While advances in stoma bags have made them easier to use and live with, you may still be interested in possible alternatives. These depend on your specific condition.

A colostomy bag (pouch) is a device used to collect stool after undergoing a colostomy. You may require one if you’ve had surgery for colon cancer, Crohn’s disease, or bowel obstruction.

The bag is attached to a stoma, a surgical opening in your abdomen that diverts stool away from your colon or rectum. Depending on the condition you’re getting a colostomy for, the stoma and the colostomy bag may be temporary or permanent.

Though colostomy bags are relatively common, the process may initially feel daunting. At the same time, stoma bags have evolved into several options for comfort and mobility.

Still, you may want to talk with a doctor about all your options, including the following possible alternatives to a colostomy bag. Keep in mind that these all depend on your condition.

Colostomy vs. ileostomy

Colostomy and ileostomy are surgeries that divert stool away from the colon or rectum. They also both involve creating a stoma, along with the use of collection bags for stool.

The key difference between colostomy and ileostomy is the point of diversion. With a colostomy, the colon (large intestine) is diverted to a stoma made in the abdomen. During an ileostomy, the ileum on the lower part of your small intestine is connected to the abdomen.

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A colectomy is the surgical removal of all or part of your colon. Doctors sometimes perform this instead of a colostomy. This may be necessary if your colon is diseased due to Crohn’s disease or another underlying condition but your rectum is still functional.

During a total colectomy, a surgeon attaches the ileum to your rectum rather than creating a stoma in the abdominal wall. In a partial colectomy, they connect the remaining parts of the colon. This bypass allows stool to pass through your anus instead of a pouching system.

Colostomy irrigation is an alternative to removing stool from your colon without wearing a colostomy bag. However, you may still need a stoma cap to protect your skin from irritation.

The process involves attaching a bag of water to your stoma to help rinse out the colon. This must be done daily and can take 45–60 minutes at a time.

While colostomy irrigation offers more control over stool removal without wearing a colostomy bag all day, this may not be the best alternative if you can’t complete the process at the same time each day.

Also, you may not be a candidate for colostomy irrigation if you have colon cancer, Crohn’s disease, or diverticulitis.

Doctors sometimes use a colostomy after surgery for rectal cancer. This may be temporary or permanent, depending on how much of your rectum has healed.

If the surgeon can spare the anal sphincter, you may not require a permanent colostomy. Also known as sphincter-sparing surgery, the procedure involves removing cancerous tumors individually rather than removing the anus entirely.

While one 2018 cohort study reported positive results of sphincter-sparing surgery in rectal cancers, the caveat is this procedure is most effective in treating ultra-low tumors only. You may also still need radiation and chemotherapy.

Unlike surgery for colorectal cancer, radiation and chemotherapy treatments don’t necessarily require a colostomy and subsequent bagging system. However, doctors may use these treatments to complement surgery, depending on the extent of the tumors involved.

Radiation for colorectal cancer involves using high-energy rays to destroy cancer cells. Doctors primarily use it to treat rectal cancer but may sometimes use it to treat colon cancers. Stool leakage (bowel incontinence) is one of many possible side effects.

Chemotherapy is a common colorectal cancer treatment that consists of drugs that kill cancer cells. Diarrhea is a common side effect, along with nausea, hair loss, and others you should consider discussing with a doctor.

If your colon problems are due to intestinal obstruction, you may consider asking a doctor about a colonic stent. Rather than diverting the colon to the abdominal wall to redirect stool, stenting involves using an implanted device to open up your colon.

One 2020 study on left-sided obstructive colon cancer suggests that the long-term outcomes were similar to colostomy. However, more research is needed.

A colostomy is an important — and sometimes lifesaving — procedure that involves redirecting stool from the colon through a stoma in the abdominal wall. This requires a colostomy bag to help collect stool.

Colostomy bags and pouching systems have come a long way in terms of discretion and comfort. However, in some cases, you might consider an alternative procedure if a colostomy isn’t right for you. Talk with a doctor about all the possible options.