Chart — Gastrointestinal

Ostomy Comparison Chart

Side-by-side comparison of colostomy, ileostomy, and urostomy — anatomical source, output characteristics, skin care requirements, diet considerations, and key nursing priorities.

Educational use only. This content is intended for nursing students and exam preparation. Always involve a wound, ostomy, and continence (WOC) nurse for complex ostomy management. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.

Colostomy

Large intestine (colon)

LLQ • Formed/semi-formed stool

Ileostomy

Small intestine (ileum)

RLQ • Liquid output • Highest skin risk

Urostomy

Urinary diversion (ileal conduit)

RLQ • Urine output (not stool)

Feature	Colostomy	Ileostomy	Urostomy
Anatomical source	Large intestine (colon) — descending, sigmoid, transverse, or ascending	Small intestine (ileum) — distal ileum	Urinary diversion — ileal conduit diverts ureters to abdominal surface
Common indications	Colorectal cancer, diverticulitis with perforation (Hartmann's), volvulus, trauma, bowel obstruction	Ulcerative colitis (total proctocolectomy), Crohn's disease, FAP, loop ileostomy for bowel rest	Bladder cancer (cystectomy), neurogenic bladder, bladder exstrophy, radiation cystitis
Typical location	Left lower quadrant (LLQ) — for descending/sigmoid. Right side for transverse/ascending.	Right lower quadrant (RLQ) — standard. Stoma protrudes 2–3 cm (spout).	Right lower quadrant (RLQ) — protrudes 1–2 cm.
Output character	Formed to semi-formed stool (descending/sigmoid). Ascending colostomy = liquid/paste.	Liquid to porridge consistency — continuous drainage. High enzyme content.	Clear yellow urine. Mucous threads normal (from ileal segment). Continuous drainage.
Output amount	Descending/sigmoid: 1–2 formed stools/day. Ascending/transverse: 400–800 mL/day.	800–1200 mL/day initial; adapts to 500–800 mL/day. High output if >1000 mL/day.	~1–2 mL/kg/hr (normal urine output). No voluntary control.
Stoma appearance	Red/pink, moist, round, slightly raised — protrudes 1–2 cm	Red/pink, moist, protrudes 2–3 cm (spout prevents skin contact with enzymatic output)	Red/pink, moist, protrudes 1–2 cm. Mucous strands in output are normal.
Skin risk level	Moderate — alkaline stool causes breakdown if leakage occurs	HIGH — enzymatic liquid is highly corrosive to peristomal skin. Meticulous skin barrier essential.	Moderate — urine is acidic and irritating. Crystal formation (white deposits) common.
Pouch type	Drainable or closed-end pouch (closed-end for formed stool). Change every 3–7 days.	Two-piece or one-piece drainable system. Empty when 1/3–1/2 full. Change every 3–5 days.	Urinary pouch with drainage valve. Empty every 3–4 hours. Night drainage bag recommended.
Diet considerations	Generally normal diet. Note gas-producing foods (beans, broccoli, cabbage). Constipation risk.	Avoid high-fiber/blockage-risk foods (corn, nuts, dried fruit, popcorn, skins). Chew food well. High fluid intake.	Cranberry juice helps reduce crystal formation and maintain acid pH. Adequate fluid intake essential.
Primary complication	Peristomal hernia, prolapse, retraction, stenosis, parastomal infection	Peristomal skin breakdown from enzymatic output, dehydration/electrolyte imbalance from high output, food blockage	Urinary tract infection, crystal formation on stoma, stomal stenosis, anastomotic leak
Irrigation possible?	Yes — sigmoid/descending colostomy can be irrigated to regulate output (every 24–48 hrs). Not for transverse or right-sided.	No — output is liquid and continuous; irrigation is not appropriate	No — urinary diversion; irrigation not used for output management
Key NCLEX distinction	Formed stool, LLQ location, lower skin risk. Irrigation possible for sigmoid/descending type.	Liquid output, RLQ location, HIGHEST skin risk, dehydration/electrolyte risk, food blockage risk.	URINE output (not stool). Mucus in output is NORMAL. Crystal formation treated with dilute white vinegar.

When to Call the Provider — Any Ostomy Type

!Purple or black stoma — ischemia or necrosis (emergency)

!No output for >4–6 hours — possible obstruction

!Significant bleeding from stoma or output

!Stoma retraction below skin level or prolapse >5 cm

!Severe peristomal skin breakdown or infection signs

!Signs of dehydration (high ileostomy output) — dry mucous membranes, tachycardia, oliguria

Source: Wound, Ostomy and Continence Nurses Society (WOCN) Clinical Guidelines; ACG Colorectal Cancer Guidelines

Related Resources

Ostomy Basics ReferenceDetailed care guide: stoma assessment, skin care, patient education

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Lower GI Bleeding GuideColorectal cancer and diverticulosis — common ostomy indications

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GI Diagnostic ProceduresColonoscopy, EGD — pre-operative diagnostic workup

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Gastrointestinal AssessmentPhysical exam including stoma and abdominal assessment

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Standards & sources

Fact-checked Jun 21, 2026

This page is written to align with WOCN Society Clinical Guidelines; ACG Colorectal Cancer Guidelines. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →