A descending colostomy is located on the lower left side of the abdomen. Reasons for placement may include descending colon cancer. The waste products may be firm and formed.

The most common type of colostomy is placed with the sigmoid colon as a single-barrel colostomy. This type of colostomy may be placed because of cancer, colitis, or other indications. The waste products are firm and formed. With the sigmoid colostomy, patients may be able to predict elimination at regular intervals and a cap (rather than a pouch) along with routine irrigation may be used with this type of colostomy. Irrigation may be helpful in dehydrated patients who will absorb some of the water from the irrigation process. In many cases, pouching systems are used that include routine draining, cleaning, and replacement of pouches.

There are several options and alternatives that may be explored prior to ostomy surgery. For instance, the placement of an ileoanal reservoir to allow the use of the anus is an option for some, but requires additional effort by the patient for care and to remain continent. Other procedures and products can be explored to find the right combination for each patient.