Ileostomy for chronic constipation: a good idea or just asking for more trouble?
Abstract
Aim
A defunctioning stoma may be an option for a small group of patients with chronic constipation who have exhausted all forms of conservative management and remain symptomatic. We investigated this group in terms of stoma-related complications and whether they regretted the intervention.
Methods
Patients presenting to Sheffield Teaching Hospitals Pelvic Floor Unit over a 7-year period with chronic constipation unresponsive to conservative management and who had undergone a loop ileostomy for management were interviewed using the decision regret scale. Details about subsequent stoma-related surgery were recorded.
Results
Thirty-seven of 38 female patients identified (median age 49 years, range 24–86) completed the decision regret scale. Median follow-up was 34 months (range 7–74). About half (49%) had no regret and a further 27% had minimal regret about the decision for a stoma. Fifty-five per cent of patients had further operations related to the stoma, some undergoing up to five operations.
Conclusion
A small group of patients with intractable constipation may benefit from a loop ileostomy but are likely to need subsequent surgery to the stoma. Despite this most patients who have had a stoma do not regret the decision.
CONFLICT OF INTEREST
The authors confirm they have no conflict of interest.
