Stoma Reversal Surgery

What is a stoma reversal?

A stoma reversal operation involves surgically joining the piece of bowel back together, allowing the body to work as before. It’s performed after a stoma, also known as an ostomy, has been created to divert faeces from the body.

Most people have stoma reversal surgery once the condition that caused the patient to need a stoma in the first place has been resolved or improved. The operation restores normal bowel function so that waste can pass through the body naturally.

Before having stoma reversal surgery, you should discuss the risks and benefits with a doctor or stoma nurse.

Why is a stoma reversal important in restoring normal bowel function?

Stoma reversal restores normal bowel function by allowing the digestive system to work as intended after a stoma has been created to remove part of the intestine or colon, or allowing the bowel to heal.

Once the stoma has been reversed, the digestive system can function properly and the patient can return to a more normal diet and bowel habits. This not only improves physical health but also positively impacts their mental well-being.

Stoma reversal surgery may not be for everyone due to it not being surgically possible and some people do opt to remain with their stoma instead of having further surgery.

The stoma reversal procedure

The good news is that reversing a stoma is usually easier than creating one. But this depends on the type of ostomy and if there are complications. During surgery, the surgeon will:

• Carefully detach the stoma from your skin
• Reattach this part of your bowel to the lower part
• Close up any incisions, including the stoma opening.

The operation is performed under general anaesthesia, so you won’t be awake or feel anything. If possible, the surgeon will use keyhole surgery, but some conditions mean that open surgery is performed and an incision is made in the abdomen.

The different types of stoma reversal

There are two types of stoma reversals, each with its own considerations.

• The first type is reversal is of a loop stoma. This procedure is typically easier to reverse as the two ends of the bowel that made the stoma are reconnected.
• The second type is reversal of an end stoma. This procedure is more complex as the end of the stoma needs rejoining to the other part of the bowel that is inside the abdomen.

How long does a stoma reversal operation take?

Stoma reversal operations vary in time depending on how the bowel will be reconnected and any complications during surgery. Your surgeon can give you a more accurate estimate of the time it will take for your specific case.

You must follow all post-op instructions and attend all follow-up appointments for a smooth recovery.

Post-operative recovery

You’ll be kept in the hospital for a few days after the operation. This will give you the chance to start to recover. You may be placed on a liquid diet initially as it’ll take some time for your bowels to start working correctly.

Once your bowels start functioning, you’ll be on a soft diet. You should expect to be discharged from hospital once you can eat, drink and go to the toilet without complications.

Your healthcare team will monitor the healing process and go through any issues or concerns. These appointments are essential to ensure the stoma is healed correctly and that there are no further issues.

During these appointments, you’ll be told when to resume regular daily activities, such as exercise and work, to avoid strain or discomfort in the surgical area.

How do you feel after stoma reversal?

Most people report feeling relief, freedom and improved self-confidence after stoma reversal. They no longer have to worry about managing their stoma bag and can resume their normal daily activities without restrictions. The recovery process may vary for each person. After the surgery, discomfort and an adjustment period are expected.

The risk of bowel obstruction after stoma reversal surgery

Bowel obstruction is a severe complication that can occur. This happens when a blockage in the small or large intestine, causing a buildup of food, fluids and gas.

If left untreated, it can lead to severe pain, vomiting and even bowel perforation. The risk of bowel obstruction after stoma reversal surgery is higher in patients with a history of bowel disease, previous abdominal surgeries and those who have had a stoma for a longer period.

Patients must closely monitor their symptoms after surgery and seek medical attention immediately if they experience any signs of obstruction.

What are other potential complications after stoma reversal?

While stoma reversal is typically successful, short-term complications can happen. One of the most common complications is infection at the site of the stoma closure, which can be treated with antibiotics. Other potential complications include bleeding and leakage from the reconnected bowel and blockage of the intestine.

Long-term complications can include:

• Faecal incontinence
• Hernias
• Abdominal adhesions

These complications might require further surgery, medical intervention, or physical therapy tailored to your needs.

What can I eat after a stoma reversal?

Immediately after surgery, you’ll be on a liquid diet that will progress to a soft diet, such as mashed potatoes, cooked vegetables and lean proteins.

As your body adjusts, you can gradually introduce more fibrous foods like whole grains, fruits and vegetables. It is also important to stay hydrated and avoid spicy or greasy foods that may irritate the digestive system.

Is it normal to lose weight after stoma reversal?

Weight loss is common after a stoma reversal because dietary restrictions, often recommended after surgery, can reduce calorie intake. The bowel’s adjustment period may temporarily affect nutrient absorption and cause diarrhoea.

As post-surgical inflammation decreases, weight fluctuations may also become more noticeable. While mild weight loss is expected, significant or rapid changes, especially with symptoms like severe diarrhoea or abdominal pain, should be discussed with your doctor to rule out complications.

The role of the pelvic floor in stoma reversal and recovery

The pelvic floor is a group of muscles at the bottom of the pelvis that help support the abdominal organs and control bowel and bladder function. During the initial surgery to create the stoma, these muscles may be weakened or damaged, leading to potential issues with continence and pelvic floor dysfunction.

Therefore, patients undergoing stoma reversal should add pelvic floor exercises to their recovery regimen. These exercises can help strengthen the pelvic floor and improve muscle control, aiding recovery and promoting better bowel and bladder function.

How long does it take to have bowel movements after stoma reversal surgery?

The answer varies from person to person due to the healing process, but you should expect your first bowel movement in the days after surgery. This may be loose at first but will start to get firmer and more regular in the weeks following surgery once your body starts to heal.

How many stoma reversals are successful?

Stoma reversal success rates depend on various factors, such as:

• The type of stoma
• The patient’s overall health
• If there were complications during surgery

The success rate is generally high, with an average of 90% being successful, with most people resuming normal bowel function.