Permanent stomas are just that — permanent. But a temporary ostomy can be closed (reversed) quite easily depending on the type of surgery. When the surgeon decides to reverse your surgery, (and that can vary from days to years and anytime frame in between), it's a good idea to take some simple steps so that the recovery time is faster and you can help potentially avoid other issues that may occur.
Ostomy Reversal Procedure
The reversal of a small bowel stoma is called an ileostomy, while a large bowel stoma reversal is called a colostomy.
You should discuss the whole ostomy reversal surgery with your surgeon well in advance. Generally speaking, a reversal can be a relatively simple surgical procedure for many people. It often does not always involve a large incision like that which was required to make the stoma.
For example, if a loop ileostomy was made and the surgeon was well aware of reversing in the future, the stoma is often simply closed by making an incision around the stoma, and gently pulling it up through the opening through which it was held, reconnecting (almost like rejoining two hose pipes), and then put back through the hole which is then closed with sutures (stitches). It generally leaves a much smaller scar than the one from the surgery required to make the stoma.
If the stoma is being reconnected and the other end is still inside — like some colostomies — a more involved procedure (surgery) may be required. How and what type of surgery is very specific to you, so always make sure you discuss the operation with your surgeon.
Prep for Colostomy Reversal
Check with your surgeon about the type of surgery and the preparation required. With a colostomy, many surgeons may have a preference for some form of bowel preparation to clean the bowel before operating. You may even be required to avoid solid foods prior to the surgery. Check what is required, if anything.
Generally with ileostomies, this is not required as the bowel can be pretty well cleaned out by fasting for 24 hours prior to surgery. If you have an ileostomy and someone prescribes a large amount of bowel preparation, it might be wise to question the need just to be sure.
You should also be prepared for a short hospital stay of a few days depending on the complexity of your procedure.
Ostomy Reversal Recovery Time
Sometimes after reversal surgery there can be a reasonable amount of diarrhea. It's a good idea to take in some wet wipes and some skin protecting cream to apply to your bottom — it can get sore very quickly if wiped too often!
Side effects after a reversal can include the potential lack of bowel control for the first few days or weeks afterwards. The type of surgery and the length of time you have had your stoma can impact how quickly you will readjust to going to the toilet without using a pouch!
When the bowel is disconnected from its usual route, sometimes it takes a while for things to return to 'normal'. Many find that there is a frequent need to go to the toilet or even a loss of continence after reversal.
Regaining 'normal' bowel movements may take days or weeks. The level of incontinence or leakage can also vary depending on several factors. Is there a new internal pouch made? Was the rectum removed? Was the ileum connected straight to the anus? How long did you have a stoma?
Months or even years after surgery, you could potentially experience a hernia as a side effect.
Returning to regularity in going to the toilet can be helped with a few techniques before you have your surgery. If you know you are having reversal surgery coming up, you should practice some specific exercises to help you have control afterwards.
Ostomy Reversal Exercises
Known as pelvic floor exercises, these muscle exercises, when practiced before reversal, can help you regain continence early afterwards. You can do them several times a day almost anywhere, often right in front of people without them even knowing!
To practice, first try going to the toilet to pass some urine — then try to stop it. Pay attention to the muscles you use when stopping the urine flow. Those are the same muscles you need to use after reversal to help with continence.
Once you know which muscles they are, try squeezing them several times a day to get them 'fit' so they know what to do after reversal. You can then do these muscle-squeezing exercises anywhere — on the bus, at the barber — anywhere.
Going to the toilet frequently after reversal is quite common. Broken skin on your bottom can be painful so be prepared early and apply a protective cream after surgery, and then reapply every time after you have been to the toilet. A wet wipe might also be gentler than using dry toilet paper.
There is one more thing to look for after reversal. Sometimes there may be some internal swelling where the stoma has been reconnected, which can cause a narrowing of the bowel. If you get unusual swelling of your abdomen or vomiting seek medical advice and follow up with your healthcare provider.
Of course the usual rules apply after surgery. Starting off with gentle exercise is good — nothing too strenuous — and avoid heavy lifting for a while. Everyone is different and so the experiences can be different. Make sure to discuss the whole procedure with both your surgeon and stoma care nurse before and after surgery to make sure you are getting the right information.
