Medical Q&As

Ileostomy - cause of depression?

Please help. I think Iím going mad! My partner underwent an operation in February to remove his entire large bowel and he was left with an ileostomy. He is due to have the ileostomy reversed in May. The thing is that he broke up with me recently. He maintains that he is still very much in love with me. Would there be a possibility that he is depressed? I'm at my wits end. Can you please help?

The term ileostomy refers to the creation of a stoma on the abdominal wall through which faecal material passes from the gut into a bag. It is similar in some respects to a colostomy. In the case of a colostomy part of the colon is removed and the remaining piece of colon empties through a stoma into a colostomy bag. In the case of an ileostomy the full extent of the colon is removed and the terminal end of the small intestine, which is known as the ileum, empties through a stoma into a bag. An ileostomy stoma is usually located on the right lower surface of the abdominal wall and is moist and red in colour. Output though an ileostomy tends to be quite liquid because of the absence of the colon, which normally extracts most of the moisture from the gut contents. People vary greatly in their responses to such surgery. Some cope with it extremely well whereas others can be quite distressed and can take a great deal of time to adjust. As a general rule those who have suffered from bowel disease over an extended period of time tend to respond better to the ileostomy procedure than those who have a shorter history of disease. In the case of the former the ileostomy at least represents relief from chronic symptoms that may have been very painful and debilitating. Those who suffer a severe acute episode requiring radical surgery have less time available to facilitate their adjustment to the disease and its implications. To address the specific point of your question; your partner has said that he still loves you and it is clear from the distress in your query that you still love him. I think that you would both benefit from talking this matter through. Perhaps your partner is shutting you out because he is concerned about the way his illness might impact on your life. Alternatively, the surgery might have affected his self-esteem and he has difficulties accepting that he has to continue with the ileostomy. He might well be depressed as you have suggested and he might require treatment for his depression. This matter needs to be discussed further between both of you and might require professional assistance from his specialist, GP or a counsellor.