Pros and Cons of Colostomy Reversal: Recovery, Timing, Eligibility, and More | MyCrohnsAndColitisTeam (2024)

Pros and Cons of Colostomy Reversal: Recovery, Timing, Eligibility, and More | MyCrohnsAndColitisTeam (1)

If you’ve recently had a temporary colostomy, you may be struggling to decide whether to reverse it. Colostomies can be life-changing events for people living with inflammatory bowel diseases like Crohn’s disease or ulcerative colitis. However, many people choose to reverse their colostomy after their colon heals.

Keep reading to learn more about the pros and cons of colostomy reversal.

What Are Colostomies and Colostomy Reversals?

Colostomies are treatments for Crohn’s disease, ulcerative colitis, diverticulitis, and colon cancer. A colostomy is the surgical rerouting of the digestive tract to a new hole called a stoma. Living with a stoma is a major life change, and it can take time to adjust.

In some cases, a colostomy is permanent. Often, however, colostomies are temporary and can be reversed. Rerouting of the large intestine (colostomy) and small intestine (ileostomy) are referred to as ostomy reversals.

Pros and Cons of Colostomy Reversal: Recovery, Timing, Eligibility, and More | MyCrohnsAndColitisTeam (2)

There are two main kinds of ostomies and ostomy reversals. The more temporary type is a loop ostomy. A loop of your colon is pulled out and cut so that two ends stick out of your abdominal wall. Then, during the reversal, the two ends are reconnected with a procedure called anastomosis. The stoma is then closed.

During the more permanent end ostomy, only the top portion of your bowel is pulled out. The rest of the colon is removed (resection) or made into a pouch. End ostomies can also be reversed, but the surgery is more invasive and riskier.

Are You Eligible for a Colostomy Reversal?

Your surgeon will decide whether you’re eligible for an ostomy reversal before your ostomy surgery. Your eligibility depends on your condition, age, and treatment plan. Ostomy reversals can be very common. In one study, 80 percent of people under 50 with diverticulitis had their ostomy reversed.

Ostomy Reversal Timing

The timing of your ostomy reversal depends on how well your colon is healing. In most cases, you’ll be eligible after three to 12 months. If you’re unsure whether to keep your stoma, don’t feel rushed to decide. You can live with your loop ostomy for years before deciding to reverse it. At least one study shows better outcomes with earlier reversals, but this depends on certain risk factors. Your doctor will know what timing is best for you.

Eligibility

Before the ostomy removal surgery, your health care provider will want to make sure your colon and rectum are healed and working well, that there’s no infection or inflammation, and that you’re healthy. Your surgeons may require a:

  • Contrast fluid X-ray to check for leaks in your colon
  • Colonoscopy (a camera attached to a flexible tube inserted into your colon) to look for inflammation
  • Rectal exam to make sure your anal muscles work
  • Blood test to check your overall health

If you don’t pass an exam right away, you may need to wait longer for your reversal.

What Are the Disadvantages of Stoma Reversal?

Colostomy reversals are serious surgeries. A potential disadvantage is that recovery can be tough and take a long time.

Postsurgical Complications

As with any surgery, a colostomy reversal comes with the risk of serious complications. One possibility is an anastomotic leak where your colon was rejoined. If bacteria from the gastrointestinal tract leak into the bloodstream or the peritoneum, the tissue lining the abdominal wall, it can be serious. This leakage can lead to a life-threatening infection that spreads throughout the body. Tell your doctor immediately if you have a fever or pain. They’ll put you on antibiotics and may need to fix the leak with surgery.

Small bands of tissue called adhesions can form in the abdomen after any abdominal surgery. These adhesions can cause tissues to stick together and form a blockage. Adhesions are common and may be painless. But, if you have painful symptoms or a bowel blockage, you may need surgery.

Incisional hernias can also develop after colorectal surgery. They can form when a section of the colon pokes out through your closed stoma or another surgical opening. One study found incisional hernias developed in 15.7 percent of stomas after ostomy reversal. Sometimes, surgery to repair the hernia is needed.

Any surgery carries the risk of infection with the bacteria Clostridioides difficile (C. diff). People with a history of C. diff infections have a higher risk of wound infection and other complications after stoma reversal surgery. If you’ve ever had C. diff, talk with your doctor about the chances of it coming back

Other Recovery Challenges

You should expect to stay in the hospital for at least three to four days, but some people find that their hospital stay is shorter. One MyCrohnsAndColitisTeam member said, “Recovery was quick and uneventful — returned home in two days.” Another community member said they were “in the hospital for an entire week.” How long you stay in the hospital depends on the type of ostomy and whether you have any complications.

