Ileostomy for chronic constipation: a good idea or just asking for more trouble?

Colorectal Dis. 2021 Jun;23(6):1474-1479. doi: 10.1111/codi.15509. Epub 2021 Feb 9.

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.

Keywords: Constipation; decision regret scale; ileostomy; stoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colostomy
  • Conservative Treatment
  • Constipation / etiology
  • Constipation / surgery
  • Female
  • Humans
  • Ileostomy*
  • Middle Aged
  • Postoperative Complications
  • Surgical Stomas*
  • Young Adult