The Odyssey of an Ileostomy: A Journey of Challenges and Resilience

Abstract

Undergoing an ileostomy is a major life transition requiring medical, psychological, and social adjustment. This thesis examines the multifaceted experience of patients undergoing ileostomy formation and reversal, focusing on postoperative complications—particularly incisional hernia and renal impairment—and the often-overlooked psychosocial impact on patients and caregivers. Using Homer’s Odyssey as a framework, it explores resilience and adaptation throughout this journey.

A mixed-methods approach was employed. A retrospective cohort of 224 patients who underwent ileostomy reversal was analysed to identify predictors of complications, with emphasis on incisional hernia. A systematic review following PRISMA guidelines synthesised evidence on renal impairment after ileostomy in rectal cancer surgery. Qualitative data were obtained through structured interviews and validated instruments, including the Stoma Quality of Life (SQOL) questionnaire and Caregiver Burden Scale (CBS), to assess long-term psychosocial outcomes.

Results showed that while surgical outcomes have improved, significant complications persist. Incisional hernias occurred in 5% of cases, with obesity a major risk factor. Renal dysfunction, both acute and chronic, was linked to fluid imbalance, comorbidities, and chemotherapy. Patients often reported greater life satisfaction after ileostomy, though this came with increased caregiver demands, leading to moderate stress.

This thesis demonstrates that the ileostomy journey involves ongoing clinical risks and psychosocial consequences. Surgical advances have improved care, but hernias and renal complications remain, underscoring the need for better risk assessment, optimisation, and follow-up. The interdependence of patient outcomes and caregiver burden highlights the importance of multidisciplinary, patient-centred care and supportive policies. Like Homer’s Odyssey, the ileostomy journey is one of trial, resilience, and growth.