Colostomy - Colostomy reversal

If your colostomy is intended to be temporary, further surgery will be needed to reverse it at a later date.

The reversal operation will only be carried out when you're in good health and fully recovered from the effects of the colostomy formation operation. This will usually be at least 12 weeks or more after the initial surgery.

However, the reversal may need to be delayed for longer if you require further treatment such as chemotherapy, or haven't recovered from the original operation when the colostomy was formed. There's no time limit for having the stoma reversed and some people may live with their colostomy for several years before it's reversed.

In some cases, reversing a colostomy may not be recommended. For example, if the muscles that control your anus (sphincter muscles) were damaged after surgery, reversing the colostomy may cause bowel incontinence.

Reversing a loop colostomy is a relatively straightforward process. An incision is made around the stoma to allow the surgeon to gain access to the inside of your abdomen. The upper section of your colon is reattached to the remaining section of your colon.

It's also possible to reverse an end colostomy. However, the surgeon needs to make a larger incision to locate and reattach the two sections of the colon. Therefore, it takes longer to recover from this type of surgery and there's a greater risk of complications.

Recovering from colostomy reversal surgery

Most people are well enough to leave hospital 3-10 days after colostomy reversal surgery, depending on which colostomy procedure you had reversed.

It's likely to take some time before you resume normal bowel function and routine. Some people experience constipation or diarrhoea, although this normally resolves with time.

Some people may experience a sore anus after the reversal. This should improve as the anus becomes used to having stools pass through it again. It may help to thoroughly wash the skin around your anus with warm water after every bowel movement, then pat it dry with a soft cloth and apply a common barrier cream. Avoid baby wipes, talcum powder or scented toilet tissues, as these can cause further irritation.

Other possible problems include an increased frequency or urgency to go to the toilet, excessive flatulence and some bowel incontinence or leakage.

As your digestive system is often sensitive after a colostomy reversal, you may be recommended to avoid eating late at night. Avoiding large meals and eating little and often instead may also help. Certain foods are also more likely to irritate the gut, and it may be helpful to limit or avoid:

  • citrus fruits such as grapefruits and oranges
  • spicy food such as curries
  • large fatty meals
  • vegetables that increase flatulence such as cabbage and onions
  • large amounts of alcohol or fizzy drinks

The reversal operation is usually a smaller procedure than the initial colostomy procedure. However, it still takes several weeks to recover and return to normal activities.

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