“…The willingness to re-engage socially after ostomy surgery is affected by anxiety and depression [12]. Anxiety and the diminished inclination to socialize are driven by the fear of 'being different', loss of self-confidence, uncertainty, frustration, helplessness [23], stigma or greater requirements for assistance with self-care [24,25]. Furthermore, body image disturbance [18,21,26,27] and the physical problems associated with an ostomy, including, flatus noise, pouch leakage, bleeding, peristomal skin complications and odour, all contribute to anxiety, social withdrawal and isolation [18,26,27].…”