[Psychocomatic aspects in colectomized patients]

Patients who have undergone colectomy can be divided into two groups: 1. patients with mainly psychosomatic diseases (ulcerative colitis, ileitis terminalis Crohn) and 2. patients with mainly neoplastic diseases of the colon or rectum. The patients of the first group suffer from their symptoms for a longer time and often want to undergo an operation. Although they have considerable personality changes in a neurotic sense they tolerate the operation better than the patients of the second group. These are suddenly confronted with the fact that an operation is necessary. The physician is confronted with depressive reactions of the patients. A satisfying relationship between the patient and his doctor has to be regarded as the basis of the treatment. Additional psychopharmacotherapy, special psychotherapeutic training or/and self-help-groups, e.g. the International Ostomy Association (IOA), can then be considered.