Stoma reversal surgery The procedure to reverse your stoma is usually technically less demanding than the original stoma surgery although this will depend on whether you have any complications such as a hernia, which can be repaired at the same time.
At 2-years, 76 (34.9%) patients had died with stoma, 42 (19.3%) were alive with stoma, and 100 (45.9%) had undergone stoma reversal. The survival of patients with and without reversal were 100% and 42.7% at 1-year, 96.0% and 35.0% at 2-years and 88.9% and 20.7% at 5-years, respectively.
Although a colostomy reversal is usually a smaller procedure than the initial colostomy operation, it still takes several weeks to recover and return to normal activities.
Reversal of Hartmann's procedure takes about 1–3 hours, depending on how extensive the surgery needs to be. Stoma reversal is done under general anaesthesia, so you will be asleep and feel no pain.
Many surgeries to undo a colostomy or ileostomy are fairly simple. But the closure is more difficult and the recovery longer if all or much of your colon is gone or not working. Reversal surgery may lead to problems such as: Temporary bowel paralysis.
Stoma reversal surgery has been reported to carry mortality rate of 0.4% to 5%7, 8, 9 and a morbidity rate of almost 50%.
You may need to drink a special fluid or take medicine to empty your bowels the day before your surgery. You may need to check into the hospital the night before your surgery. You may be given medicine or an enema to help empty your bowels. If you are not admitted, your surgeon will give instructions.
Ileostomy reversal surgery usually has a shorter recovery time than the surgery that created the ileostomy. However, a person may need to spend 3–4 days in the hospital. A person should be aware that it will take time after surgery for their usual bowel movements to return.
Irrigation is an alternative to wearing a colostomy appliance. It involves washing out your colon with water either every day or every other day.
Your healthcare professional will advise whether stoma reversal is possible. The outcome of reversal surgery depends on how much and which part of the bowel has been removed. If very little of the rectum remains, then it is likely that bowel control will be impaired.
It usually takes 6 to 8 weeks to recover from an ileostomy and get back to your usual activities. But you should avoid strenuous activities or heavy lifting for 3 months while your tummy muscles heal. It's important to rest and take the time you need to adjust to the change in your body.
Too much physical activity can increase the risk for hernias. Muscles around the stoma that support it are a bit weaker after surgery. Avoid lifting more than 8lbs., especially for the first six weeks after surgery. Ostomy support belts are highly recommended when lifting or using abdominal muscles.
The operation is performed under a general anaesthetic and usually takes about 90 minutes to 3 hours. Your surgeon will free up the end of your bowel inside your abdomen and the end used to make the colostomy. Your surgeon will join the two ends back together and place your bowel inside your abdominal cavity.
Dietary advice following reversal of ileostomy
At the start it may help to increase fibre only gradually by eating white bread rather than wholemeal, peeling and coring any fruit or vegetables, and having small portions of vegetables which are fibre-rich (spinach, cabbage, celery, onion, swede, beans, peas, tomato).
A colostomy reversal, also known as a colostomy takedown, is a reversal of the colostomy process by which the colon is reattached by anastomosis to the rectum or anus, providing for the reestablishment of flow of waste through the gastrointestinal tract.
Our study population demonstrates 75.7% reversal rate, which is within this range. Of all defunctioning ileostomies in this study, 25% were never reversed and subsequently became permanent stomas.
Try to avoid spicy foods and fried foods and high fibre and highly seasoned dishes, just have plain cooked food and chew and eat slowly. After surgery you may be considering which food would suit your new life with a stoma. Avoiding high fibre, heavily seasoned, spicy and fried foods would be a good start.
Three to six months after your reversal operation your bowels will probably have a more settled pattern. However, if you have had chemotherapy or radiotherapy before or after your reversal operation your bowels may take longer to settle than those who have not.
It's common for children to have problems with how the bowel works after a stoma reversal surgery. Your child may have frequent bowel movements. Some children have symptoms such as constipation, loose stool, incontinence, sudden bowel urges, a skin rash, or pain.
It's always a good idea to empty or change your stoma bag before you go to bed as it will help to prevent your bag from filling up too much overnight and disturbing your sleep. A full stoma bag is always at risk of leaking and that's not something you want to experience during the night.
If you're able to drink, warm water or peppermint tea may help with this pain. If the pain is severe and the medication isn't controlling it, you can ask the nurses for stronger painkillers. You should start to pass bowel movements a couple of days after the operation.
The surgery itself will last several hours. Upon awakening in recovery, a colostomy bag will be attached to the abdomen over a new stoma and there may be one or more drainage tubes. Once vital signs (pulse, blood pressure, respiration) are stable, it will be time to move to a hospital room.
Jerry Kramer
He was inducted into the Hall of Fame on August 4, 2018. During his career, Kamer had surgery due to a perforated intestine. After the procedure, Kramer had a colostomy bag while his intestines healed. He described the colostomy as “a horror movie that hasn't been made yet.”