What is a stoma reversal?
A stoma reversal is surgery to attach your bowel together after a colostomy or ileostomy (also called ostomies). During ostomy surgery, the bowel was separated and attached to an opening made in the skin of your belly. The opening is called a stoma. Stool passes through the stoma and out of your body.
Ostomy surgery can be permanent or temporary. It depends on the reason for the surgery. A stoma reversal can be done if there is a large enough section of healthy bowel left to be rejoined. A temporary ostomy may be used for certain health problems. These include problems such as bowel cancer, ulcerative colitis, Crohn's disease, and bowel injuries.
How is a stoma reversal done?
A stoma reversal is done after the original surgery has healed. This most often takes at least 6 to 8 weeks. But in some cases it can take up to 12 months. Your bowel and anal muscles need to be working for the reversal to work well.
The doctor rejoins the ends of the bowel that were separated. The bowel is stitched or stapled back together. The part of the belly where the stoma was is then closed with stitches.
How the stoma reversal is done depends on what type of ostomy surgery you had. One type involves making a large cut (incision). This way takes longer to heal. The other type uses smaller cuts. It doesn't take as long to heal.
What can you expect after a stoma reversal?
It's common to have problems with how the bowel works after a stoma reversal. This is because part of the bowel has been removed. You may have symptoms such as loose stool, incontinence, sudden bowel urges, and pain. Other risks include infection in the belly and blockage or scar tissue in the bowel.
You may have the same precautions you had after your ostomy. Your doctor will want you to avoid bending, heavy lifting, and other strenuous activities. Your doctor can tell you when it's okay to return to your activities and routines, such as driving. This may take up to several weeks or months.
Caring for yourself at home
Your doctor may recommend things you can do at home to help improve how your bowel works. You may be told to:
- Change your diet.
- Eat small, frequent meals.
- Drink plenty of fluids.
- Keep a food diary. You can use it to track what you eat and how it affects you.
As your bowel heals, you may work with a dietitian to know what foods are best. Your doctor may recommend walking or doing pelvic floor exercises. They may help improve your bowel function. You also may take medicines for diarrhea or use creams to help with soreness.
Coping with bowel problems
Dealing with bowel problems can be hard. Many people feel embarrassed or frustrated at times. But your care team can help. You can talk with your doctor or other members of your care team about these issues. They can help you seek support and learn ways to cope.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Current as of: June 6, 2022
Author: Healthwise Staff
Medical Review:E. Gregory Thompson MD - Internal Medicine & Adam Husney MD - Family Medicine & Kenneth Bark MD - General Surgery, Colon and Rectal Surgery