Colostomy Reversal Success and Tips for Future Patients

Hello Ostomates:

(LONG POST AHEAD) I had my colostomy reversal surgery on February 21st and thought it would be helpful to share some of the details in case you have to prepare for similar procedures in the future. I added some “Lessons Learned” of what I'd do differently if I had to do it all again.

PREP: My surgery was scheduled for 7:30 AM on a Friday, and I had to be at the hospital by 5:30. Nothing to eat or drink after midnight the day of. So, I had to back up my bowel prep so that it would end on time. I was on clear liquids all day Thursday and did Sutab prep twice, ending at 10:30 PM. Unfortunately, I also had to take 2 different antibiotics on Thursday, and I had only liquid. So, I was very nauseous the remainder of the day and evening, continuing the next morning until surgery.

-I switched from closed pouches to drainable pouches Thursday morning, and once the Sutab started working, it went through pretty quickly, but I had no blowouts or explosions. I kept an eye on it.

-Lesson learned: I should have had some anti-nausea OTC med on hand that I could take with liquid; it may have helped.

SURGERY DETAILS: I had a robotic-assisted laparoscopic colostomy takedown. Surgery was a little over 2 hours. I have 6 new incisions. My surgeon reconnected the descending colon (where the stoma was) to the remainder of the sigmoid colon with (permanent) titanium staples! He joked that I may set off metal detectors now. To close the stoma site, there is a belly-button-like little crater secured by dissolving stitches in a cross-pattern underneath. It will eventually close up. It's seeping blood a bit, and I'll have to change the dressing daily for a month.

PAIN: The surgeon used nerve blocks, and I only used Tylenol for pain thereafter. I don't do well with narcotic pain meds and wanted to avoid anything that might cause constipation when I'm trying to get my GI system working again. I had 3 types of pain going on: residual skin pain from my ostomy skin barrier, surgery, and GAS! So much gas pain from the surgery. On day 3, I requested some simethicone (Gas-X or Phazyme) to at least break up some of the gas in my system and help with that pain.

-Lesson learned: Request simethicone from the beginning!

RECOVERY IN THE HOSPITAL: I was in the hospital for 4 days. On Friday evening, they started me on a clear liquid diet. Saturday morning breakfast and lunch was full liquid, and then low residue for dinner. At 3 AM on Sunday, I started passing the required gas (yay) and then shortly after passed a lot of clots and mucus (to be expected). Pretty explosive and lots of gas. Sunday evening, I had a more formed stool and bowel movement, and 3 more Monday morning. Cleared for discharge!

RECOVERY AT HOME: My bowel function is still a little unpredictable. I had little to no activity the day after (except mucus and gas), but then the next day, the BMs started at 2 in the morning and continued to 10 at night. Lots of gas and explosive movements. The day after that, just mucus again. It will take a while to get into a more normal routine. In the meantime, I'm prepared with incontinence wear (just in case) and staying near the bathroom. I've been taking my probiotics and normal supplements again, so it will take some time to heal my gut. Still using Tylenol but only at night, along with warm compresses on the tender incision sites.

-Lesson learned: Stock up on incontinence wear and wound supplies (gauze, paper tape) ahead of time. The hospital gave me some of both, but not a great fit and I had to buy some right away.

SURPRISES:

-GAS! Wow, I had no idea. Laparoscopic surgery requires a lot of air in the abdomen, but I was surprised at how much gas was inside the GI tract also. A mystery.

-The bowel movements started up more quickly than I thought, which was good.

-More pain with this surgery than the original ostomy surgery (but more incisions and more internal reconstruction involved.)

RESULTS: I am so happy to get the ostomy appliance off my poor skin! It will take months to heal the rash scars and blood blisters from the adhesive allergy. More importantly, I will finally have a more streamlined, functional, pain-free colon, and ultimately be able to expand my diet beyond “low-residue.”

Thanks for hanging out with me the last few months!! Lots of encouraging words from everyone – so grateful!

Great news that all is well.

Regards, IGGIE

Hey Newbie, continued success on this new road of yours!

Great information sharing! Thanks for the effort; I am sure many will find it helpful. Wishing you a speedy and complete recovery and future days where everything will come out all right! jb

Congratulations! I hope your recovery continues to progress well.

Words of Encouragement from Ostomy Advocates I Hollister

Hi Newbie, thanks for the good news and positive outcome.

Hello Newbie,

Thank you so much for your follow-through - as has been said by others, your ability and willingness to share is so valuable for those who follow your own experience.

May your continued recovery be total, and I sincerely hope that you are able to maintain an appliance-free life with no further needs for colectomies.

BW going forward for a rewarding life - You have already helped those reading your words on here - I hope that you may consider popping into Site from time to time - as positive outcomes are a sustainable balanced read for the Membership.

Thank you.

~ ~ ~ ~ waves ~ ~ ~ ~ ~

BW

Jayne

Sounds like you had a successful but exhausting recovery!!

When I had my nightmarish reversal, they suggested I use plenty of skin preps on my anus, which hadn't had much use for many years - which was a good thing. But I very quickly learned that it was a good idea to carry toilet paper with me wherever I went just in case I had to use a public toilet, which frequently does not have any toilet paper left in it. (And since I have had my beloved stoma back the last 17 years, I still take toilet paper with me wherever I go (which does not happen very frequently.....

All the best for the future Newbie24!!

Wow! Newbie24, it's amazing we both had reversals in the same day. When I read your story, I can't believe it. I was able to go home the next day after passing some gas, but then didn't cut loose for a couple of days after that, which worried me. But it's been relatively regular since then. The worst part for me has been the skin and wound care. The adhesives are killing my skin. And the stoma site gives me constant pain. I'm going in for my 2-week follow-up tomorrow. Hoping to get some good news.

