Ostomy-Friendly Bathrooms
Designs for Ostomy-Friendly Bathrooms
preparation
A colostomy is a surgical procedure
that creates a stoma,
an opening that allows waste to pass
from the colon through the abdominal wall
into an external prosthetic called a "pouch" or "ostomy bag".
A
colonoscopy
is entirely different!
It's an examination involving an endoscope,
a tube with camera and light inserted up the bottom end
of the digestive track to examine the interior
of the colon.
Colostomy
has to do with a stoma,
a hole.
Colonoscopy
has to do with looking,
as if through a periscope.
Around 100,000 ostomy surgeries are
performed each year in the U.S.,
where it's estimated that there are
between 725,000 and one million
ostomates,
or people living with an ostomy.
That's between one in every 300
and one in every 450 people.
Without public facilities that are equipped
for ostomate use,
they are largely confined to home and work.
A broadly accessible public toilet
needs space for an ostomate to
drain or perhaps replace an ostomy bag,
maintain and perhaps replace other components,
and clean up.
Living in the U.S., I had never seen this at home.
I became introduced to the concept,
and the fixtures,
on a trip to Japan in 2024.
Here's a typical toilet sign at Tokyo Haneda Airport.
The torso with "+" means that the facility is
ostomate-friendly.
What's Ostomy-Friendly?
Recommendations
The United Ostomy Associations of America or UOAA has a set of recommendations:
Accessible signage — the standard graphic of a figure with an ostomy or in writing: "ostomy friendly facility".
Hooks — to hang ostomy supply travel bags and personal belongings while emptying or changing ostomy pouches.
Shelf — providing a clean surface on which to lay out ostomy supplies.
Mirror — allowing ostomates to see their stoma while catheterizing or changing their pouch.
Sanitary receptacle — for used ostomy supplies.
Sink, soap dispenser, and paper towels — with warm water available.
I would add to that list:
Privacy — U.S. public restrooms are designed for just barely adequate privacy, or less. Stall door latches often don't work correctly, there are wide gaps between the wall panels and the door, and those walls only extend from about knee level to eye level.
Nanago Dori Park, Shibuya, Tokyo, Japan
TokyoToilet
Project
The Tokyo Toilet project commissioned seventeen modern public toilet designs from sixteen prominent architects. On a trip to Japan in May, 2024, I visited all of them. See that series of pages for details on all of them. Each of the seventeen locations included an ostomate-supporting space.
The locations generally had three spaces, often one for men, one of women, and one for people in wheelchairs, people changing baby diapers, and ostomates.
The less common combination was one for men with just two or three urinals and a sink, one for men or women with a toilet, and one friendly to ostomates, the wheelchair-bound, and others.
Going through the ostomate fixture pictures that I have for the locations in numerical order, we start with location #3, at Nanagō Dōri Park. Left to right is the sink, the toilet, and the ostomate fixture.
Notice that there's a large shelf above the ostomate fixture. The fixtures seemed to be standardized across the project, so this will show how the same ostomate fixture and toilet were used within a variety of designs around Shibuya.
All of these are marked as "used" with the blue border. I was drinking plenty of fluid to rehydrate, but even so, at many of these the use was limited to washing my hands.
Nishihara Itchome, Shibuya, Tokyo, Japan
Location #04 at Nishihara 1-chōme has a shelf at medium height beside the ostomy fixture, and the top of the ostomy unit, above its flush tank, provides further shelf space. The water control handle adjusts for flow and temperature through the faucet head. The black button above the toilet paper activates the flush mechamism for the ostomy unit.
Yoyogi Fukamachi Park, Shibuya, Tokyo, Japan
The international media fixated on the toilets at locations #08 and #09, where they are in glass enclosures. They're built with smart glass walls that become opaque when someone goes inside and locks the door.
The walls contain a liquid crystal film between two layers of glass. The liquid crystal layer turns transparent when a voltage is applied, as is the case when the door is unlatched. The glass is tinted, so the result is that one toilet might have walls that are transparent with a light green tint when no one is inside, and an opaque light green when someone has gone in and latched the door. The accessible-to-all toilet is a sort of light orange or peach color. The door isn't latched, it isn't even closed, so we can see into and through the toilet. Notice the wheelchair and ostomate symbols on the door.
If I go inside and just pull the door closed, not latching it, I have a light orange view of the park, and anyone out there would have a similar view of me.
But as soon as I turn the knob to latch the door, that removes the voltage that had been applied to the liquid crystal layer, and the glass all turns opaque.
The top of the ostomate fixture unit serves as a nice shelf. The conventional sink is to the left side.
Notice the soap dispenser — these designs do require regular maintenance and cleaning.
Well, sure, it's a public toilet, it's going to need ongoing attention. That isn't possible in the U.S., which seems to be an impoverished country.
Yoyogi Fukamachi Park, Shibuya, Tokyo, Japan
The toilets at location #12, Nabeshima Shoto Park, have a sort of old-timey-meets-future forest theme on the outside, and log sections inside. Here's the ostomy fixture, the sort of drop-in charger in which you can park a kid, and the toilet.
Again, a conventional faucet flow and temperature control, plus the flush button at upper left.
Ebisu Station, Shibuya, Tokyo, Japan
Location #15 at Ebisu Station places the ostomy fixture next to the toilet.
No, I did not go to Japan just to see the Tokyo Toilet project. But while I was there on a 4-week trip anyway, I thought that I should squeeze the 17 locations into the last two days.
Both Shibuya City and the individual architects were demonstrating the need for clean, safe, and fully accessible public toilets.
Of course all of the project's locations were useable by people in wheelchairs, people with stomas, and people with babies. But is this a general trend? In Japan, as it turns out, yes.
Tokyo Haneda Airport
I did my marathon Tokyo Toilet trek on my last two days there. The following day I packed up, took the train out to Haneda Airport, and checked in for a flight to the U.S. And look at the sign for the toilets near my gate.
Tokyo Toilet — Overview and Introduction
#1: Sasazuka Greenway
#2: Hatagaya
#3: Nanagō Dōri Park
#4: Nishihara 1-chōme Park
#5: Nishisandō
#6: Yoyogi Hachiman
#7: Haru No Ogawa Community Park
#8: Yoyogi Fukamachi Mini Park
#9: Urasando
#10: Jingūmae
#11: Jingū Dōri Park
#12: Nabeshima Shōtō Park
#13: Higashi Sanchome Park
#14: Ebisu Park
#15: Ebisu Station
#16: Ebisu East Park
#17: Hiroo East Park
Other Toilets in Japan:
στόμα or stoma is Greek for "mouth", which is the first opening as you pass through the human digestive system.