Patients' views of a colostomy for fecal incontinence

Formation of a permanent stoma often is seen as a last resort when all other interventions for fecal incontinence have failed. However, no previous study has examined patients' views of a colostomy to manage fecal incontinence.

People who had a colostomy to manage fecal incontinence were recruited via an advertisement in the magazine of the British Colostomy Association or from those operated at a specialist colorectal hospital. Four questionnaires were sent, asking about the stoma, previous incontinence, anxiety and depression, and quality of life.

A total of 69 replies were received. Respondents were 11 males and 58 females with a median age of 64 years and a median of 59 months since the operation. Rating their ability to live with their stoma now on a scale of 0 to 10, the median response was 8 (range, 0-10). The majority (83 percent) felt that the stoma restricted their life "a little" or "not at all" (a significant improvement from perceived restriction from former incontinence, P = 0.008). Satisfaction with the stoma was a median of 9 on a scale of 0 to 10 (range, 0-10). Eighty-four percent would "probably" or "definitely" choose to have the stoma again. Quality of life (SF-36) was poor, but neither depression nor anxiety was a prominent feature.

The majority of previously incontinent people were positive about the stoma and the difference it had made to their life. However, a few had not adapted and disliked the stoma intensely. Health care professionals should discuss a stoma as an option with patients whose lives are restricted by fecal incontinence.