Even after returning home, it’ll likely be several weeks before you’re back to your normal self. There are steps you can take to help you recover more quickly.

Adjust Your Diet

You’ll want to adjust your diet as your colon heals. Start with a diet of soft foods. Eat small meals more frequently. Skip spicy, citrusy, fatty, and fizzy foods and drinks, because they may irritate your already sensitive bowel. As time goes on, you can slowly incorporate more foods. Make sure to track any changes in symptoms to see if a new food is irritating your digestive system.

Stay Hydrated

You’ll likely have irregular bowel movements. Drink plenty of water to help with constipation. Try not to consume anything that will increase the frequency of bowel movements if you have diarrhea, like caffeine or fatty foods. If your symptoms aren’t improving, talk to your doctor. They may prescribe a medication that can help with diarrhea, like loperamide (Imodium).

Keep Yourself Comfortable

You may experience discomfort in your anus. This is especially true if you have diarrhea. Clean with warm water and a soft cloth, and use creams like zinc oxide after pooping. Avoid anything that you find irritating, like scented wipes.

Try To Train Your Muscles

It may be difficult to control your bowel movements. Incontinence after a colostomy reversal is normal and nothing to be embarrassed about. You likely haven’t used those muscles in months or years, and they’ve gotten weaker over time.

If your bowel function isn’t improving, you can try pelvic muscle retraining (PMR). A trained physical therapist will take you through exercises to strengthen your sphincter (the muscles around your anus). PMR can also help with retraining the nerves around your anus to communicate to your brain that it’s time to go. Follow up with your surgeon about PMR to make sure that your body is ready.

Words of Advice

The decision to reverse your colostomy can be a difficult one. Many members of the MyCrohnsAndColitisTeam community have dealt with this decision before and can offer advice based on their experience.

Some members who have had a colostomy are thrilled with their quality of life after the procedure. They find they have more freedom with what they can eat, experience less cramping, and don’t have to run to the bathroom. One MyCrohnsAndColitisTeam member said, “I haven’t felt better than I do right now. Not sure I ever want the reversal. I am loving my life.”

Others find the stoma to be difficult to manage. They describe problems with adhesives, dumping the ostomy bag, and leaking and soreness of their stoma. Some of these problems improve over time, but it can be a big enough drain to lead people to want a reversal.

As one MyCrohnsAndColitisTeam member advised, “It’s a tough disease to cope with, both mentally as well as physically. I know getting the reversal will lessen both burdens for you.” Another community member said of their decision, “I had a colostomy and a reversal. I stayed in remission for quite a while, but flares do come back. I’m glad I had my reversal and wouldn’t change a thing.”

You and your doctor can decide whether a colostomy or reversal is right for you, so work with your health care team to evaluate which treatment plan might be best.

Talk With Others Who Understand

MyCrohnsAndColitisTeam is the social network for people with inflammatory bowel diseases and their loved ones. On MyCrohnsAndColitisTeam, more than 184,000 members come together to ask questions, give advice, and share their stories with others who understand life with ulcerative colitis or Crohn’s disease.

Have you chosen to have a colostomy reversal? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References

  1. Colostomy — Cleveland Clinic
  2. Ileostomy & Colostomy (Ostomy) Reversal — Cleveland Clinic
  3. Loop Colostomy — Cleveland Clinic
  4. Reversal: Colostomy — NHS
  5. Facts About Ostomy Reversals — United Ostomy Association of America Inc.
  6. Hartmann’s Colectomy and Reversal in Diverticulitis: A Population-Level Assessment — Diseases of the Colon and Rectum
  7. Association of Timing of Colostomy Reversal With Outcomes Following Hartmann Procedure for Diverticulitis — JAMA Surgery
  8. Management of Colorectal Anastomotic Leak — Clinics in Colon and Rectal Surgery
  9. Abdominal Adhesions — National Institute of Diabetes and Digestive and Kidney Diseases
  10. Incisional Hernia at the Site of Stoma Reversal — Incidence and Risk Factors in a Retrospective Observational Analysis — International Journal of Colorectal Disease
  11. A History of Clostridioides Difficile Infection Portends Infection Recurrence and Worse Outcomes After Stoma Reversal — Surgery

BROWSE KEYWORDS

Bowel Issues Remission Flare Management Surgery Indeterminate Colitis Crohn's Disease Ulcerative Colitis Member Interests Crohn's or colitis Journey Treatments Diagnosis View All

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Pros and Cons of Colostomy Reversal: Recovery, Timing, Eligibility, and More | MyCrohnsAndColitisTeam (2024)

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