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Quality of Life of the Ostomate

  • Meagan M. Costedio
  • James I. Merlino
Chapter

Abstract

Creation of an ostomy can have a detrimental effect on a patient’s quality of life leading to depression, social isolation, and body image issues. While construction of a well-sited, well-made stoma without complications is the basis of good function, perioperative education is an essential part of maximizing postoperative satisfaction. Perioperative education should start with a detailed assessment of all aspects of the patient’s life, a basic introduction to the structure and function of stomas, and a realistic description of how their life is likely to change. Preoperative marking and education by enterostomal therapists not only improves patient satisfaction and quality-of-life scores, but decreases hospital length of stay and stoma-related readmission rates.

Patients undergoing end colostomy for rectal or anal cancer and those with temporary stomas are two groups with particularly low postoperative quality-of-life scores. Some of these patients may be missing the preoperative planning sessions as the decision to create a stoma may be made intraoperatively. Not only do these groups warrant active preoperative education if the possibility of stoma creation exists, but they may benefit from support groups and enhanced postoperative care, despite the fact that their stoma is temporary.

Importantly, patients who are sick from a disease process, such as those with medically refractory ulcerative colitis, often have improvement in quality-of-life scores after surgery, with or without an ileostomy. In other words, removal of the severely symptomatic colon is more important than reconstruction.

The keys to maximizing the quality of life in patients with a stoma are good function, minimal complications, and sensitive support. Preoperative recognition of patients at high risk for problems can prevent some issues, while providing patients with reliable postoperative support can make the difference between living and just surviving.

Keywords

Familial Adenomatous Polyposis Permanent Stoma Permanent Colostomy Inflammatory Bowel Disease Questionnaire Ileoanal Pouch 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Colorectal Surgery, Digestive Disease InstituteCleveland Clinic FoundationClevelandUSA

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