Loop Ileostomy and Loop Colostomy: What a Loop Stoma Is and How Life With One Works

What is a loop stoma?

A loop stoma is made by lifting a loop of bowel up through a small opening in your belly and opening its front wall, so one stoma ends up with two openings joined together at the base.

One opening is the working side. It connects to the bowel coming from your stomach, and that is where output comes out into your pouch. The other opening is the resting side. It leads to the part of your bowel further down, which is taking a break. Because the bowel is not cut all the way through, the two openings sit right next to each other and usually look like one larger, oval stoma.

When the loop is made from the small bowel, it is a loop ileostomy. When it is made from the large bowel (the colon), it is a loop colostomy. The idea is the same; what changes is the kind of output and how often it comes. If you are still getting your head around the two types, our guide to ileostomy vs colostomy walks through them side by side, and types of ostomy puts every kind of stoma in one place.

Why surgeons choose a loop stoma

A loop stoma is usually a temporary stoma. It diverts output away from part of the bowel for a while, so that part can heal or rest. You may hear it called a diverting, defunctioning or protective loop ileostomy or colostomy. The most common reasons are:

• Protecting a new join. After part of the bowel is removed and the two ends are joined again, for example in surgery for bowel cancer or for diverticulitis, a loop stoma keeps output away from that join while it heals.
• Protecting a J-pouch. People who have their colon removed for ulcerative colitis or familial polyposis and get an internal J-pouch often have a temporary loop ileostomy first.
• Resting the bowel. Inflammation, an infection, a fistula or a blockage further down can settle while nothing passes through that section.
• A quicker operation. In an emergency, or when someone is too unwell for a bigger operation, a loop stoma can be made faster and is often easier to close later.

Most loop stomas are planned with a reversal in mind. Some stay longer than expected, and occasionally a loop stoma becomes permanent if closing it would not be safe or helpful. Your surgical team will talk you through the plan for your stoma.

Loop stoma vs end stoma: the differences that matter

An end stoma is made differently: the bowel is divided and one end is brought out, so there is a single opening. Here is how the two compare in everyday terms.

Loop ileostomy vs loop colostomy

A loop ileostomy usually produces loose, frequent output, from liquid to porridge-like, so drainable pouches and good hydration matter. A loop colostomy, often made from the transverse colon in the upper belly, tends to give softer, pasty output and can be larger, which is why it is the type most prone to prolapse. Daily routines for each are covered in living with an ileostomy and colostomy care at home.

What a loop stoma looks like and how it behaves

The rod in the first days

Some surgeons place a small plastic rod, sometimes called a bridge, under the loop for the first few days to support it while it settles. It sits across the stoma and is usually removed on the ward or by your stoma nurse, quickly and without much fuss. Your pouch fits over it in the meantime.

Swelling and size

Every new stoma is swollen at first, and a loop stoma can look surprisingly big. The swelling usually goes down over the first six to eight weeks, so measure your stoma regularly and adjust the opening in your barrier as it shrinks. A gap between stoma and barrier is a common reason for leaks and sore skin.

Mucus from your bottom

The resting part of your bowel still makes mucus, so with a loop stoma it is normal to feel the urge to go and to pass some mucus from your back passage now and then. Sitting on the toilet when you feel that urge usually clears it. Mention it to your stoma nurse if it becomes uncomfortable or changes a lot.

Output

Output comes from the working opening. With a loop ileostomy it can be frequent and watery in the early weeks; if your pouch fills very often or you feel dizzy and thirsty, read our guide to high-output ileostomy and call your team. With a loop colostomy, output usually becomes softer and more regular as you recover.

Pouching a loop stoma

A loop stoma is often wider than an end stoma, so the right barrier and a careful fit make the biggest difference. Your stoma nurse will help you choose, and pouch makers send free samples so you can compare.

1. Measure both openings

   Use the measuring guide to cover the whole stoma, both openings and the bit of bowel between them, not just the working side.

2. Cut or mould to fit

   Cut-to-fit or mouldable barriers suit oval loop stomas well. Aim for a snug fit with only a tiny gap around the edge.

3. Choose the right pouch

   Drainable pouches are usual with a loop ileostomy; with a loop colostomy your nurse may suggest drainable or closed, depending on output.

4. Empty early

   Empty the pouch when it is a third to half full, so its weight does not pull on the seal.

5. Fill the gaps

   Seal rings or paste can fill creases and uneven skin around a wide stoma. If one side sits low, ask about a convex barrier.

6. Re-measure as it shrinks

   Check the size every week or two in the first couple of months and update your template.

If leaks keep happening, our guide to an ostomy bag that keeps leaking goes through the usual causes, and the pouch change guide covers the routine step by step.

Daily life with a loop stoma: clothes, movement and sleep

Clothes that work with a wider stoma

A loop stoma often sits a little higher or wider than an end stoma, so the waistband is where most people notice it. High-waisted pieces that sit above the stoma, rather than across it, are the easy win. In the first weeks, while there is a rod or the area feels tender, soft joggers, dresses and loose tops are the most comfortable. After that, almost any outfit works again.

High-waisted ostomy underwear with an inner pocket holds the pouch flat against your body, and a soft ostomy wrap smooths the outline under fitted clothes. Both hold the weight of the pouch close, so there is less pull on the barrier as it fills.

Moving and lifting

Walking is usually encouraged from the first days after surgery, a little more each day. Your team will tell you when you can lift heavier things and start core exercises again; a physiotherapist can show you gentle exercises that support the area around your stoma. Our guide to exercise with a stoma covers the next steps when you are ready.

Sleep, work and intimacy

Most people sleep on their back or side with the pouch emptied before bed. Going back to work, travelling and being intimate are all possible with a loop stoma, temporary or not. If closeness is on your mind, our honest guide to stoma sex and intimacy covers the practical side.

Reversing a loop stoma

Closing a loop stoma, often called a reversal or takedown, reconnects the two sides of the loop so output goes through your bowel again and you no longer need a pouch.

• When

  Not before about six weeks, and often a few months after the first operation, once the part of the bowel that was resting has healed. It can be later, for example if you need chemotherapy first. There is no single right time; your team decides with you.

• Before

  Many teams check the healed join first, often with an X-ray using contrast or a camera test, and may examine your back passage.

• The operation

  Usually done through the stoma site itself, so it is often a smaller operation than the first one, followed by a short hospital stay.

• After

  Your bowel needs time to get used to working again. Frequent or urgent trips to the toilet are common at first and usually settle over weeks to months.

It is not always possible or advisable to reverse a stoma, and some people choose to keep theirs because life with it is good. Our guides to ileostomy reversal surgery and life after a stoma reversal explain what to expect.

Questions to ask your surgical team

A loop stoma comes with a plan, and knowing it makes the months ahead easier. These are worth asking:

• Is my stoma a loop ileostomy or a loop colostomy, and which opening is the working one?
• Is it meant to be temporary, and roughly when would a reversal be considered?
• What tests will I have before a reversal?
• How much fluid should I drink, and what are the signs of dehydration to watch for?
• When can I lift, drive, exercise and go back to work?
• Who do I call about leaks, sore skin or changes in my stoma?

Loop ileostomy and loop colostomy: your questions