CORRELATION BETWEEN ENTEROSTOMY AND MENTAL HEALTH: A NARRATIVE REVIEW
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6060Keywords:
Enterostomy, Colostomy, Ileostomy, Mental Health, Depression, Anxiety, Quality of LifeAbstract
Background: Enterostomy, including colostomy and ileostomy, is a common surgical intervention performed in patients with colorectal cancer, inflammatory bowel disease, traumatic injuries, and other gastrointestinal disorders. Although often life-saving, enterostomy is associated with profound physical, psychological, and social changes that may significantly affect mental health and overall quality of life.
Objectives: This narrative review aims to synthesize current evidence regarding the association between enterostomy and mental health outcomes, with particular emphasis on anxiety, depression, body image disturbance, psychosocial adaptation, stigma, quality of life, sexual functioning, and the effectiveness of supportive interventions.
Methods: A narrative review was conducted using twenty peer-reviewed studies published between 2013 and 2026, including systematic reviews, meta-analyses, randomized controlled trials, cohort studies, qualitative meta-syntheses, and cross-sectional investigations. The selected literature evaluated psychological outcomes among patients living with temporary or permanent enterostomies.
Results: The reviewed evidence consistently demonstrates a substantial association between enterostomy and adverse psychological outcomes. Anxiety and depression are highly prevalent among ostomy patients, with reported prevalence rates ranging from approximately 39% to 48%. Body image dissatisfaction, stigma, social isolation, sexual dysfunction, and reduced quality of life are frequently reported. Psychosocial adaptation is influenced by self-efficacy, social support, acceptance of disability, and stoma-related complications. Emerging evidence suggests that psychological preparation, prehabilitation programs, and innovative technologies reducing leakage-related anxiety may improve psychological outcomes and quality of life.
Conclusions: Enterostomy is strongly associated with multiple dimensions of psychological distress. Comprehensive multidisciplinary care integrating psychological support, patient education, rehabilitation, and long-term follow-up may improve adaptation and mental well-being. Future research should focus on longitudinal psychological outcomes and targeted mental health interventions for ostomy patients.
References
Kovoor, J. G., Jacobsen, J. H. W., Stretton, B., et al. (2023). Depression after stoma surgery: A systematic review and meta-analysis. BMC Psychiatry, 23, 352. https://doi.org/10.1186/s12888-023-04871-0
Farahani, M. A., Sargolzaei, M. S., Shariatpanahi, S., Dehkordi, A. H., Dalvand, P., & Heidari-Beni, F. (2022). The prevalence of anxiety and depression in patients with ostomy: A systematic review and meta-analysis. Psycho-Oncology, 31(12), 2020–2035. https://doi.org/10.1002/pon.5988
Vonk-Klaassen, S. M., de Vocht, H. M., den Ouden, M. E. M., et al. (2016). Ostomy-related problems and their impact on quality of life of colorectal cancer ostomates: A systematic review. Qual Life Res, 25, 125–133. https://doi.org/10.1007/s11136-015-1050-3
Díaz-Sánchez, C., Rodríguez-Muñoz, P. M., Navarro-López, V., Carmona-Torres, J. M., Sánchez-Gil, A., Sánchez-González, J. L., & Rivera-Picón, C. (2026). Impact of ostomy on quality of life in patients with colorectal cancer: A systematic review and meta-analysis. Healthcare (Basel, Switzerland), 14(4), 444. https://doi.org/10.3390/healthcare14040444
Yeniğűn Akbulut, S. C., & Ilgaz, A. (2026). Psychosocial effects and quality of life after stoma surgery: Systematic review and qualitative meta-synthesis. BMC Psychology, 14(1), 315. https://doi.org/10.1186/s40359-026-03993-w
Clark, M., Chur-Hansen, A., & Mikocka-Walus, A. (2023). Systematic review with meta-analysis: Current and emerging models of preoperative psychological preparation for individuals undergoing stoma surgery. Journal of Psychosomatic Research, 168, 111211. https://doi.org/10.1016/j.jpsychores.2023.111211
Koc, M. A., Akyol, C., Gokmen, D., Aydin, D., Erkek, A. B., & Kuzu, M. A. (2023). Effect of prehabilitation on stoma self-care, anxiety, depression, and quality of life in patients with stomas: A randomized controlled trial. Diseases of the Colon and Rectum, 66(1), 138–147. https://doi.org/10.1097/DCR.0000000000002275
