Colorectal Cancer: Be informed if you are a candidate for an ostomy reversal 

 

By Joanna Burgess-Stocks, BSN, RN, CWOCN

 

  • Not everyone who has an ostomy as a result of colorectal cancer and other diseases will have the option of having their ostomy reversed.  Some people will need to keep their ostomy for life.

 

  • Your surgeon will determine when an ostomy will be reversed. There are many factors that determine a reversal such as the extent of the disease, a patient’s overall health and treatment process (radiation and chemotherapy).  Most patients with temporary ostomies will have the ostomy for about 3-6 months.

 

  • Surgery for reversal of an ostomy is usually much less involved than the surgery that you had to create the ostomy. So if you are feeling nervous, keep that in mind. A typical hospital course is 3-4 days on average.

 

  • For some patients, interrupting bowel function with a temporary ileostomy increases the chances that you will experience alterations in bowel function after reversal of your stoma. These symptoms can include rectal urgency, frequency, fragmentation of stool and incontinence. It is important that you notify your surgeon as soon as possible with these symptoms. Treatment includes behavioral strategies based on the symptoms and includes dietary modifications, incontinence products, skin care (use of barrier creams such as zinc oxide) and medications such as loperamide. More involved but helpful recommendations are pelvic muscle retraining (PMR) to regain sphincter strength and biofeedback. This therapy is done by a highly trained physical therapist.

 

  • Some physical therapists recommend PMR prior to surgery or radiation to assess muscles and teach strategies for ongoing muscle strengthening that can be carried over after surgery. This helps to address any coordination or existing weakness prior to radiation due to chemo or post-operative recovery. If PMR is recommended after surgery, it is best to wait at least 6 weeks and with the surgeon’s approval.

9 replies
  1. Sonia
    Sonia says:

    I have had a reversal done I. July and I am not having good results. Sometimes in the night I have to get up 8 times to go.sometimes whenever and wherever it happens. Very embarrassing. Thinking on getting back back. Just seem to be tied to home and can’t really plan outings

    Reply
    • Jan
      Jan says:

      I had my reversal done in July also. I find my diet, total food consumption and time last eaten directly affects how many times I am up at night. I stick with trying to eat no later than 7 pm. Much better if I eat around 5:30. I keep my diet on the low residue type meals when bowels movements are too much or rectal burning/soreness from wiping is just too much. I also take Loperamide at dinner when needed. You might want to try some of these. My nightly post normal dinner evacuations are down to 3 times. Oh. I try to eat a smaller meals at dinner and try to remember to consume food slowly.

      Reply
  2. Josh
    Josh says:

    Hello I too have had a reversal done just a little over a week ago. Here it is the 8th day and I think it’s going okay, however I have this awful bloating feeling all day long with episodes of continuous gas expelling. When I do expell the gas I feel better but how long could I honestly expect for this feeling to be present. As I move around the gas does expell. But I’m afraid to “fart”, not knowing if it’s air or poop. I’m thankful to have had the reversal done but it’s painful. Could I use a gas x type med ?

    Reply
  3. Deborah Smith
    Deborah Smith says:

    Had ostomy take down in November 2018 now I have 2 large lumps on each side of my stomach of incision.. Little concerned.

    Reply
  4. Sue
    Sue says:

    I had my large intestines removed because of Crohn’s disease. I’ve never had any sign of the disease any place other than my colin. It’s been about 4 years sine the surgery. In the past two tears I’ve had a terrible time with peristomal hernias and have multiple surgeries to try to fix them. It doesn’t last long. I’ve had 3 surgeries since October of last year so in 6 months. I wonder if it’s possible to have reversal surgery without a colin?

    Reply
    • UOAA
      UOAA says:

      Hi Sue,
      The post you’ve replied to is mainly about ostomies which are intended specifically to be temporary. Yours clearly wasn’t intended to be temporary. Two kinds of “reversal” may be possible for people without a colon, although neither is generally considered appropriate for people who’ve had Crohn’s disease. One possibility, if you still have your anus and anal sphincters, would be J-pouch (ileoanal reservoir) surgery. The other possibility is continent ileostomy (Kock pouch) surgery, which may include the “BCIR” variant of the Kock pouch. Both of these would require you to undergo further major surgery, and most doctors are very reluctant to do either of them on patients with a history of Crohn’s disease. Another surgical option you might consider, given your history of peristomal hernias, is not to “reverse” your ostomy, but just see if it can be relocated to the other side of your abdomen (assuming this hasn’t been tried already).

      Reply

Trackbacks & Pingbacks

  1. […] was fortunate to have a reversal three months later. I recovered quickly with no further health issues. I have a scar, but it […]

  2. […] reading a lot about ostomy reversals, and there’s an article this month from the UOAA, “Facts About Ostomy Reversals“. This article focuses on reversals after colorectal cancer, but the information applies to […]

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