To help understand the ostomy market in the United States, let’s take a look at some statistics.

The United Ostomy Association (in 2010) reports that good statistics related to the number of ostomy surgeries performed, as well as the number of people living with ostomies, is difficult to estimate—but they do publish numbers. This difficulty is due, in part, to the reporting and coding mechanisms used to track medical procedures. The specific codes most providers use to bill for ostomy-related conditions and procedures vary, and many codes can be used for the same condition or procedure. For example, the ICD-9 codes 153-154 and 197.5 are for malignant neoplasm of large intestine and rectum. ICD-9 codes 520 through 579 are listed for diseases of the digestive system, and 580-629 describe diseases of the genitourinary system. Several DRGs could be used to bill for services provided to inpatients admitted for treatment of ostomy-related complications or new surgeries.[1] Tracking this is difficult because the coding systems are not always disease specific, and do not always indicate whether a surgery is temporary or permanent, or if the procedure is for a patient already in the system due to their being previously reported by a different provider. More recent electronic tracking mechanisms and proposed changes to existing coding systems should help to make tabulating numbers of patients a little easier.

Our best numbers show that about 120,000 surgeries are being performed annually,[2] and that 40% of those result in a temporary ostomy[3] (while the other 60% are considered permanent ostomies). The number of people in the US with an ostomy is reported to be between 500,000 and 1,000,000.[2][4] And of the three main forms of ostomies--colostomy, ileostomy and urostomy--data shows that the percent breakdown of surgeries by type is nearly equal among the three with colostomies at 36.1%, ileostomies at 32.2% and urostomies at 31.7%.

Reasons for the Creation of an Ostomy

An ostomy may be required if there is a disruption in the elimination of waste products through the gastrointestinal or urinary tract. Examples of conditions that lead to fecal diversions include colon and rectal cancer, inflammatory bowel diseases such as Ulcerative Colitis or Crohn’s Disease, or congenital anomalies such as Hirschsprung’s Disease. Infections, which on rare occasions may result in an ostomy, include diverticulitis with perforation and toxic megacolon associated with C. difficile infection. Examples of conditions which may result in a urinary diversion include bladder cancer and some anomalies present at birth. Traumatic injury which disrupts the continuity of the GI or GU tract (examples of which could be gun shot or stab wounds, or blunt force trauma), may necessitate the creation of an ostomy. Next, let’s briefly review gastrointestinal anatomy which is pertinent to caring for a patient with a fecal diversion.

1. Ostomy Statistics: The $64,000 Question. Volume: 49, Ostomy Wound Management. Available at: http://www.o-wm.com/article/1756. Accessed October 7, 2010.

2. The Oryx Group. Ostomy surgery in the United States. February 1997. Proprietary data on file. ConvaTec, a Bristol-Myers Squibb Company.

3. Stomal Complications: At What Price?. Volume: 49, Ostomy Wound Management. Available at: http://www.o-wm.com/article/1531. Accessed October 6, 2010.

4. Frost predicts steady growth for ostomy market. Home Care Monday. June 3,2002. Available at: http://june.homecaremonday.com/june_3_2002/index.htm. Accessed May 8, 2003.