Your Clear Guide to Ileostomies and Colostomies for IBD
Published: April 9, 2026
“Will I need an ostomy?”
This question can loom large for people with inflammatory bowel disease (IBD). And it’s no wonder. Ostomy surgery is a major step for anyone dealing with Crohn’s disease or ulcerative colitis.
For Kaylaa’ White, a 23-year-old Crohn’s & Colitis Foundation social media ambassador, an ostomy became part of her Crohn’s disease journey because of what she refers to as a “never-ending flare.”
“Surgery was a last resort, but I was fortunate to have extensive conversations with my wound care and colorectal team before we got to the decision point,” she said. “Before my ostomy, I was just surviving. Now I'm living.”
In this article, we’ll explain what an ostomy is and what it may mean for your health and daily life.
What is an ostomy?
An ostomy is a surgery that creates an opening in the abdomen. The surgeon pulls the end of the intestine through the opening, creating a "stoma." Waste leaves the body through the stoma and collects in a pouch (ostomy bag) that sits on the abdomen and is attached to the stoma. An ostomy can be temporary or permanent.
Your care team may recommend an ostomy to:
Allow diseased sections of your intestine to heal
Improve your quality of life
Relieve severe symptoms of IBD
Vitaliy Poylin, MD, a colorectal surgeon at Northwestern Medicine in Chicago and a Foundation Patient Education Committee advisor, explained that an ostomy is often part of a larger treatment plan. “A stoma is not a failure,” he said. “It is sometimes the safest way to help someone heal and move forward.”
The two primary ostomy types for people with IBD
The two main types of ostomies for people with IBD are ileostomies and colostomies. The name refers to which part of the intestine is affected.
Ileostomy basics
Ileostomies are more common than colostomies. With an ileostomy, the surgeon brings a portion of the ileum through the abdominal wall to form a stoma. The ileum is the last part of the small intestine.
Surgeons may recommend an ileostomy to move waste from your body when the colon (main part of the large intestine) or rectum has been removed or is not working. The stoma typically goes on the right side of the abdomen.
Because an ileostomy bypasses the colon, output is usually more liquid compared to output with a colostomy. You may need to empty the pouch more often.
Colostomy basics
With a colostomy, the surgeon brings part of the colon through the abdominal wall to form a stoma. The stoma is typically on the left side of the abdomen, but it can be on the right.
A colostomy may be appropriate when disease affects a specific part of the colon or rectum, and the remaining colon is healthy. Some people with Crohn’s disease may get a colostomy if the colon can still function well.
Output from a colostomy is often thicker than that from an ileostomy. The consistency depends on where the stoma is located along the colon. A colostomy placed farther along the colon usually produces more solid stool.
Temporary vs. permanent ostomies
An ostomy can be temporary or permanent, Dr. Poylin explained. “The first question patients ask is often whether they will need an ostomy for the rest of their lives,” Dr. Poylin said. “It depends on how severe the disease is, whether there’s infection or poor healing, and whether it’s safe to reconnect the bowel. Sometimes we use a temporary ostomy to let the body heal. Other times, a permanent ostomy is the safest and most reliable long-term option.”
Living with an ostomy
Learning stoma care takes time. Most patients work closely with ostomy nurses, who teach them how to change the pouch, protect their skin, and order supplies.
With support, most people return to work, school, travel, exercise, and social activities. You may need to make adjustments to diet and routines at first, but many people find they have more freedom once severe symptoms improve.
Kaylaa’ said her ileostomy changed her life for the better. “At the most basic level, everyone wants to be able to eat, sleep, and go to the bathroom. You can't begin to live life if you can't do those things. With my ostomy, I can do all of that and more.”
Her experience reflects how well-designed ostomy products can restore comfort and confidence in everyday life. Most ostomy products are built with air filters in them that use charcoal, which neutralizes potential odors. Unless the individual has an ostomy leak, you won’t be able to smell anything. Ostomies are designed to be hidden easily under most clothing if you choose. You can wear the same clothing you wore before your surgery with very few exceptions. To provide peace of mind and additional support, some people may wear special accessories to help keep the ostomy in place and prevent it from showing.
Support and resources
An ostomy is a major step in anyone’s treatment journey.
If you have questions, talk with your care team. You can also explore the Foundation’s Ostomy Support Resources webpage and can reach out to the Foundation’s IBD Help Center to speak with an information specialist.