common. 

B. Based on permanence 

Temporary stoma: For diversion while distal bowel heals (e.g., post-surgery for obstruction or injury). 
Permanent stoma: For irreversible conditions (e.g., bladder removal, permanent colostomy after rectal cancer). 

C. Based on configuration 

End stoma: Single opening. 
Loop stoma: Loop brought out with a rod or bridge to prevent retraction. 
Double-barrel stoma: Two openings for different ends of bowel. 
Continent stoma: Internal pouch drained via catheter. 

2. Adjuncts / Accessories for Stoma Care 

These help protect skin, manage effluent, and improve quality of life. 

Pouches / Bags 

One-piece systems: Skin barrier and pouch are a single unit. 
Two-piece systems: Barrier and pouch are separate; easier pouch change. 
Drainable vs. closed-end: Drainable for ileostomies; closed-end often for colostomies. 

Skin barriers / wafers 
Protect peri-stomal skin from irritation or breakdown. 
Can be cut-to-fit or pre-cut. 
Hydrocolloid, silicone, or convex shapes for different stoma types. 

Seals / rings / pastes 
Fill skin creases, secure pouch, prevent leaks. 
Commonly used with irregular stoma shapes. 

Belts / adhesives 
Provide extra support to keep pouch in place. 
Useful for patients with stoma retraction or obesity. 

Caps / plugs 
For colostomy patients with formed stool who want occasional discretion. 
Can be used temporarily for short-term closure. 

Irrigation devices (for some colostomies) 
Allows patient to flush colon at set times, reducing need for pouch use. 

Catheters 
For continent urostomies or intermittent catheterization of ileal conduits. 

Odour or gas control products 
Filters built into pouches (e.g.; charcoal) or separate drops to reduce odour. 

3. Key Considerations 

Stoma location: Usually in the right or left lower abdomen depending on type. 
Output consistency: Ileostomies are more liquid → need more secure pouches. 
Skin protection: Essential to prevent dermatitis. 
Lifestyle impact: Accessories are selected to allow normal activity, sports, work, intimacy.