ABSTRACT
Patients with fecal incontinence are usually depressed and embarrassed. An abdominal colostomy may then be offered to the patient as a last alternative. A colostomy is well accepted by the patient since it reliably simplifies bowel care and prevents fecal incontinence, and clearly improves quality of life. The option of a colostomy with its pros and cons is explicitly mentioned, but it is also stressed that this should only be considered by them when all alternatives have failed and they are severely inconvenienced by their incontinence. It will be their initiative to start the discussion on a colostomy construction. Mere division of the bowel without resection leaves a rectosigmoideal stump at least 20 to 30 cm long. Since mucus production in the excluded bowel will persist and mucus retention is impossible due to the incontinence-causing impaired sphincter function, a continuous anal drainage of brown-greyish, foul-smelling mucus will occur, wetting and staining the underwear and irritating and eroding the perineal skin.
