Life After a Colectomy: Getting a Colostomy Reversed

Colectomy is a procedure where a surgeon removes part or all of the colon (a section of the large intestine). You might get a colectomy if you have colon cancer or if treatment for your ulcerative colitis, Crohn's disease, diverticulitis or another condition affecting the colon isn’t working. Colectomy might also be necessary if you have a blocked colon or uncontrollable bleeding there.

People who have a colectomy might also need a colostomy. That’s when the surgeon creates an opening in the abdomen (called a stoma) and connects the colon through it to a bag or pouch as a way for waste to be eliminated from the body.

Can a colostomy be reversed? This article answers that important question.

Permanent and Temporary Colostomies

In some instances, a colostomy must be a permanent change. However, it can also be a temporary solution, either by intent or because of an improvement in the patient’s condition. In either case, a surgeon can perform a colostomy reversal, reconnecting the colon to the rectum to allow for normal waste elimination.

What Are the Requirements for Colostomy Reversal?

If a colostomy reversal is possible in your case, you need to meet certain criteria before the surgery can be performed. Those requirements include:

• You are fully healed from your colectomy. Typically, this takes around three months.
• There’s no disease, active infection or inflammation in your colon.
• You must have adequate continence, meaning your anal nerves and muscles are healthy and functional.
• You must be well enough to undergo surgery.

What Happens Before Your Colostomy Reversal?

Before you undergo a colostomy reversal, your doctor may order various tests to ensure you’re ready. These include an endoscopy (an imaging exam to check for signs of disease or obstruction), a gastrointestinal X-ray (to check for leakage) and a digital rectal exam to confirm you have anorectal muscle control. You will also get blood tests to assess your nutritional status and look for other health issues.

You may be required to fast overnight before your procedure and clean out your bowels with a laxative material. Your doctor will also have you avoid alcohol and tobacco, as they can adversely affect your recovery. You will be in the hospital for a few days after your procedure, so you should plan accordingly.

What Happens During and After Colostomy Reversal?

Your surgeon will detach your colon from your stoma and reattach it to your rectum. Then, they will close all incisions, including your stoma. Colostomy reversal is often done using a minimally invasive procedure, but some cases might require open abdominal surgery.

The procedure typically takes a few hours. However, it can take longer if the surgeon has to address issues like scar tissue or a hernia that has developed.

Following your surgery, it will take some time for the lower part of your digestive tract to begin functioning normally. Initially, you will be on a liquid diet before moving on to a soft diet. When you can eat, drink and poop with no problems, your doctor will release you from the hospital.

Potential risks from colostomy reversal can include pain, bloating and swelling. You might also experience diarrhea, constipation or the sensation of having to go frequently or urgently. Some people experience ongoing weakness in their anorectal muscles, leading to fecal incontinence and requiring physical therapy.

Talk With Your Doctor About Colectomy and Colostomy Reversal

You can learn more about colectomy surgery on our website. If you have questions about whether you’re a candidate for colostomy reversal or about the procedure, your doctor can answer them and provide more details on the process.

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