April 1969

Psychologic Response to ColectomyII. Adjustment to a Permanent Colostomy

Author Affiliations

New York
From the Department of Psychiatry, Columbia University, College of Physicians and Surgeons (Drs. Druss and O'Connor and Mrs. Stern) and the Presbyterian Hospital, New York (Drs. Druss and O'Connor.)

Arch Gen Psychiatry. 1969;20(4):419-427. doi:10.1001/archpsyc.1969.01740160035006

IN A PREVIOUS article1 we reported on an investigation of the adaptation patients make to a total colectomy and the resulting abdominal stoma. This group was composed of 41 patients with chronic ulcerative colitis who eventually required colectomy and a permanent ileostomy. The findings indicated that the overall state of health and function was excellent. Most patients felt that the ileostomy was preferable to living with severe ulcerative colitis: the operation was perceived as a relief, not as a burden. Manifestations of emotional problems were less evident than would be expected, due to freedom from the debility and diarrhea that had existed for many years. Half of the group, however, described problems with their ileostomy such as fear of "accidents," odor, "straining," or sexual difficulties. In order to understand these problems more fully, it was decided to study another group of patients with intestinal stomas: those with colostomies following surgery

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