Results of stoma formation for idiopathic megarectum and megacolon.

Bowel resection for idiopathic megarectum and megacolon does not always predictably relieve symptoms and has a significant morbidity. We have therefore evaluated the results of stoma formation in this condition. All patients had a bowel frequency of less than one per week, and all had a dilated rectum or colon. Eight patients, six of who had had a previous unsuccessful operation for their constipation, had a colostomy--this relieved the constipation and the need for laxatives in all six patients with rectosigmoid dilatation, although one patient could not tolerate his stoma. Two patients with dilatation of the whole colon were not helped. An ileostomy was formed in four patients with previous colonic resection, with relief of constipation in all. However pain and abdominal distension were common persistent symptoms in both groups. Four patients with a colostomy and all four patients with an ileostomy felt subjectively improved with a stoma. Stoma formation is a viable alternative to more major surgery, either as a primary procedure or after previous surgery has failed.