The Management of the Patient With the Permanent Colostomy

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“THE term colostomy, or artificial anus, is of ominous significance to the patient. However, it is interesting to follow the change in his attitude from doubt and depression, through increasing confidence, and finally to personal pride in his ability to manage the artificial opening. As he begins to realize that he can actually lead a normal life despite his handicap, depression is replaced by planning for the future.

Many physicians who refer patients ultimately requiring colostomy sec only a few such cases in the ordinary practice of medicine and as a result have little experience in its management. Since these same patients will return with many of their problems to the referring physician, we feel that our experience in dealing with such problems might well be described.

In the past 5 years we have had the opportunity to instruct and follow 500 patients with permanent colostomies.“1

Initial Contact

Most patients with carcinoma of the rectum are somewhat aware of their plight before they are seen at the Clinic. The referring physician has made a digital examination in most cases and referred the patient for biopsy and treatment. Information regarding the diagnosis may have been passed directly or inferred. In either case, the patient is worried and in great fear. Unfortunately, it seems that most of them have been acquainted with or know of some person who has had a palliative colostomy; therefore they have a preconceived idea of their future which may be unjustified.

As soon as the biopsy specimen. . .



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