Please keep us up to date on your progress.

Your posting was very helpful and scary.

Hi: Sorry that my posting was scary...not intentional, just wanted to give out some information about what I learned 😊.

I am now 3 weeks post-op and have had one follow-up visit with my surgeon about 10 days after discharge. I was having a lot of pain in one incision on the lower right side. He explained that the one incision was bigger because that's where he had to put the stapler in (and LOL, I was envisioning this whole big office stapler going in there; no wonder it hurt.) The stapler had to then go over to the lower left side where he was attaching the remaining sigmoid colon to the descending colon, and the robotic arm did the stapling together with permanent titanium staples. Anyway, too much information, but he had to use a tighter suture due to the size of that incision; if he'd used a looser one, it would risk a hernia, which could require a second surgery, so no thanks!! Anyway, the pain has subsided and only acts up if I do an overly vigorous walk. I use warm compresses on it, and that helps. He checked the other incisions, and the stoma site is closing together nicely and looks like a new, tiny little belly button now with a big plus sign of incisions behind it - no wound dressing needed anymore.

As for bowel activity, it's a learning process. Before my initial ostomy surgery, I tended toward IBS-D, and every morning like clockwork when I'd get up, I'd have one normal BM and that would be it for the day. Now, things are moving a lot more slowly and at odd times of the day. I'm sure there is still swelling in the lower part of the colon from the surgery, so that's making the stool narrower than normal, but it's basically functioning. Perhaps my new normal will be less volume, firmer, and more frequent?? Hope it's not IBS-C! Not sure. I have a follow-up appointment with both my surgeon and my gastroenterologist next week to assess the situation in terms of return to normal function.

A plus: I'm finally able to add some more foods that have some fiber and residue without getting cramping or gas. I've been indulging in the fruits I've missed for 4 months (grapes, strawberries, oranges), more veggies (spinach, winter squash, even cabbage!) Haven't tried nuts or wine yet, or tossed salad, but those are next on the list. So grateful to have some variety in my diet.

I'll do another post next week and let you all know about the return to normal bowel function (at least in my case) and what the docs have to say about that.

All the best for your continued support!!!

TY N24 for the detail in your post - most informative [when discussing techniques and reasons behind stuff there is never too much - but can be inaccurate info - so your observations are valuable because of the detail ...... It helps thinking and also allows us - not to jump to conclusions but ask questions as to how our own circumstances may [or may not] relate to the finer points of others' experience.

Thank you.

BW

~ ~ ~ ~ ~ waves ~ ~ ~ ~ ~

Jayne

Update on my colostomy take-down recovery:

I met with my surgeon on Monday and my gastroenterologist today. I am 4 weeks post-surgery now, and both doctors said I'm recovering well and better than expected.

I thought I'd share some final details that might be of interest. Everyone is different, of course, so keep that in mind.

My surgeon released me from any restrictions (lifting), and I can resume my acupuncture and abdominal core PT when ready. I described my bowel function (decreasing frequency, size, shape, and times close to nearly normal) and that I still had to "work" at it. He said the new/replaced section of the sigmoid colon is indeed narrower because it's essentially stretched. It will be narrow for a while but will dilate over time. The "flattening" of the stool is also to be expected due to the narrower pathway. He checked all incisions, and all 6 are healing normally. The site of the stoma incision has now closed completely in a tiny circle. There is still some tenderness underneath from all the incisions, so I'm still healing.

I saw my physical therapist this week; she did an exam and decided I need to wait another 3 weeks before resuming my core abdominal exercises in order to give more time for the deep sutures/incisions to heal.

I went to my gastroenterologist this morning; he reviewed my bowel function progress, my supplements, and diet. He said that normal bowel function may take up to a year (!). I asked about stool softeners, and as I suspected, he recommended against them because I need to retrain my system to function normally, and that would delay the process. He also said that my NEW, remodeled gastrointestinal system will work much better now that the section of my colon with the abscess and inflamed diverticula is gone! As for healing, he agreed that acupuncture and PT would certainly help, and he also suggested red light therapy to enhance the healing at a cellular level (I will look into that; my husband has a device that I can use.) Supplements: he suggested increasing vitamin K2 to 200 mcg per day, keeping my magnesium glycinate at 400 mg twice a day. He also suggested alternating probiotics - I normally use VSL#3 - he said to alternate with other brands/forms now and then. Diet: I've been gluten-free and dairy-free for years (I just feel better), and he also recommended staying away from seed oils and using butter or olive oil instead. White rice (my staple) is better than brown rice, and experimenting with higher residue foods like I've been doing since surgery is advisable as tolerated. He said I don't need to see him for a year, and no more colonoscopies are needed!

By the way, I don't know if you've heard of robotic-assisted laparoscopic surgery or have that available where you live. For my initial ostomy surgery (emergency basis due to bowel perforation) as well as my take-down surgery, he used that technique. Here he is in a video explaining how it works: https://www.youtube.com/watch?v=X694uXeboVI Yes, that's my surgeon, Dr. Kevin Rodriguez. I was very lucky that he happened to be the on-call surgeon that night in the ER and that he had been trained in the Da Vinci robotic system. So...if you have the option to have robotic surgery as an alternative to "open" surgery, the recovery time is a lot faster. The wonders of technology!

Best wishes to all of you. I'll check in from time to time and let you know how things are progressing and to offer help and suggestions to my ostomates. You're the best!