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Ileostomy for chronic constipation: a good idea or just asking for more trouble?
George Davis1, Keith Chapple1, Steven R Brown2
1Department of Colorectal Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Summary
For severe chronic constipation, a loop ileostomy (intestinal stoma) can be effective, though many patients require further surgery. Most patients do not regret this intervention for intractable constipation.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Chronic constipation unresponsive to conservative management affects a subset of patients.
- Surgical options are limited for intractable cases, with defunctioning stomas considered.
- Loop ileostomies have been used for severe, refractory constipation.
Purpose of the Study:
- To evaluate stoma-related complications in patients with chronic constipation.
- To assess patient regret after undergoing a loop ileostomy for intractable constipation.
- To determine the long-term outcomes and satisfaction with defunctioning stomas.
Main Methods:
- A 7-year retrospective review of patients with chronic constipation treated with loop ileostomy.
- Interviewing patients using the decision regret scale.
- Recording data on subsequent stoma-related surgeries.
Main Results:
- 37 female patients (median age 49) were analyzed with a median follow-up of 34 months.
- 49% reported no regret and 27% minimal regret regarding the ileostomy.
- 55% of patients underwent further operations related to the stoma, with some requiring up to five procedures.
Conclusions:
- A loop ileostomy may benefit a select group of patients with intractable constipation.
- Patients undergoing this procedure often require subsequent stoma-related surgery.
- Despite potential complications and need for reoperation, most patients do not regret the decision for a stoma.
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