Facts About Ostomy Reversals

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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.

26 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
      • jsjkubota
        jsjkubota says:

        Jan how are you doing now ? I’am 59 year old male that had my reversal in nov 2019. Its been rough . I have good days and bad I had a lot of complications. While I had my ostomy the doctor only had a 1/4 in to work with after he removed my rectum so that’s part of the problem. I sit in the bath room a lot. Sometimes I wish I still had the ostomy! I take Imodium multiple time a day so I can go outside are go off for a little while to the store. All the doctor says is it takes time I know that is true. For someone who likes to outside all the time its hard to deal with it.Until i found this website there is not much information out there my surgeon didn’t tell me about the recovery time all he said was it take time. Well I’am going to quit now I could go on for ever. Hope you are doing well !!!

        Reply
        • Jan
          Jan says:

          I think our recovery period is very similar. There seems to be very little info about life after the reversal. We are blessed to have the reversal but life is different. I too take Imodium daily and sometimes it works well and other times – not so much. It does get old to have to prepare for an outing or a shower. I have experienced weight gain from the low residue diet but transitioning intake of foods that I used to eat is sort of slow. This one seems to be a take one day at a time.

          Reply
    • Mimi
      Mimi says:

      Hi I had my ileostomy reversal about 10 days ago and my bowel issues seem to be so different than so many others I’ve read. Initially after coming home I too had frequent burning stools. Over the last 3 days only 1 bm. Is this normal for constipation post reversal? I was not prepared in any way for possible post op issues. So distressed.
      Thx for any support or suggestions.

      Reply
      • Sandra
        Sandra says:

        I have had the same issues as you. My refersal was done almost 3 months ago and I have been on a dose each day which I take in half doses.

        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
    • Nancy
      Nancy says:

      I had my ostomy reversal a month ago. I noticed a lump near the incision site a few days after the reversal. I had developed a hernia and had to have more surgery. This was a rare occurrence…1 in 25,000 cases per my surgeon. The hernia could have caused major complications if not corrected including another bowel blockage. I now feel better than I have felt in at least 2 years. A very very long hard road and I am so thankful it is behind me. I wish positive outcomes for all of you going through this.

      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
      • jerry cohen
        jerry cohen says:

        i read sue’s post and wanted others to have another perspective. hopefully encouraging to those facing illeostomy. i had illeostomy 13 years ago as a result of very serious ulcerative colitis and four years ago liver transplant. what i would like to convey is 2 months after illeostomy my life had no resemblance to pre illeostomy. conditions. in my case removing colon even positively affected my psc but eventually that caused transplant which brings me to today where i am exercising again and lead normal life. i hope this helps

        Reply
  5. Josh G
    Josh G says:

    Greetings all. I had my take down done last October 2018, it is now July of ‘19 and I must say things are good. It took several months to get back to a normal state of expelling waste. I must say that I do have to spend a lot of time in the bathroom from 530am to about 900am. Depending on my food intake I can go to the bathroom on an average of about 7 times a day. Yeah it seems like a lot but I also do not have a pancreas nor a spleen nor a gall bladder nor appendix. I had to have a total pancreatic auto islet cell transplantation with a pancreatectomy. So my digestive system is far different from many because I have to take an enzyme supplement called creon to help break down the foods. Depending on the amount of creon I take can adversely affect the outcome. Anyway I am more than pleased too be pain free and wel on my way to my next adventures. But not with out a five gallon bucket on a road trip just in case. Hang in there fellow ostomates it all comes around when your time is right.

    Reply
    • Catrick Howell
      Catrick Howell says:

      I also do not have a spleen or gallbladder. I’ve also had one kidney removed, uterus, cervix and one of my ovaries and fallopian tubes. I recently just had peristomal hernia surgery when I had my colostomy reversed along with my appendix removed. I am searching for answers because my nausea, vomiting and hernia like pain are debilitating at times and ongoing constantly. I also have a sharp objects protruding through my skin and it was open surgery that was supposed to take 3 hours but lasted 6. I’m baffled with what is wrong with me and what is going on with my body. I schedule an appointment with the surgeon but it’s a week away.

      Reply
  6. Sylvie
    Sylvie says:

    Hello, my reversal was done 4 months ago and since then I have been taking imodium almost everyday ( mostly when I need to go out of the house) and metamucil twice a day but I still manage to go 8-10 times a day. It has improved since the first months but I don’t see myself going back to work with this many times going to the bathroom especially when that takes up about 2 to 3 hours. I have also noticed that if I take imodium during the day well then I am up part of the night going to the bathroom so very tired the next day. Has anyone gone back to work with these conditions ?

    Reply
    • Hasmik
      Hasmik says:

      Yes ,I went to work after one month. I had my reversal 6 months ago/ was living with nightmare pouch one year 6 months And couple of days. By my personal experience just cut your food . My doctor told me that I must lost same weight(10pounts). I ate2 times a day. First one is morning at 10 am and second one is 5pm. My restroom attendance is starting 5 :45 pm or 8 pm. It could take 2hours or if I’m lucky just half hour.Just imagine that you are ballerina and must sit on diet forever. About Imodium -was taking it almost 4 months with Metamucil. Now I am not using it. But each month it is getting better.I just accept for myself that I m learning my body’s new behavior- my surgeon told me before so I was kind of ready…

      Reply
  7. Jim Cotter
    Jim Cotter says:

    I had my ileostomy reversal in mid July.Things are getting better but I make many trips to bathroom I have strained and whipped a lot so hoping the blood I see once in awhile is that and not my cancer returning. I am actually have my 6 month ct scan today from lar surgery fingers crossed.

    Reply

Trackbacks & Pingbacks

  1. […] to be permanent unless I developed problems down the road. In April of 2017 I was able to get it reversed (taken […]

  2. […] penulis mencatat bahwa sebagian besar operasi pembalikan ileostomi terencana terjadi 3-6 bulan setelah operasi awal seseorang, selama individu tersebut tidak mengalami komplikasi apa pun […]

  3. […] depending upon the physicality of the ostomy, a reversal in a matter of six months to a year is either discussed or promised to the patient. It is usually […]

  4. […] just discovered that her colostomy, which resulted from the loss of some of her colon, will not be reversed, as she had hoped. It is too dangerous, and her ulcerative colitis is rearing its ugly head. […]

  5. […] United Ostomy Associations of America: Facts About Ostomy Reversals (https://www.ostomy.org/facts-ostomy-reversals/) […]

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

  7. […] 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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