Medication-related challenges in patients living with an ostomy: Insights from a national cross-sectional exploratory survey

Patients with an ostomy may experience altered drug absorption and efficacy due to gastrointestinal changes, potentially leading to medication-related safety risks. This study aimed to explore patient-reported experiences with oral medication therapy and to identify gaps for improved counseling.

A national cross-sectional exploratory online survey was conducted among adults (≥18 years) with an ileostomy or colostomy in Austria between June and October 2025. A study-specific questionnaire was developed based on literature review and expert input, addressing perceived medication effectiveness, observation of undigested dosage forms, and communication with healthcare professionals. Descriptive statistics, chi-square tests/ Fisher's exact test, and binary logistic regression analyses were performed.

Fifty participants provided information on ostomy type (58.0% ileostomy, 42.0% colostomy). Among respondents, 35.8% reported observing undigested tablets or capsules in their ostomy bag, with significantly higher rates in ileostomy patients (55.2%) compared with colostomy patients (14.3%; p = .003). Perceived changes in medication effectiveness were reported by 29.2% of participants, again with significantly higher prevalence among ileostomy patients (42.9% vs. 10.0%; p = .014). Only 24.5% of respondents had received professional counseling on potential medication-related changes after ostomy formation. Logistic regression analyses suggested that ostomy type (OR = 0.094, 95% CI: 0.017-0.527) and lack of professional information (OR = 0.083, 95% CI: 0.008-0.807) were associated with perceived medication-related problems.

A substantial proportion of ostomy patients experience medication-related problems, including undigested dosage forms and perceived changes in drug effectiveness. Ileostomy patients are particularly vulnerable. The findings indicate potential gaps in patient education and communication with healthcare professionals. Systematic medication review after ostomy formation, proactive counseling on high-risk dosage forms, and improved interprofessional collaboration may represent important strategies to enhance medication safety in this vulnerable population.