Reasons for Ostomy: Common Medical Conditions Explained  

An ostomy, or a stoma, is a surgically created opening in the abdomen that is used to remove bodily waste. An ostomy can be a life-saving surgery. There are several reasons for ostomy. It can be needed due to cancer, inflammatory bowel disease (IBD), diverticulitis, birth defects, incontinence, and other medical conditions. In India, while the exact number is not available, ostomy surgeries are also becoming more common due to increasing rates of colorectal cancer, inflammatory bowel disease, trauma, and infections such as intestinal tuberculosis. Understanding the underlying causes can help patients and caregivers better navigate the journey of living with a stoma.

Ostomy reasons

The most common ostomy reasons are:

1. Colorectal cancer 

Colorectal cancer is a disease that affects the colon (large intestine) or rectum. It is one of the most common cancers worldwide and has one of the highest mortality rates. Risk factors for colorectal cancer include advancing age, family history of the disease and lifestyle factors.

2. Ulcerative colitis 

Ulcerative colitis is a chronic inflammatory disease that causes inflammation and ulcers in the colon (large intestine) and rectum. Young age (usually under 30) and family history are considered amongst the risk factors for the condition.

3. Crohn’s disease

Crohn’s is a type of inflammatory bowel disease (IBD) that causes irritation and swelling in the digestive tract. Crohn’s disease can occur in any part of the digestive tract, from the mouth to the anus , but most commonly occurs in the small intestine and the beginning of the large intestine.

4. Diverticulitis

Diverticulitis is a condition characterized by inflammation of the small pouches in the large intestine wall. Diverticulitis is believed to be more common among people over 50. Ostomy may be required for severe or frequent diverticulitis.

5. Abdominal, pelvic or perineal trauma

Abdominal, perineal or pelvic trauma, for example due to an accident, may result in urgent stoma surgery.

6. Spinal cord injury

Spinal cord injuries (SCI) are amongst common reasons for an ostomy. When a spinal cord is injured, the bowel system can lose the ability to communicate with the brain. In this case, a colostomy may be considered.

7. Intestinal Tuberculosis (TB)

In countries like India, intestinal tuberculosis (TB) can lead to strictures, perforations, or fistula formation in the bowel. In such cases, a temporary or permanent stoma may be needed as part of treatment.

8. Typhoid

In India, typhoid fever remains a leading cause of intestinal perforation, particularly in the distal ileum, often requiring emergency surgery. These perforations frequently occur in young adult males and are associated with poor nutritional status and delayed hospital presentation—factors that significantly increase morbidity and mortality.

Reasons for urostomy

A urostomy is a surgery that creates a stoma for the urinary system. It is performed when the bladder is damaged or removed. A urostomy is a permanent ostomy.

Some conditions which may require a urostomy include:

• Bladder cancer
• Severe kidney disease
• Chronic bladder inflammation
• Spinal cord injury
• Neurologic dysfunction
• Congenital anomaly (such as bladder exstrophy)
• Spina bifida

FAQ

1.What are common reasons that an ostomy is performed? What are common reasons for an ostomy bag?

Injuries and certain medical conditions, such as colorectal cancer or bowel cancer, IBD, diverticulitis, can lead to an ostomy. People with ostomies use ostomy bags to dispose of bodily waste.

2. Is stoma temporary?

An ostomy can be either temporary or permanent. Sometimes the bowel needs to recover from the damaging condition and a stoma is created temporarily. One can have it for several weeks to several months before the procedure is reversed. 

3.What are the most common reasons for colostomy?

A colostomy may be needed if one cannot pass stool through their anus. A colostomy is often performed in a situation when part of the colon has been removed. Some of the most common reasons for colostomy include colorectal cancer, diverticulitis, Crohn’s disease, cervical cancer and bowel incontinence. Read more about colostomy here. 

4. What are the most common reasons for ileostomy?

The most common reason for ileostomy is inflammatory bowel disease (specifically, ulcerative colitis and Crohn’s disease). Colorectal cancer, familial polyposis and trauma to the intestines can also lead to a stoma being necessary. Learn more about ileostomy. 

5.What is the most common reason for urostomy?

A urostomy can be performed in case of bladder removal or serious bladder damage due to trauma or disease. Conditions that can lead to a urostomy include bladder cancer, severe kidney disease or urinary incontinence . A urostomy might also be an option for people who suffered spinal cord injuries. Learn more about urostomy.  

Read about living with a stoma