Even as long ago as the 1940s, surgeons conducting a review at the Cleveland Clinic (Jones and Kehm, 1946) could summarize the routine care of the permanent colostomy as usually quite satisfactory, stating that after patients recover from the initial worry prompted by the need for a colostomy, most of them learn to manage their colostomy quite well. "These patients come from all walks of life and carry on their daily work as usual. One patient stated that he could see no advantage of the normal anus over a colostomy. While this may be somewhat overstated, it is true that most people with a permanent colostomy can live a useful, happy life." They found that, just as in anyone else, dietary indiscretion was the usual factor in occasional bowel habit disruption. This historical experience has been borne out, as today the conclusion still stands that most patients can successfully manage a colostomy as part of their activities of daily living.