What are the differences in body image between patients with a conventional stoma compared with those who have had a conventional stoma followed by a continent pouch?

Abstract

This paper describes a qualitative study of seven patients which explored the perceptions of body image in patients with a conventional stoma, compared with those who have had a conventional stoma followed by a continent pouch. The operation of choice for patients with ulcerative colitis (the group of patients in the study) who wish to avoid permanent ileostomy is restorative proctocolectomy with ileal reservoir, more commonly known as the 'pouch' procedure. The outcome of this study, using a phenomonenological approach, reflects the problems faced by patients undergoing stoma surgery; that is, patients with a stoma, on the whole, expressed difficulties in coming to terms with an ostomy, with perceived negative feelings of body image. In contrast, patients with a continent pouch, provided they were not experiencing difficulties with the pouch, were of the opinion that such a procedure enhanced their lives over that of an ileostomy. However, in examining these patients' feelings, it was found that the majority still considered their experience traumatic. This implies that the benefits of a continent pouch were not so obvious, as body image changes of stoma surgery still had a perceived negative effect on the patients. This affected the outcome of the study so that the differences of the two groups of patients were not as significant as perceived by the writer.