Calman, L., Turner, J., Fenlon, D., Permyakova, N. V., Wheelwright, S., Patel, M., Din, A., Winter, J., Richardson, A., Smith, P. W. F., Foster, C., & members of the CREW Study Advisory Committee (2021). Prevalence and determinants of depression up to 5 years after colorectal cancer surgery: Results from the ColoREctal Wellbeing (CREW) study. Colorectal Disease: The Official Journal of the Association of Coloproctology of Great Britain and Ireland, 23(12), 3234–3250. https://doi.org/10.1111/codi.15949
Du, X., Wang, D., Du, H., Zou, Q., & Jin, Y. (2021). The correlation between intimate relationship, self-disclosure, and adaptability among colorectal cancer enterostomy patients. Medicine, 100(19), e25904. https://doi.org/10.1097/MD.0000000000025904
Sceats, L. A., Dehghan, M. S., Rumer, K. K., Trickey, A., Morris, A. M., & Kin, C. (2020). Surgery, stomas, and anxiety and depression in inflammatory bowel disease: A retrospective cohort analysis of privately insured patients. Colorectal Disease: The Official Journal of the Association of Coloproctology of Great Britain and Ireland, 22(5), 544–553. https://doi.org/10.1111/codi.14905
Xi, Z., Rong, C. M., Ling, L. J., Hua, Z. P., Rui, G., Fang, H. G., Long, W., Zhen, Z. H., & Hong, L. (2022). The influence of stigma and disability acceptance on psychosocial adaptation in patients with stoma: A multicenter cross-sectional study. Frontiers in Psychology, 13, 937374. https://doi.org/10.3389/fpsyg.2022.937374
Simpson, E., Pourshahidi, K., Davis, J., Slevin, M., Lawther, R., O'Connor, G., Porrett, T., Marley, J., & Gill, C. (2023). Living with and without an intestinal stoma: Factors that promote psychological well-being and self-care: A cross-sectional study. Nursing Open, 10(12), 7811–7825. https://doi.org/10.1002/nop2.2030
Goodman, W., Downing, A., Allsop, M., et al. (2022). Quality of life profiles and their association with clinical and demographic characteristics and physical activity in people with a stoma: A latent profile analysis. Qual Life Res, 31, 2435–2444. https://doi.org/10.1007/s11136-022-03102-5
Tang, W. S. W., Chiang, L. L. C., Kwang, K. W., & Zhang, M. W. B. (2022). Prevalence of depression and its potential contributing factors in patients with enterostomy: A meta-analytical review. Frontiers in Psychiatry, 13, 1001232. https://doi.org/10.3389/fpsyt.2022.1001232
Ayaz-Alkaya, S. (2019). Overview of psychosocial problems in individuals with stoma: A review of literature. International Wound Journal, 16(1), 243–249. https://doi.org/10.1111/iwj.13018
Bahayi, K., Attaallah, W., Yardımcı, S., Bulut, H., & Özten, E. (2018). Depression, anxiety, sexual dysfunction and quality of life in patients with ileostomy or colostomy. Turkish Journal of Colorectal Disease, 28(2), 69–75. https://doi.org/10.4274/tjcd.87369
Ambe, P. C., Brunckhorst, E., Hansen, H. D., Gotfredsen, J. L., Vestergaard, M., & Ajslev, T. A. (2023). Effect of a novel digital leakage notification system (Heylo) for ostomy care on quality of life and burden of living with an intestinal ostomy: The ASSISTER trial, a randomized controlled cross-over trial. Mayo Clinic Proceedings. Digital Health, 1(3), 438–449. https://doi.org/10.1016/j.mcpdig.2023.06.013
Makrygianni, P., Polikandrioti, M., Koutelekos, I., Tsiampouris, I., & Vasilopoulos, G. (2026). Anxiety and depression in patients with colorectal cancer undergoing ileostomy. Clinics and Practice, 16(1), 18. https://doi.org/10.3390/clinpract16010018
Phung, V. D., & Fang, S. Y. (2023). Body image issues in patients with colorectal cancer: A scoping review. Cancer Nursing, 46(3), 233–247. https://doi.org/10.1097/NCC.0000000000001085
Ang, S. G., Chen, H. C., Siah, R. J., He, H. G., & Klainin-Yobas, P. (2013). Stressors relating to patient psychological health following stoma surgery: An integrated literature review. Oncology Nursing Forum, 40(6), 587–594. https://doi.org/10.1188/13.ONF.587-594
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Copyright (c) 2026 Piotr Wites, Hubert Łagosz, Katarzyna Wites, Patryk Piotrowski , Alicja Włodarczyk , Aleksandra Jabłońska, Magdalena Pyzik, Kinga Ziółkowska, Karolina Markusiewicz , Piotr Bahyrycz
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