What Is a Colostomy Reversal?

A colostomy is a procedure that redirects the colon to an opening in the abdomen, where stool is collected in an external bag. In some cases, a colostomy is only a temporary necessity, and once the patient’s condition improves, a colostomy reversal may be performed. This surgery reattaches the colon to the rectum.

There are numerous reasons for performing a colostomy procedure, ranging from short-term conditions such as intestinal injury to ongoing illnesses that cause constant intestinal blockage. Short-term colostomies are often performed in such a way that they can be more easily closed during a colostomy reversal. One technique, called a loop ileostomy, pulls both ends of the bowel through the opening. During the colostomy reversal, the surgeon can reattach the two ends outside the body, push them through the opening, and stitch up the wound.

Other types of colostomies may require more invasive surgery to reverse. Typically, a laparoscopic procedure can be used, allowing the surgeon to make several small cuts rather than a single, large incision, and reattach the colon inside the body through assistance from the camera on the end of the laparoscopic tube. In some cases, open surgery may be required, in which the surgeon makes an incision large enough to reach and reattach the colon without technological assistance such as guided imagery.

It is very important for patients to follow all colostomy reversal pre-operative instructions, especially if fasting is required. Depending on the procedure and surgeon’s preferences, patients may be required to avoid food or drink for a certain amount of time before the surgery. Some procedures may also require bowel cleansing techniques, such as drinking a special fluid designed to flush the intestines. Following these instructions carefully reduces the risk of complications during and after surgery.

The side effects of a colostomy reversal can occur even if the patient follows all instructions and the surgery goes smoothly. Loss of bowel control for several days following the procedure is one of the most common complications, but typically resolves on its own without medical intervention. Patients may be instructed to perform special exercises to help strengthen the ability to control bowel movements.

Although the benefits often outweigh the risks, there are some potentially serious complications that can occur after a colostomy reversal. Internal abdominal swelling may cause constriction within the intestines. Patients should alert their surgeon immediately if they notice any swelling or experience severe nausea and vomiting. Infection is always a risk with any type of surgery, as is complications resulting from the use of anesthesia. Carefully following all post-operative instructions and alerting the surgeon if any abnormal symptoms appear can help reduce the risk of complications.