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.
Possible side effects after stoma reversal
In a small percentage of patients it can take up to 6 months before the bowel motions become more firm. It is fairly common to pass looser and more frequent stools than you may have been used to previously.
After Surgery
Patients often start passing gas and stool through the rectum in 24 to 48 hours (one-two days), but sometimes it takes 72 hours (three days). By the third or fourth day after surgery, patients are often discharged from the hospital. The closure of the stoma in the belly is done with sutures (stitches).
Physical therapy. A doctor may recommend pelvic floor physical therapy. This therapy can help re-train the pelvic floor muscles to have a bowel movement. However, most surgeons will recommend waiting until at least 6 weeks after the ileostomy reversal surgery before beginning this therapy.
Three to six months after your reversal operation your bowels will probably have a more settled pattern. However, if you have had chemotherapy or radiotherapy before or after your reversal operation your bowels may take longer to settle than those who have not.
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.
Common problems following reversal surgery
You may experience loose motions or even constipation, a feeling of urgency, some discomfort/pain when passing motions, sore skin from the back passage, incomplete emptying, and some degree of incontinence for up to a few months following surgery.
If you're able to drink, warm water or peppermint tea may help with this pain. If the pain is severe and the medication isn't controlling it, you can ask the nurses for stronger painkillers. You should start to pass bowel movements a couple of days after the operation.
An ileostomy reversal is performed as an inpatient procedure in a hospital or medical facility. It requires the use of general anesthesia. It takes about an hour to complete. Do not eat or drink anything, including water, when you awaken unless you are directed to take medication by your surgeon.
Reversal of Hartmann's procedure takes about 1–3 hours, depending on how extensive the surgery needs to be. Stoma reversal is done under general anaesthesia, so you will be asleep and feel no pain.
It's common for children to have problems with how the bowel works after a stoma reversal surgery. Your child may have frequent bowel movements. Some children have symptoms such as constipation, loose stool, incontinence, sudden bowel urges, a skin rash, or pain.
Surgery can also affect your stress level2 and your medication routines. 3 These changes can lead to a different bathroom pattern. Usually, these changes resolve as you recover. For many people, bowel function returns to normal just after a few days or weeks, depending on the condition.
But new poop will now exit through your stoma. Most people will be able to feel their bowels move and know when poop is about to come out. But you won't be able to control it anymore. Unlike your anus, your stoma doesn't have a muscle system that allows you to close it at will.
Try to avoid spicy foods and fried foods and high fibre and highly seasoned dishes, just have plain cooked food and chew and eat slowly. After surgery you may be considering which food would suit your new life with a stoma. Avoiding high fibre, heavily seasoned, spicy and fried foods would be a good start.
It takes around 8 weeks to feel fully recovered from stoma surgery. You may also feel quite emotional and maybe a little bit overwhelmed. Having stoma surgery is a big change physically and emotionally.
Following stoma reversal, 110 patients developed an incisional hernia at the stoma incision site. The median time to hernia detection was 7 months. Eighty‐three (75·5 per cent) of the 110 hernias were detected within 12 months.
The bowel may take a little while to recover. Passing wind is a sign that your bowel is starting to work again. It is normal for the bowel to be irregular and sometimes is necessary to give medications to either slow the bowel down or give mild laxatives to encourage the bowel to move.
Skin irritation
This is the most frequently observed complication with all stoma types [2, 7, 12].
Our study population demonstrates 75.7% reversal rate, which is within this range. Of all defunctioning ileostomies in this study, 25% were never reversed and subsequently became permanent stomas.
Ensure you try and eat a sensible well balanced diet with fresh fruit and vegetables and drink plenty of fluids. After this surgery it may take a few weeks for your appetite to return. It is important to ensure you drink plenty of fluids but try taking regular, smaller portions of food.
A systematic review of 48 studies from 2009, including 6,107 patients, showed a 17.3% overall morbidity following the closure of loop ileostomy with a mortality rate of 0.4%. There was considerable range in morbidity (from 3 to 38.5%) and mortality (from 0 to 6.9%).
A change in output from your stoma could contribute to sore skin. If you experience loose stools, you may find it helpful to temporarily use a drainable bag or a high output bag to prevent frequent bag changes, which can result in sore skin.
After a stoma, the bottom part of the bowel no longer has poo passing through it, but it still produces mucus. Dead cells from the lower bowel or rectum may be mixed in with the mucus.