A stoma bag, also known as an ostomy pouch, is a prosthetic medical device that provides an alternative pathway for bodily waste (urine or stool) to leave the body after a surgical procedure involving the large intestine, small intestine, or urinary system. Stoma bags allow people without full intestinal or urinary function to avoid conventional defecation and urination. The type of output that goes into a stoma bag depends on the type of stoma/ostomy surgery performed.
Types of Ostomies
There are three main types of ostomies:
- Colostomy – Where the end of the colon (large intestine) is brought through the abdominal wall to form a stoma. A colostomy bag collects stool/feces waste.
- Ileostomy – Where the end of the small intestine (ileum) is brought through the abdominal wall to form a stoma. An ileostomy bag collects stool/feces waste.
- Urostomy – Where the ureters or urethra are diverted through an opening in the abdominal wall to form a stoma. A urostomy pouch collects urine waste.
What Goes in Each Type of Ostomy Bag
Colostomy and Ileostomy Bags
Both colostomy and ileostomy pouches collect fecal waste that comes from the digestive system. Stool and feces exit through the stoma into the pouch where it can be safely contained outside the body.
Urine does NOT go into colostomy or ileostomy bags. Only digested food waste and fecal matter should go into these ostomy bags.
Urostomy Bags
A urostomy pouch collects urine waste. With a urostomy, the ureters or urethra are diverted through an opening in the abdomen called a stoma to drain urine out of the body.
Urine goes directly from the ureters/urethra into the urostomy pouch. No stool or feces should go into a urostomy bag, only urine.
Why Urine and Feces Don’t Mix in Ostomy Pouches
There are a few key reasons why urine and feces do not drain together into the same ostomy pouch:
- Hygiene – Urine and feces contain different wastes and bacteria. Mixing the two could increase the chance of infection around the stoma site. Separate pouches keep things more hygienic.
- Skin protection – Urine can be irritating to skin. Keeping it isolated in a urostomy pouch protects the skin around the stoma.
- Convenience – Urine and stool may need to be emptied from the pouch at different frequencies. Separate pouches allow more convenience in managing output.
- Odor control – Isolating urine and feces helps control odor. Pouches can be specifically designed to contain urine or stool smells.
Can Urine Go in a Colostomy or Ileostomy Bag?
While it’s not recommended, it is anatomically possible for someone with both a urostomy and colostomy/ileostomy to have their urine go into the ostomy bag designed for fecal waste:
- Someone who has both an ileostomy and urostomy stoma could have their pouches close together, allowing urine to get into the ileostomy pouch. This is rare and can cause skin irritation and infection risk.
- In an emergency situation where a urostomy pouch is unavailable, a colostomy or ileostomy pouch could be used to collect urine. This would require frequently emptying the pouch to avoid skin contamination.
- If the openings of a urostomy and colostomy are very close, some mixing of urine and stool could occur inadvertently. The stomas should be separated as much as possible.
However, in general urine should always be diverted into a specialized urostomy pouch if one is available. Mixing urine and feces should be avoided for hygiene and skin protection.
Can Feces Go Into a Urostomy Bag?
While urine and feces should stay separated, it is also anatomically possible for some fecal matter to end up going into a urostomy pouch:
- If a person has both an ileostomy and urostomy placed close together, some cross-contamination of stool into the urostomy pouch could occur. This can increase infection risk.
- If a urostomy stoma is located lower down on the abdomen, feces could travel down and get into the pouch. Proper placement higher on the abdomen prevents this.
- In a surgical emergency, a urostomy bag could be used to temporarily collect both urine and stool, but this runs major infection risks.
In most cases, feces should not end up in a urostomy pouch. The stomas should be separated surgically and properly placed to keep waste streams fully independent.
Tips for Keeping Urine and Feces Separated
Here are some tips for people with ostomies to keep urine and fecal output cleanly separated into the proper pouches:
- Ensure stomas are surgically placed as far apart as possible on the abdomen.
- Always use the pouch designed specifically for your type of ostomy output.
- Check skin and sealing around stomas frequently to look for any leakage issues.
- Consult a WOC (Wound, Ostomy, Continence) nurse if you have any concerns about pouching systems.
- Empty pouches frequently to avoid accidental mixing of waste.
- Consider specialized ostomy wraps or belts to help separate stomas.
- Avoid colon irrigation or bladder flushes that could force cross-contamination.
When to Seek Medical Advice
You should seek medical advice in these situations related to urine/feces mixing with ostomies:
- Signs of skin irritation, infection or unusual odor around the stoma site
- Consistent leaking from the ostomy pouch seals
- Ongoing problems with waste contaminating the inappropriate pouch
- Discomfort, pain or bulging around the stoma
- Change in stoma appearance, swelling or retraction
- Any other concern with managing your stoma or ostomy pouches
Seeing a doctor promptly can help diagnose and treat any complications, and help get your ostomy management back on track.
Conclusion
In summary, urine should go into a urostomy pouch and feces should go into an ileostomy or colostomy pouch. Some inadvertent mixing of waste may rarely occur in certain circumstances, but separating urine and stool is best practice for ostomy hygiene and skin protection. Following proper pouching protocols, frequently emptying pouches, and consulting medical advice at the first sign of any complications can help maintain effective waste management with an ostomy.